BPLB2015-005678-495 -4t. ( AMPI 0
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Ti ty °% 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPLB2015-0056
56770 MERION
762032017
MONTAVADO RESIDENCE GAS LINE
$500.00
Applicant:
WESTLAKE LANDSCAPE INC, BRIAN
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
PA 0
APR 8 2015
MYOFLAOUVA
COMMUN((YDEVELOPMENTDEPAMMENT
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: _ License No.: :LIC -0006975
Date: Contracto
OWNER- LDE ECLARATION
I hereby affirm under penalty of perjury t�h at I am exempt from the Contractor's State
License Law for the following reason (S c. 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 Divisio 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
permit subjects the applicant to a civil penalty of not more than five hundred dollar
($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 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777=7153
Date: 4/8/2015
Owner:
GARY MONTAVON
56770 MERION
LA QUINTA, CA 92253
Contractor:
WESTLAKE LANDSCAPE INC, BRIAN
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)399-1510
Llc. No.: :LIC -0006975
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 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 should become subject to the
workers' compensation provisions of Section 3700 of the Labo Hode, I shall forthwith
comply with those provisions.
Date: `!P�lL Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM7ENSATION 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 rela ' g to building
construction, and hereby authorize representatives of this city to ente pon the above-
mentioned property for inspection purposes. , /7
Date: Signature Signature (Applicant or Agenf(-/
FINANCIAL INFORMATION
' DESCRIPTION ACCOUNT QTY AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
'AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE'
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #,
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $36.26. $0.00
TOTALS:00
Description: MONTAVADO RESIDENCE GAS LINE
Type: PLUMBING Subtype: Status: UNDER REVIEW
Applied: 4/8/2015 PJU
Approved:
Parcel No: 762032017 Site Address: 56770 MERTON LA QUINTA,CA 92253
Subdivision: TR 25499-1 CM 78/129-128 CM 78/129 - Block: Lot: 1
Issued:
136
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ZIP
Details: RUN APRROX. 100 LN FT X3" OF GAS LINE FOR FOR 18" ROUND FIRE PIT PER 2013 CALICORNIA PLUMBING CODES.
CONDITIONS
CONTACTS
NAME TYPE NAME
ADDRESSS CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT WESTLAKE LANDSCAPE INC, BRIAN
0 OUTSIDE CITY LIMITS LA QUINTA
CA
92253
(760)250-2924
CONTRACTOR WESTLAKE LANDSCAPE INC, BRIAN
0 OUTSIDE CITY LIMITS LA QUINTA
CA
92253
(760)250-2924
OWNER GARY MONTAVON
56770 MERION LA QUINTA
CA
92253
(760)250-2924
Printed: Wednesday, April 08, 2015 9:49:10 AM 1 of 2 CR
SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED I COMPLETED I RESULT REMARKS NOTES
DATE DATE
PLUMBING FINAL" BLD
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
Printed: Wednesday, April 08, 2015 9:49:10 AM 2 of 2
RWYS TEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT 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:0•
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED I COMPLETED I RESULT REMARKS NOTES
DATE DATE
PLUMBING FINAL" BLD
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
Printed: Wednesday, April 08, 2015 9:49:10 AM 2 of 2
RWYS TEMS
. ' Bin #
Permit #P.O.
Project Address:
Qty of LQ Quinta.
Building 8t Safety Division
Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
r1" Building Permit Application and Tracking Sheet
% 7� / ��r 1 (�/� Owner's Name: f ava ;I /
A. P. Number:
Address: 5& — 770
//
Legal Description:
City, ST, Zip: 1A QUf 4 C (z Z
Contractor: ; &,-\
��S / a %x.19 Q
til � L �
Tele hone: Z C
P (Q Pi Z
Address: - f() 60
Project Description:
City, ST, Zip: 4�- &L, n `{- 2 2
Li�l7C
ne•
TeleP ho .
CQl%
z L'
.
r
I t- ,
State Lic. # : (6Y
U (
City Lie. W.-..
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: hone:Construction
an
Occupancy:
TYcY:
Type: S
State Lic.
Project type (circle one): New Add'n Alter Repair Demo
Namc of Contact Person:
�f`(.�
Sq. Ft.:
F#Stories'.
#Units:
Telephone #,of Contact Person: 7 4?CJ2 Soz Q Z
Estimated Value of Project: S�
# Submittal
APPLICANT: DO NOT WRITE BELOW THIS LINE
Req'd Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Dcposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted -
Mechanical
Grading plan
2qd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up
S.M.I.
ILO.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
3" 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 Fccs
Total Permit Fees
Brian Westlake Landscape, Inco
(Brian Westlake
Owner
Post Office Box 5175
�
NeuJ Avt'r5 Ta be- or'co
V it LR
Cv,�.�:�, vS(.c, ti (C)b-r
—" o z
Deco ` k>4
1�3
t
71 (ti. 1-14e.r'"�
LANDSCAPE, INC.
Lic.# 857801
AI
Brian Westlake Landscape, Inco
(Brian Westlake
Owner
Post Office Box 5175
�
La Qulnta, Ca. 92248
760..2924 Phone
760.625625.1359 Fax
bwlandscape@gmail.com
LANDSCAPE, INC.
Lic.# 857801
j'j�,�t.6
Sc A c C7 1 8
!TU -