14-0909 (TT)VOICE (760) 777-7125
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/10/2014
Application Number: TT -14-909 Owner:
Property Address: 45190 SEELEY DR COLSON & COLSON
APN: 604630027 45-190 SEELY DR.
Application Description: LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $25,000.00
Applicant: Contractor:
COLSON & COLSON COLSON & COLSON
45-190 SEELY DR. 45-190 SEELY DR.
LA QUINTA, CA 92253 LA QUINTA, CA 92253
LIc. No.:
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
1 hereby affirm under penalty of perjury one of the following declarations:
{commencing with Section 7000) of Division 3 o the Business and Professions Code, and
I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect.
compensation, as provided for by Section 3700 ofthe Labor Code, for the performance ol
LicensieCIfss: License No.:
the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: - Contractor:
1&��
Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' com pen sation insurance carrier and policy number are:
OWNER-BUIAILDER D LARATION
Carrier: Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance ofthe work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so a? tifo,become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any
compensation laws of California, and agree t h.uld become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed
workers' compensation provisions ofSJectio3 00 of the Labor Code, I shall forthwith
statement that he or she is licensed pursuant to the provisions of the tor I �tate
comply witl�thoslprovisions.
License Law (Chapter 9 (commencing with Section 7000) of Division 3COntr:c s
ofth BusiSe -
—7
and Professions Code) or that he or she is exempt therefrom and the basis for the alle 9
Date: C)
1 q Applicant:
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).:
WARNING: FAILURE TO SECURE WORKERS'C MPENSATION COVERAGE IS UNLAWFUL,
1, as owner of the property, or my employees with wages as their sole
C P
AND SHALL SUBJECT AN EMPLOYER TO CRIM11 AL PENALTIES AND CIVIL FINES UP TOONE
compensation, will do the work, and the structure is not intended or offered for sale.
HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he
IMPORTANT:Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(_) 1, as owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct ' the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, and
as a result ofthis application , the owner, and the applicant, each agrees to, and shall
who contracts for the projects with a contractor(s) licensed pursuant to the Contractors'
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
State License Law.).
employees for any act or omission related to the work being performed under or
I am exempt under Sec- B.&P.C. for this reason
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not
commenced within 180 days from date of issuance of such permit, or cessation of work
Date: Owner:
for 180 days will subject permit to cancellation.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's Address:
I certify that I have read this application and state that the dab information is correct.
0
Do
I agree to comply with all city and county ordinances and sta aws relating to building
construction, and hereby authorize representatives of this i tc he a bove-
mentioned oper7 for inspection purposes.
Date- _,Ir, Signature (Applicant or Agent)
FINANCIAL INFORMATION
DESCR I I i PTION
ACIC I 6LINT
ltkfY�� AMOUNT'�'
-PAID
PAID DATE
HOURLY PLAN CHECK - YES
101-0000-42600
2.25 $157.50
$0.00
PAID BY
METHOD
RECEIPT#
CHECK #
CLTD BY
Total Paid forCITY STAFF - PER HOUR: $157.50 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
SPECIAL INSPECTION
101-0000-42404
1
$71.50
$0.00
PAID'BY
METHOD
RECEIPT #
CHECK#
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
SPECIAL INSPECTION PC
101-0000-42600
1
$178.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK4
CLTD BY
Total Paid forCOMPLIANCE SURVEY/SPECIAL INSPECTION: $250.25 $0.00
TOTALS: $407.75 $0.00
INSPECTIONS
PARENT PROJECTS
Printed: Wednesday, July 09, 2014 2:18:57 PM 2 of 2 CITWIYSTEMS
Description:
Type: TEMPORARY TRAILER
Subtype: Status: APPROVED
Applied: 6/20/2014
Approved: 7/9/2014 JJO
Parcel No: 604630027 Site Address: 45190 SEELEY DR LA QUINTACA 92253
Subdivision:
Block: Lot:
Issued:
Lot Scl Ft:
Building Scl Ft: Zoning:
Finaled:
Valuation: $2S,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings:
No. Stories: No. Unites:
Details: TEMP. SALES TRAILER. WITH ADA RAMP, BATHROOM AND ADA PARKING. PER CITY TUP APPROVAL
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
Printed: Wednesday, July 09,.2014 2:18:57 PM 1 of 2 CRWYSTEMS
it #
/+
_.�rcject Address:
City of La - Qui=
Bui[ding &r Safety Division
A.0. Box 1504., 78 -495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
0160A) i
Cm1..A_wJ
Telephone:
Address: Sgo LL
Project Description:
City, ST, Zip: 0A
Telephone:
_/1
/ED
State Lie. 4:
---------------
City Lie. #z
-
Arch., Engr., Designer:
jUN 2 0 H14
Address:
City., ST, Zip:
t C1 iY OF L.AQUINTK—
COMMI INITY rmis
nPIMENT
Telephone:
X —.0"..
Co Occupancy:
nstruction Type:
Project type (circle one): Now Add'n Alter Repair Demo
State Lie. 4:
. . . . . . . . . . . . . . . . .
Name of Contact Person:
L %,4AA 7
Sq. Ft.:
# Stories:
,7c
W Un its: )U,
Telephone 4 of Contact Person:
Estimated Value of Project: CC)
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Rcqld
Rcc1d
TRACKING
PERMIT FEES,
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cales.
'Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for- corrcclio e
C-1/iss-
Electrical
Subcontactor Li st
Called Contact Person
Plumbing
Grant Deed
Plans poicked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Gradin
IN IIOUSE:-
3,4 Revi,
Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
'Date of permit issue
School Fees
Total Permit Fees
Y . 0/00 Ict-c-
P -S, -
�5