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BPLB2017-008211 a VOICE (760) 777-7125 78-495 CALLE TAMPICO D FAX FAX (760) 7.77-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT (760) 777-7153 BUILDING PERMIT Date: 6/12/2017 Application Number: BPLB2017-0082 Owner: Property Address: 55212 RIVIERA MICHEAL PARKER z APN: 775153062 55212 RIVIERA Application Description: PARKER / GAS LINE FOR FURNACE 30LF LA QUINTA, CA 92253 cn Property Zoning: n - w Application Valuation: $800.00 ^o z CV w � t Applicant: Contractor: o LEAK SPECIALTIES LEAK SPECIALTIES 1268 8TH ST 1268 8TH ST �:- LU COACHELLA, CA 92236 COACHELLA, CA 92236 U O .(760)564-9440CD Z Q z Llc. No.: 807812 cn U7 -------------------------------------------------------------------------------------------- LU 0 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.: 80-77812 Date �� —� Z �� 7 Co1� httactor.: OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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).: ( 11, 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.). ( 11, 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 polity number are: Carrier: EXEMPT Policy Number: _ `oCcertify 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. _[_2 A(04-L� PPIi `. -.� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I WFUL, 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. Datil "-CZ—C7 Signature (A pplicant.or;Agent)`L /G' i ' Date: 6/12/2017 Application Number: BPLB2017-0082 Owner: Property Address: 55212 RIVIERA MICHEAL PARKER APN: 775153062 55212 RIVIERA Application Description: PARKER / GAS LINE FOR FURNACE 301-F LA QUINTA, CA 92253 Property Zoning: Application Valuation: $800.00 'Applicant: Contractor: LEAK SPECIALTIES. LEAK SPECIALTIES 1268 8TH ST 1268 8TH ST _ COACHELLA, CA 92236 COACHELLA, CA 92236 (760)564-9440 --------------------------=----------------------------------------------------------------- Llc. No.: 807812 Detail: DISCONNECT AT EXISITNG STUB OUT AND REROUTE AND RECONNECT EXISITNG STUB OUT FROM GARAGE TO FRONT HOUSE ALONG EXISITNG WALL. PER 2016 CALIFORNIA PLUMBING CODE. J FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $25.33 Total Paid for PLUMBING FEES: $38.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 J 9.7 Bin /i _. # Permit u t I V Proje toddire~: S—�, 2 Z: City. of La Quinta Building &r Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701.2 1 ' Building Permit Application and Tracking Sheet v O�_vnc" r�+s_1R a~� a �e A. P. Number. r'Addr ft ivIQ2 Legal Description: Ci �'.ST,'� Z� ' qty,- n:1 u z 2 s~ nfi=a t Co c r. ; 0 , 4 G / C l �, P n Tele ho e. ......................... ................... _ d-dreT ss: 4 Ad Z Project Desc piton: city,*STZip� �'© Q c �'82236 o Tel h nE 7 P e 6 C - ]Estate —Li c'.#ri (' 7 Z City Lie. #; Arch.,'Dngr., Designer: Address: t , City, ST, Zip: Telephone: - Construction Type: Occupancy: State ic. #: dd n Alter Repairair Demo e (circle one • New A Tlame;of Contact on: .._ Persp r() (4 t �S_ Ft.: # Stori #Units: Telephone # of Contact Petson::>;' 7 6 0 2 g,S"- t j �l ,EstimatedyUal_ u__•e of Project: Q APPLICANT: DO NOT WRITE BELOW THIS LINE it Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item • Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Ca1eS.* Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction ' Flood plain plan Plins resubmitted Mechanical Grading plan 2" Revicw, ready for correctionslissue Electrical 'SubcontactorList 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.T.P.P. Pub. Wks. Appr Date of permit issue + ' School Fees, Total Permit Fees C� LA) P ttiJ �tVle►(A)e- 5-t_ C • .G , CITY OF lA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION. Z 7L,o BY DA 4"W'd 61 P.-