BRES2021-080178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/27/2022
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BUILDING RESIDENTIAL (WEB)/DWELLING - SINGLE FAMILY DETACHED
BRES2021-0801
78641 DEACON DR E
770230004
DESERT HOMES / 3,598SF DWELLING W/ADU
$310,765.20
Owner:
DESERT HOMES INC.
45373 Shaugnessy Dr
Indio, CA 92201
Applicant:
Philip Gertsman
45373 Shaugnessy Dr
Indio, CA 92201
Contractor:
GRAYSTONE CUSTOM BUILDERS INC
3419 VIA LIDO SUITE 455
NEWPORT BEACH, CA 92663
(949)466-0900
LIc. No.: 971085
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 7000} of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.: 971085
Date: Contractor:
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged 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).:
(___) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
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
within one year of completion, the owner-builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(___) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(___) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
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 Name:_______________________________________________
Lender's Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self-insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9216106
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
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 for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Date: 4/27/2022
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BRES2021-0801
78641 DEACON DR E
770230004
DESERT HOMES / 3,598SF DWELLING W/ADU
$310,765.20
Owner:
DESERT HOMES INC.
45373 Shaugnessy Dr
Indio, CA 92201
Applicant:
Philip Gertsman
45373 Shaugnessy Dr
Indio, CA 92201
Contractor:
GRAYSTONE CUSTOM BUILDERS INC
3419 VIA LIDO SUITE 455
NEWPORT BEACH, CA 92663
(949)466-0900
LIc. No.: 971085
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - -Detail: 3,598SF DWELLING - LOT 14 [VB/RES-3/CLASS A-FR/13D]. THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH
[FRED SHEU ENGINEERING]. 2019 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $276.91
Total Paid for ART IN PUBLIC PLACES - AIPP: $276.91
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $13.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $13.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - CIVIC CENTER 252-0000-43200 0 $1,230.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - COMMUNITY CULTURAL 254-0000-43200 0 $956.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - FIRE PROTECTION 257-0000-43200 0 $369.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - LIBRARY 253-0000-43200 0 $397.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - MAINTENANCE FACILITIES 259-0000-43200 0 $313.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - PARK IMPROVEMENTS 251-0000-43200 0 $2,106.00
DESCRIPTION ACCOUNT QTY AMOUNT
DIF - TRANSPORTATION 250-0000-43200 0 $4,009.00
Total Paid for DIF - SINGLE FAMILY DWELLING 2020: $9,380.00
DESCRIPTION ACCOUNT QTY AMOUNT
RESIDENTIAL, EA ADDITIONAL 1,000SF 101-0000-42403 0 $56.68
