BPLB2014-102754990 Avenida Madero
BPLB2014-1027
78-495 CALLE TAMPICO D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 z FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/17/2014
Application Number: •:---BPLB2014-'1027--
--_. 54-4 q0 / UEN I ISA
`/1A'D
Owner:
PropJrt ddressi-
KARL RIEBEL
APN:
774232026
54490 AVENIDA MADERO
Application Description:
WATER HEATER CHANGE OUT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
.
$1,762.00 11
_ n
Applicant:, U U Contractor:
RESCUE ROOTER OCj 1 ZQ14 RESCUE ROOTER
0 OUTSIDE CITY LIMITS 0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253 CATV QF U\QUWpE pJi09 LA QUINTA, CA 92253
OOMMONm O ELOPMEN
(951)341-9370
Llc. No.: :LIC -0111366
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.
Liclass: _ License No.::UC-0111366 ` /L
aens -
te: 7 y ontractor: ' L
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 foga
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(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.).
( 1, 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 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 Sectidn!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; _ Polity Number:
I certify that in the performance_of the work for which this permit is issued, I
shall hot 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:pplicant:
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, orcessation 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 u n the above-
mentio d property for inspection purposes.
ate: APS' nature (Applicant or Agent)-__
I .
FINANIAL 1 .
` ,' ACCOUNT a QTY, ,,a1" AMOUNT 'ti PAIDK z, PAID DATE
rDESCRIPTION , „. ..
BSAS SB1473 FEE
101-0000-20306
0 $1.00
$0.00
PAID:BY
METHOD,,w';RECEIPT#
x CHECK#
k , Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
}rt DESCRIPTION
t' ACCOFUNT ; {4
QTY k
AMOUNT
?` PAID'r 4'_
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0:00
s PAID"BY
METHOD ;
6_{
RECEIP.T #
':4•
CHECK # f
CLTD BY .
tt
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION :F-
` ACCOUNT - 1. "
4
4N
z'AMOUNT,
PAID-.'
PAIDDATE
, d
WATER HEATER/VENT
101-0000-42401.
0
$12.09
$0.00
tp
METHOD ' f
Nt-
=RECEIPT # "
CHECK #
CLTD BY '
DESCRIPTION' *
:. .._',.'s. .L ..rr&'.n. a.
s +{.r ACCOUNT ak `'yQTYK,AMOUNT'
.. C
VTC
PAID rR °° '
4. zs.sn`bl
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.25
$0.00
g e r PAID'BY .,t; Aix, ^f£ y
-r x WEFHOD '
x RECEIPT .# §
' CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.34 $0.00
7177 7 -TOTALS: $112.10 $00
}
Bin #
7
Permit # j
Project Address: 59 019 p
.City of La Quinta .
.-Building &r Safety Division
P.O. Box 1504, 78-495. Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking -Sheet
Ell O Owner's Name: L C13EL
A. P. Number:
Address': Sy qQ0 AVEtiL0A IA OfAd
Legal. Description:
City, ST, Zip: LA , ut N i—A , (-A
tra
Can clot:
Telephone: 7 1 23'
% 1 RS
G d
z z;
Address:
t.) r
Project Description: l3 AjE_fL HEAT. C 1I—
City, ST, Zip.
C,JC} 4' L
Telephone: n - 9 3 N f 1 .3
P
State Lic. # : ifo /S S
City Lic. #•.. 34ep
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
P
:?:.;;;:;.;;::.t `:;..:.:;;:>:
..:.. ...
::.s:•<;::>::::» ;:•>:>!: r<;>:•r<>:>.;: <
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: N ((
Sq. Ft.:
# Stories:
#Units:
Telephone #,of Contact Person: 1(o o ')—? 6-2-3
Estimated Value of Project: / '7 (p
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 Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans pieked'up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
If.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'" Review, ready for correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Description: WATER HEATER CHANGE OUT
; ---: - ...
MA
R QNE
A, W
Type: PLUMBING Subtype:
Status: APPROVED
Applied: 10/17/2014 KHE
Approved:
Parcel No: 774232026 Site Address: 54490 AVENIDA MADERO LA QUINTACA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA . Block: 261
Lot: 14
Issued:
UNIT 24
0 OUTSIDE CITY LIMITS LA QUINTA CA
92253
Lot Scl Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $1,762.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: INSTALL NEW 40 GALLON PROPANE WATER HEATER IN GARAGE.
MADERO
N - i =Z I 1 0 i-
%-WA'ME;1Y,PE--F'F 2" V
C17 =s q;
; ---: - ...
MA
R QNE
A, W
APPLICANT RESCUE ROOTER
0 OUTSIDE CITY LIMITS LA QUINTA CA
92253
CONTRACTOR RESCUE ROOTER
0 OUTSIDE CITY LIMITS LA QUINTA CA
92253
OWNER. KARL RIEBEL
54490AVENIDA LA QUINTA CA
92253
MADERO
Printed: Friday, October 17, 2014 2:44:41 PM 1 of 2 Cmw' SYSTEMS
PARENT PROJECTS
Printed: Friday, October 17, 2014 2:44:41 PM 2 of 2
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