BPLB2015-0100Applicant:
P D G PLUMBING
42335 WASHINGTON STREET F218
PALM DESERT, CA 92211
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: C36 License No.: 968205
Date: /2y�/ / 5- Contractor?Xc
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
P D G PLUMBING
42335 WASHINGTON
PALM DESERT, CA 92;
(760)600-6853
Llc. No.: 968205
Date: 8/24/2015
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 th wgk 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:- Policy Number: _
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 sh Id become subject to the
workers' compensation provisions of Section 3700 of a bor Code, I shall forthwith
comply with those provisions.
Dates) 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 toe ter upon the above
moned property for inspection purposes.
Dat Signature (Applicant or Agent)
4
78-495 CALLE TAMPICO
'
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
�-
BUILDING PERMIT
Application Number:
BPLB2015-0100
Owner:
Property Address:
54018 RIVIERA
RIVIERA VILLAS
APN:
775033010
300 E STATE STE 100
Application Description:
PGA / GAUTHIER / GAS LINE FOR FIREPIT REDLANDS, CA 0
Property Zoning:
Application Valuation:
$2,000.00
Applicant:
P D G PLUMBING
42335 WASHINGTON STREET F218
PALM DESERT, CA 92211
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: C36 License No.: 968205
Date: /2y�/ / 5- Contractor?Xc
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
P D G PLUMBING
42335 WASHINGTON
PALM DESERT, CA 92;
(760)600-6853
Llc. No.: 968205
Date: 8/24/2015
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 th wgk 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:- Policy Number: _
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 sh Id become subject to the
workers' compensation provisions of Section 3700 of a bor Code, I shall forthwith
comply with those provisions.
Dates) 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 toe ter upon the above
moned property for inspection purposes.
Dat Signature (Applicant or Agent)
FINANCIAL INFORMATION
DESCRIPTION ��- ACCOUNT i *c QTY ` AMOUNT_ ;:"'PAID PAID DATE..
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
m •; 3;. PAID BY x .,
"'- METHOD _
•.,. � �. � _� ., � � ��;�RECEIPT#° _ yCHECK# a'� ��CLTDBY-
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
. DESCRIPTIONS'__
��t. ACCOUNTO!,
;QTY,
,: ,°AMOUNTS'
,� PAID "ia a
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
- _
u <; PAID
METHOD{ �,;'
RECEIPT 4.
CHECK #
CLTD BY
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
`DESCRIPTIONS -= r i' 4,
t,
�` ` Kfy, ACCOUNTQTY�
r' AMOUNT,:
�s PAID ;
,PAID DATE'
GAS SYSTEM, 1-4 OUTLETS
-101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD x t
RECEIPT ,# a °_; `
�; "s CHECK #
CLTD BY
DESCRIPTION": "
=',ACCOUNT �° ,. .',QTY
'AMOUNT.F,
g-
�" - PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
a. :PAID BY r
., METHOD
` a +RECEIPT #
A' CHECK # `
°�rCLTD BY
Total Paid forPLUMBING FEES: $36.26 $0.00
TOTALS:00
r
r
Description: PGA / GAUTHIER / GAS LINE FOR FIREPIT
Type: PLUMBING
Subtype: Status: UNDER REVIEW
Applied: 8/24/2015 SKH
Approved:
Parcel No: 775033010 Site Address: 54018 RIVIERA LA QUINTA,CA 92253
Subdivision: TR 33015
Block: Lot: 1
Issued: .
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning: '
Finaled: .
Valuation: $2,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: PLUMBING - 58LF OF 3/4" GAS LINE FOR FIRE PIT. 2013 CALIFORNIA BUILDING CODES.
_
,�: NAME-`
ADDITIONAL SITES -
Printed: Monday, August 24, 2015 11:09:31 AM 1 of 2
. SYS 7Eh1S
CONDITIONS
ONTACTS
-- - --
NAME TYPE �; :`
_
,�: NAME-`
ADDRESSI;CITY�
STATE ZIP,PHONE FAX. EMAIL
APPLICANT
P D G PLUMBING
42335 WASHINGTON
PALM DESERT
CA
92211
STREET F218
CONTRACTOR
P D G PLUMBING
42335 WASHINGTON
PALM DESERT
CA
92211
STREET F218
OWNER
RIVIERA VILLAS
300 E STATE STE 100
REDLANDS
CA
0
Printed: Monday, August 24, 2015 11:09:31 AM 1 of 2
. SYS 7Eh1S
DESCRIPTION
M ACCOUNT ' '
QTY
^
' PAID. a
PAID DATE
RECEIPT.#
'CHECK#
-'METHOD,
;PAID BY"
LTD
,:AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$0.00
OUTLETS PC
Total Paid forPLUMBING FEES: $36.26 $0.00
TOTALS:00
INSPECTIONS
SEQID , INSPECTION TYPE y.INSPECTOR SCHEDULED COMPLETED
RESULT REMARKS NOTES
.DATE DATE
PLUMBING FINAL" BLD
Printed: Monday, August 24, 2015 11:09:31 AM 2 of 2
SYSTEMS
W
-
C�
Z
w
W
�Q
EXISTING RESIDENCE
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE �BY
W00
0
Lo
H
a
PROPOSED
GAS -LINE
EXTENSION
Al
PROPOSED DESIGN (SCALE: /e• = 1'-0') JULY 29, 2015
-
I. �
w
EXISTING RESIDENCE
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE �BY
W00
0
Lo
H
a
PROPOSED
GAS -LINE
EXTENSION
Al
PROPOSED DESIGN (SCALE: /e• = 1'-0') JULY 29, 2015
M3
V
Bin #
• Permit 4#
10D
Project Address: 5 Q' 8.
City of La Quinta
Building &r Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
i U l f ra %4wner's Name: 1 6-e t e�
A. P. Number: J 1 ri
— C
Address:
a�f elr
Legal Description:
b''Ijj CQ0
City, ST, Zip: ,
tu (21
Contractor:/
V r�
Telephone:
P hone:
Address: 25 OS
Project.Deseription:
City, ST, Zip: j7,Q (r't .�83 - �-
Ne u.J e d/
Telephone: P
o e.•
�
'Dr C
State Lic. # 1011O
City Lic. #.:
Arch., Engr., Designer:
Address:
City,, ST, Zip:
Telephone:
r
.
Construction Type: Occupancy:
Lic.#
0Stato
ProJect hPa (circle cle one • New Add'n Alter Repairai
r Demo
Name of Contact Person:(G O 8 r1 °
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 7/.Q
jblIlEatimated
Value of Project: c
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title.24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2pd Review, ready for-corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees -
Total
Total Permit Fees