BMCH2016-024878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O16-0248
Property Address: 49520 W W MISSION DR
APN: 602150012
Application Description: HVAC CHANGEOUT
Property Zoning:
Application Valuation: $15,824.00
Applicant:
PRIORITY ONE AIR CONDITIONING AND HEATIN
P 0 BOX 1681
PALM DESERT, CA 92261
. haw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
i
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: C20 License No.: 752180
Date: Contractor:
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) license_ d 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. Q.
Lender's Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760)777-7153
Date:. 8/2/2016
Owner:
ANDRES MEDINA
49520 mission drive west
la quinta, ca 92253
Contractor:
PRIORITY ONE AIR CONDITIONING AND HEATIN
P0BOX1681
PALM DESERT, CA 92261 -
(760)773-0811
Lic. No.: 752180
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: REPUBLIC UNDERWRITERS INSURANCE COMPANY Policy Number:
ATWO08894
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 Labor Code, I shall forthwith
comply with those provisions.
Date: 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 fora 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.
Date: Signature (Applicantor Agent):
Date: 8/2/2016
Application Number:
BMCH2016-0248
Owner:
Property Address:
49520 W W MISSION DR
AND.RES MEDINA
APN:
602150012
49520 mission drive west
Application Description:
HVAC CHANGEOUT
la gyi.nta, ca 92253
Property Zoning:
Application Valuation:.
$15,824.00
Applicant:
Contractor:
PRIORITY ONE AIR CONDITIONING AND HEATIN
PRIORITY ONE AIR CONDITIONING' AND HEATIN
P O BOX 1681
P 0 BOX 1681
PALM DESERT, CA 92261
PALM DESERT, CA 92261
J
- (760)773-0811
Llc. No.: 752180
Detail:
I
}
HNANciAL 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
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$145.04
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$72.52
Total Paid for CHANGEOUT: $217.56
DESCRIPTION
ACCOUNT
QTY
AMOUNT
Credit Card Fee
101-0000-43505
0
$6.83
Total Paid for Credit Card Fee: $6.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
.101-0000-42404
0
$91.85
Description: HVAC CHANGEOUT
7 0a
Type: MECHANICAL - HVAC
Subtype:
Status: FINALED
Applied: 7/7/2016 ECON
CHANGEOUT (WEB)
-
Approved: 7/7/2016 ECON
Parcel No: 602150012 Site Address: 49520 W W MISSION DR LA QUINTA,CA 92253
Subdivision: TR 28912 .^
Block:
Lot: 12
Issued: 7/7/2016 ECON
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning: _
Finaled: 7/14/2016 DCL -
Valuation: $15,824.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0_
:No. Stories: 0
No: Unites: 0
Details:
r' ,
A Issued'to:Finaled
FINANCIAL INFORMATION t
• Printed:.Tuesday, August 02, 2016 11:39:24 AM 1 of 3
. - SYSTEMS
7 0a
Applied:to:,Approved'
Approved to Issued �
A Issued'to:Finaled
FINANCIAL INFORMATION t
• Printed:.Tuesday, August 02, 2016 11:39:24 AM 1 of 3
. - SYSTEMS
-y.
7-
'AMOUN
-S7
"'..'C
DESCRIPTION
ACCOUNT
QTY.
T
1,PAI
ID DATE�,�
tECEIPT #
METHOD
BY
201607071
BSAS SB1473 FEE-
101-0000-20306
$1.00:,
$1.00
7/7/16
WEB904
954131182.
CREDIT
Roy Meghnagi
ECON
3
'Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
I
HVAC CHANGEOUT-201607071
101-0000-42402
0
$145.04
$14S.04'
7/7/16.
WEB904
954131182
CREDIT
Roy Meghnagi
ECON
SPLIT -SYSTEM .
3
201607071
HVACCHANGEOUT-
101-0000-42600
0
$72.52
$72.52
7/7/16
WEB904-
954131182
CREDIT
Roy Meghnagi
ECON
SPLIT -SYSTEM PC
3
Total Paid for CHANGEOUT: $217.56 $217.56
-
20160707
Credit Card Fee
101-0000-43505
0
$6.83
$6.83
7/7/16
WEB964
I
954131182
CREDIT
Roy M6ghnagi
ECON
-
3
Total Paid for Credit Card Fee: $6.83 $6.83
201607071
PERMIT ISSUANCE
101-0000-42404 404
0
$91.85
$91.85
7/7/16-
WEB904
954131482
CREDIT
Roy Meghnagi
ECON.
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
61 TOTALS: 317.24 $317.24
MECHANICAL FINAL"
DCL
7/14/2016 1
7/14/2016
APPROVED
r ,.. PARENT' PROJECTS
eTRAKiT Inspection
Request
7/12/2016 8:36 AM PRIORITY ONE AIR
CONDITIONING AND HEATIN
Contact Name: PRIORITY ONE AIR
CONDITIONING AND HEATIN
Site Address: 49520 W W MISSION DR
Phone:7607730811
e -Mail: PRIORONEROY@VERIZON.NET
Printed: Tuesday, August 02, 2016 11:39:24 AM 3 of 3
`., srsrEMs