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MECH (10-1212)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: -1.0-00001212. Property Address: 49455 AVENIDA MONTERO APN: 646-181-018- - Application description: MECHANICAL .Property Zoning: LOW DENSITY RESIDENTIAL Application Valuation: 16500 Ta�/-440almm BUILDING &SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: ' -------------------- ------------------------------ LICE SED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I m lice'sedunder provisions of Chapter 9 (commencing with Section. 7000) of Division 3 of the Business d Pro essionals Code, and my License is in full force and effect. Lise Class: C36 -C20' -C4 License No.: 184826 Date: ' lv' o'n1ractor: 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 Codel 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 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 _ I 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 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 Owner: SANTOS LOUIE & KARLA 49455 AVENIDA MONTERO LA QUINTA, CA 92253 Contractor: BUSH PLBG.HEAT AND A/C, 429 TEXAS STREET REDLANDS, CA 92374 (909)335-0535 Lic. No.: 184826 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/08/10 ------------------- 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 3700of 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 INS CO WEST Policy Number WSD500132501 _ I certify that, in the performan f the work for which this permit is issued, I shall not employ any person in any manner so to ecome subject to the workers' compensation laws of California,. and agree that, if I shou bec a subject to the workers' compensation provisions of Section (/ 3700 of the La r d , I s 11 forthwith comply with those provisions. - q6�e: it �( 17 A icant.' /WARNING: FA E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 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, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any actor 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 @icessation of work for 180 days will subject permit to cancellation. . I certify that I have read this application and state t f the aion is correct. I agree to comply with all city and county ordinances and state laws relating buildin, and hereby authorize representatives of this co nt to enter upon a above-mentioned operty fpurposes. D e: l 7 �� nature (Applicant or AgentL LQPERDIIT - Application Number . . . . . 10-00001212 Permit MECHANICAL Additional desc . Permit Fee 66.00 Plan Check Fee 16.50 - Issue Date Valuation 0 Expiration Date 5/07/11 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 9.0000 EA MECH FURNACE <=100K 18.00 2.00 16.5000 EA MECH B/C >3-15HP/>100K-500KBTU 33.00 ----------------------------------------------------------------------------- Special Notes and Comments HVAC CHANGE OUT - (2) UNITS 4/5TONS [CF=1R REG NUMBER:310-A0001269B & 310-a0001270AB] 2007/2008 CALIFORNIA BUILDING CODES. - Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total -66.00 .00 .'00 66.00" Plan Check Total 16.50 .00 .00 16.50 Other Fee Total 1.00 _00 .00 1.00 Grand Total 83.50 .00 .00 83.50• LQPERDIIT IMACIFaNG abtnitted rally ready ready tact permit PERMIT FIDS Submittal+d Recd for oorredioas Pian Check Deposit Plan Sed Of1i uinta Plan Check Balance Pian Check Construction ' M , .. Mechanical RMewed. P.O.:.x 1504, 78-495 Caffe Tampko Truss Cala. Plumbing Called Conta •(766) 777-7012 1 S.Mitted Mile 24 Cates. Grading _-BUIlding PeffnItAPP11cation Developer Impact Fee Floodplain pian �, •• �, Plana resubm Grading plan ,� 2'! Review,Subeontactor fjdMOVAMIg Called Cbnta 'total Permit Fern Cant Decd 94 Call MI.. Plans picked H.O.A. Approval Plans rtsabm INHOUSE-- MU +srna : w•t �,+ Review, Planning Approval Called Con Pub. Wks. Appr " 1 School Fees ;;:i:.2 �' k\y�<<tie>'.,nY:•�1(��^1�.�C%a�; � � i � .•iu •�n IMACIFaNG abtnitted rally ready ready tact permit PERMIT FIDS Submittal+d Recd for oorredioas Pian Check Deposit Plan Sed Plan Check Balance Pian Check Construction ' Strnetaral Cala Mechanical RMewed. Electrical Truss Cala. Plumbing Called Conta 1 S.Mitted Mile 24 Cates. Grading Plus pig Developer Impact Fee Floodplain pian A.LP.P. Plana resubm Grading plan 2'! Review,Subeontactor Urt Called Cbnta 'total Permit Fern Cant Decd Plans picked H.O.A. Approval Plans rtsabm INHOUSE-- Review, Planning Approval Called Con Pub. Wks. Appr Date of School Fees IMACIFaNG abtnitted rally ready ready tact permit PERMIT FIDS Item Anoant . for oorredioas Pian Check Deposit et Pessoa Plan Check Balance ■p Construction ' fitted Mechanical for correctiondissue Electrical ct Person Plumbing up 1 S.Mitted Grading for correetlonsilssve Developer Impact Fee Person A.LP.P. Issue 'total Permit Fern