13-0293 (PLBG).'P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number:
13-00000293
Property Address:
54949 RIVIERA
APN:
775-153-023- -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1220
VOICE (760) 777-7012
TA�� � -FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT �� �% INSPECTIONS (760) 777-7153
BUILDING PERMIT
Applicant: Architect or Engineer:
-----------------
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 Professionals Code, and my License is in full force and effect:
Licens Clfass C27 D06LicenseLice_tnse No.: 883625
Dai `� W Contraor:C'y p, `� CV d,
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).:
1 _ 1 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.).
1 _ ) 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:
LQPERMIT
-----------------------------------------------
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 7ich this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy f ifnber EXEMPT
I certify that, in.the performance of th rk for wNch this permit is issued, I shall not employ any
person in any manner so a e m subject to the workers' compensation laws of California,
and agree that; if I sh d b oma s b act to -the workers' compensation provisions of Section
.� 3700 of the Labor ode,
she
rt
ly with those provisions.
Date./ l2D Applicant: �
75
WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADD TION 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 Director of Building and Safety 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, indemnif and hold harmless the City
of La Quinta, its officers, agents and employees for any act or ormssi n 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 void,if work is not commenced
within 180 days from date of issuance of such permit ssatio. of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that tt a abov . ar �n is correct. I agree to comply with all .
city and county ordinances and state.laws relating to wlding onstru , and hereby authorize representatives
of this co ty to enter upon the above-mentioned roperty or insp tion urposes.
Dater Signature (Applicant or Agent):
Date: 3/18/13
Owner:
TOM MCLEAN
LA QUINTA, CA.92253
(760)289-7828
Contractor:
jl a
GORDO LANDSCAPE, JAVIER
D (�
P.O. BOX 7123
LA QUINTA, CA 92248
MAR 18 2013
(760)619-4906
Lic. No.: 883625
CITY OF U1 QUINTA
-----------------------------------------------
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 7ich this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy f ifnber EXEMPT
I certify that, in.the performance of th rk for wNch this permit is issued, I shall not employ any
person in any manner so a e m subject to the workers' compensation laws of California,
and agree that; if I sh d b oma s b act to -the workers' compensation provisions of Section
.� 3700 of the Labor ode,
she
rt
ly with those provisions.
Date./ l2D Applicant: �
75
WARNING: FAILURE TO SECUR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO C MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADD TION 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 Director of Building and Safety 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, indemnif and hold harmless the City
of La Quinta, its officers, agents and employees for any act or ormssi n 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 void,if work is not commenced
within 180 days from date of issuance of such permit ssatio. of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that tt a abov . ar �n is correct. I agree to comply with all .
city and county ordinances and state.laws relating to wlding onstru , and hereby authorize representatives
of this co ty to enter upon the above-mentioned roperty or insp tion urposes.
Dater Signature (Applicant or Agent):
Application Number . . . . .
13-00000293
Permit . . . PLUMBING
Additional desc .
Permit Fee 18.00
Plan Check Fee
4.50
Issue Date . .
Valuation . . .
. 0
Expiration Date 9/14/13
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 3.0000 EA PLB
GAS PIPE 1-4 OUTLETS
3.00
----------------------------- -----------------------------------------------
Special Notes and Comments-'
1 GAS LINE 120 LF. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . ... . .
BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total 18.00
.00 .00
18.00
Plan Check Total 4.50
.00 .•00
4.50
Other Fee Total 1.00
.00 .00
1.00
Grand Total 23.50
.00 .00
23.50
LQPERMIT
Bin. #
CItY Of QuInto
Building 8L Safety Division
P.O. Box 1504,78-495 Calle Tampico
1.a.Quinta, CA 92253 -:(760) 777-7012
Building Permit -Application' and Tracking Sheet
Permit # tel,
�' ✓
Project.Address: - �'J i v� C[��
Owner's Name:. W, M�e
A. P. Number.
Address: . rj Ll - (Zr v t e f A .
Legal Description:
City, ST, Zip: Lr,,-
Contractor. 6-u(-J(, � ��
Telephone: `
Address: P O V�,`j 1 Z.3
,-
Project Description: %�� �� $ C4,,leu pe
-City, ST, Zip: Lrq 6� U\. V,
Telephone: -1&0, (o (el - q 0
State Lic.# : f j 3to Zj
City Lie C/O 3 5 V6 ..
�n
Arch, Engr., Designer.
Address:^
City, ST, zip: Lam; Com- % z2 Y6
Telephone:
State Lic. #: a
Construction Type:. 4 pLOccupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: l 22 V # Stories: 4 # Units: /
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project: r7Sb w
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
'Rec'd
TRACENG
PERMIT FEES
Plan Sets
Pian Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
galled Contact Person
Pian Check Balance
Title 24 Calci.
Plans picked up
Construction '
Flood plata plan
Plans resubmitted. ,
Mecharilcal
Grading plan
2'! Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plwnbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"° Review; ready for correctionslissae
Developer Impact Fee
Planning Approval.
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
EXISTIN& ANCCORTYAW
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WAB 3ml = 1w
`02M,LEAN
It 1: $ I f3.1: N I I A L 0 V S I C. N
PATIO RENOVATION
For
'McLEAN RE51DENGE
54-q49 RIVIERA, P6A HE5T, La GUINTA
OF
'JANUARY 2013
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ED,
MSTIM LMVSC.4M STW
0 NM PATIO
69*% GAS LINE
.EXISTIN6-5L 18
ExrITM WMAM STM
51TE PLAN 5HQHNC7HBT PATIO 4 50LITH 510E COURTYARD
WAB 3ml = 1w
`02M,LEAN
It 1: $ I f3.1: N I I A L 0 V S I C. N
PATIO RENOVATION
For
'McLEAN RE51DENGE
54-q49 RIVIERA, P6A HE5T, La GUINTA
OF
'JANUARY 2013