DESCRIPTION ACCOUNT QTY AMOUNT
RESIDENTIAL, EA ADDITIONAL 1,000SF PC 101-0000-42600 0 $23.36
DESCRIPTION ACCOUNT QTY AMOUNT
RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $166.73
DESCRIPTION ACCOUNT QTY AMOUNT
RESIDENTIAL, FIRST 1,000SF PC 101-0000-42600 0 $55.02
Total Paid for ELECTRICAL - NEW CONSTRUCTION 2021: $301.79
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE NEW RESIDENITIAL PC 101-0000-42420 0 $83.00
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE NEW RESIDENTIAL 101-0000-42421 0 $83.00
Total Paid for FIRE FEES: $166.00
DESCRIPTION ACCOUNT QTY AMOUNT
RESIDENTIAL - CUSTOM HOME >7KSF PC 101-0000-42600 0 $208.41
Total Paid for GRADING 2021: $208.41
DESCRIPTION ACCOUNT QTY AMOUNT
CONDENSER/COMPRESSOR 101-0000-42402 0 $125.04
DESCRIPTION ACCOUNT QTY AMOUNT
CONDENSER/COMPRESSOR PC 101-0000-42600 0 $83.37
DESCRIPTION ACCOUNT QTY AMOUNT
EXHAUST HOOD 101-0000-42402 0 $27.78
DESCRIPTION ACCOUNT QTY AMOUNT
EXHAUST HOOD PC 101-0000-42600 0 $11.12
DESCRIPTION ACCOUNT QTY AMOUNT
FURNACE 101-0000-42402 0 $125.04
DESCRIPTION ACCOUNT QTY AMOUNT
FURNACE PC 101-0000-42600 0 $83.37
DESCRIPTION ACCOUNT QTY AMOUNT
OTHER MECHANICAL EQUIPMENT 101-0000-42402 0 $41.68
DESCRIPTION ACCOUNT QTY AMOUNT
OTHER MECHANICAL EQUIPMENT PC 101-0000-42600 0 $41.68
DESCRIPTION ACCOUNT QTY AMOUNT
VENT FAN 101-0000-42402 0 $97.23
DESCRIPTION ACCOUNT QTY AMOUNT
VENT FAN PC 101-0000-42600 0 $38.92
Total Paid for MECHANICAL 2021: $675.23
DESCRIPTION ACCOUNT QTY AMOUNT
MULTI-SPECIES RESIDENTIAL 0-8 UNITS - 2021 UPDATE 101-0000-20310 0 $1,400.00
Total Paid for MULTI-SPECIES RESIDENTIAL: $1,400.00
DESCRIPTION ACCOUNT QTY AMOUNT
NEW CONSTRUCTION PERMIT 2021 101-0000-42400 0 $2,560.34
Total Paid for NEW CONSTRUCTION PERMIT 2021: $2,560.34
DESCRIPTION ACCOUNT QTY AMOUNT
NEW CONSTRUCTION PLAN CHECK 2021 101-0000-42600 0 $1,692.50
Total Paid for NEW CONSTRUCTION PLAN CHECK 2021: $1,692.50
DESCRIPTION ACCOUNT QTY AMOUNT
BUILDING SEWER 101-0000-42401 0 $27.79
DESCRIPTION ACCOUNT QTY AMOUNT
BUILDING SEWER PC 101-0000-42600 0 $19.45
DESCRIPTION ACCOUNT QTY AMOUNT
FIXTURE/TRAP 101-0000-42401 0 $291.69
DESCRIPTION ACCOUNT QTY AMOUNT
FIXTURE/TRAP PC 101-0000-42600 0 $291.69
DESCRIPTION ACCOUNT QTY AMOUNT
GAS SYSTEM, 5+ OUTLETS 101-0000-42401 0 $41.68
DESCRIPTION ACCOUNT QTY AMOUNT
GAS SYSTEM, 5+ OUTLETS PC 101-0000-42600 0 $27.78
DESCRIPTION ACCOUNT QTY AMOUNT
ROOF DRAIN 101-0000-42401 0 $41.67
DESCRIPTION ACCOUNT QTY AMOUNT
ROOF DRAIN PC 101-0000-42600 0 $41.67
Total Paid for PLUMBING 2021: $783.42
DESCRIPTION ACCOUNT QTY AMOUNT
RECORDS MANAGEMENT FEE - MAJOR 101-0000-42416 0 $21.00
Total Paid for RECORDS MANAGEMENT FEE - MAJOR: $21.00
DESCRIPTION ACCOUNT QTY AMOUNT
SMI - RESIDENTIAL 101-0000-20308 0 $40.40
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $40.40
DESCRIPTION ACCOUNT QTY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
DESCRIPTION ACCOUNT QTY AMOUNT
TUMF 2021 - SINGLE FAMILY DWELLING 224-0000-20320 0 $2,358.00
Total Paid for TUMF 2021: $2,358.00
DESCRIPTION ACCOUNT QTY AMOUNT
NEW CONSTRUTION - SINGLE FAMILY RESIDENTIAL 101-0000-42400 0 $161.00
Total Paid for ZONING CLEARANCE - PLANNING PLAN CHECK: $161.00
TOTALS:$20,043.00