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Home My WebLink AboutWIND23-0020 APP-DEC.pdf73-510 Fred Waring Drive, Palm Desert, CA 92260 • (760) 776-6420 • (760) 776-6392 fax • www.cityofpalmdesert.org Project Address: _______________________________________________________Suite #_____________________ Total Value of work: $_______________ Note: Plan Review Fees may be adjusted after Plan Review Project Description (be specific): Contractor Business Name Property Owner Name Address Address City Zip City Zip Phone Phone Fax Fax E-mail E-mail Contractor License No. Architect Name Designer Name Engineer Name Address Address City Zip City Zip Phone Phone Fax Fax E-mail E-mail License No. License No. PLEASE COMPLETE THE REVERSE SIDE Applicant Name Signature Date Contact Telephone Number E-Mail (For Office Use Only) JOB ID: ________________________ PLANS FILED: __________________ City of Palm Desert Department of Building and Safety Building Permit Application Home Depot U S A Inc dba The Home Depot 602331 Business License No EXP: 858-486-9700 949-207-3468 x2 THDAPS@AdvancedPermitServices.com 2016-068084 6/30/23 9855 Distribution Ave, Ste 110 San Diego, CA 92121 330 Augusta Drive 2,209.00 Thomas McBratney Palm Desert 92211 330 Augusta Drive (604) 556-1462 Replace 1 retrofit window. No size changes. thdaps@advancedpermitservices.com Jim Bucklin 2/10/23 73-510 Fred Waring Drive, Palm Desert, CA 92260 • (760) 776-6420 • (760) 776-6392 fax • www.cityofpalmdesert.org Structure Information: *for Residential additions please indicate only square footage being added to home Commercial Square Footage Residential* Square Footage Assembly Area Living Area Office Garage Area Retail Accessory Cover Warehouse/Storage No. of Baths Total Building No. of Bedrooms Accessory Cover No. of Dwelling Units Multi-family, Residential and Commercial Projects, including Tenant Improvements plans must be submitted to the Fire Department. Fire requires one (1) set of plans for T.I.’s. Please call (760) 346-1870 for further information regarding Fire plan submittals. THE FOLLOWING ITEMS ARE BEING SUBMITTED: (Please check all that you have provided) 2 COMPLETE SETS OF PLANS, including the following supporting documents: Structural Calculations Title 24 – Energy Calculations Truss Calculations Soils report CF-R Forms Manufacturer’s Specifications Electrical Mechanical Plumbing Home Owner’s Association Letter of Approval Assessor: Please submit the following for all permits (except for Walls/Fences, Water Heater, HVAC, Re -Roof, Electrical, and Plumbing):  Commercial projects- 1 title page, 1 site plan, 1 elevation, 1 floor plan  Residential projects- 1 site plan, 1 dimensioned floor plan, at least 1 elevation plan FEES Plan Check Hourly: $168.00 Inspection Hourly: $159.00 Archive Fee: 8.5x11 up to 11x17 $.07 per page Plans $.80 per page Color up to 8.5x11 $.11 per page Do not base your permit fees off of the fees stated above. For Reference Only. Construction Type: VA VB Other:_________ Roof Type: Tile Shingles Other: ________ Occupancy Group: R-3 A.2 U Other:________ Fire Sprinklers: YES NO CITY OF PALM DESERT Department of Building & Safety 73- 510 Fred Waring Drive Palm Desert, CA 92260 TEL: 760-776-6420 EMAIL: building@cityofpalmdesert.org CONTRACTOR DECLARATION CONTRACTOR LIC#: PERMIT#: 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. Worker’s Compensation Declaration: 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. I hereby affirm under the penalty of perjury ONE of the following declarations (SELECT ONE): OWNER BUILDER DECLARATION PERMIT#: I have and will maintain a certificate of consent to self-insure for workers’ compensation, as provided for by the Director of Industrial Relations as provided 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: 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: PRINT NAME: SIGNATURE: I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to 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 Contractors' 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 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 the property, 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 it was not built or improved 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a licensed contractor pursuant to the Contractors' State License Law.) I am exempt from Licensure under the Contractors' State License Law for the following reason: DATE: PRINT NAME: SIGNATURE: