BPLB2014-102078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 9225
)IMMUNITY DEVELOPMENT DEPARTMENT
Application Number:
BPLB2014-1020
Property Address:
77929 LAGO DR
APN:
658270051
Application Description:
HOT WATER HEATER REPLACEMENT
Property Zoning:
Application Valuation:
$1,700.00
Applicant:
GENERAL AIR CONDITIONING
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
BUILDING PERMIT
(U SEP 16 2014 I
COMMUNITY CITY
LA QUINTA
LOPMENT DEPARTMENT
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 -0003606
///Date: C?Ifo lJ4 Contractor:! i �—?
1,
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).:
( 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.).
(_) 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 prdperty 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. . BAP.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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/16/2014
Owner:
LARRY CHAPPELL
Contractor:
GENERAL AIR CONDITIONING
'0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)343-7490
Llc. No.: :LIC -0003606
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 Labor Code, I shall forthwith
comply with those provisions.
f
Date: 4 16 Applicant: uaerL �+�cs
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, 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: lb Signature (Applicant orAgent):
FINANCIAL • •
DESCRIPTION ACCOUNT CITY AMOUNT PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $0.00
PAID BY METHOD
RECEIPT # CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT
101-0000-42401
0
$11.92
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0
$7.15
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $19.07 $0.00
TOTALS:• 0•
Description: HOT WATER HEATER REPLACEMENT
Type: PLUMBING Subtype: Status: SUBMITTED
Applied: 9/11/2014 MFA
Approved: 9/11/2014 MFA
Parcel No: 658270051 Site Address: 77929 LAGO DR LA QUINTA,CA 92253
Subdivision: TR 4418 & INT COMMON AREA Block: Lot: 26
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $1,700.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: WATER HEATER CHANGE OUT - 50 GALLON/GAS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL
INSPECTION. 2013 CALIFORNIA BUILDING CODES
DESCRIPTIONACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY . CLTD
BY
BSAS SB1473 FEE 1 101-0000-20306 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
BSA: $1.00 $0.00
Printed: Tuesday, September 16, 2014 12:54:12 PM 1 of 2 C .
SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES.
PLUMBING FINAL"
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID'BY
BY.
PERMIT ISSUANCE
101-0000-42404
0
1 $90.57
$0.00
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
WATER HEATER/VENT
101-0000-42401
0
$11.92
$0.00
WATER HEATER/VENT
101-0000-42600
0
$7.15
$0.00
PC
Total Paid for PLUMBING FEES: $19.07 $0.00
TOTALS: $110.64 00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES.
PLUMBING FINAL"
ATTACH M E NTS
Printed: Tuesday, September 16, 2014 12:54:12 PM 2 of 2 ,
SYSTEMS
Bin #
Qty of La Quinta
- Building 81: Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 'jam QZ t 3� Lmso
Owner's Name: L ar-r C�.ez l
A. P. Number: t
Address: `1'7 ct 2 g L a
Legal Description:
City, ST, Zip: L, C, �r 0. CAZZ 'l
Contractor:
�
Telephone: %
<'`'<='�'k�"�:`i'•:::
Address: ` 3W)0 eSerV Vit
Project.Description:
City, ST, Zip: I bws 0.`. L1m c. CA It Z 2-7G
1Zi v cc S® E> — W cxa e0.}eC
Telephone: -76(>-Z . q
-z< s'<?;,:.;........: >,::,•
State Lic. # : (0%0346
City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone- ]e
P
-
~,
............................:...................
Construction Type: Occupancy:
State Lie. #
Project type circle one): New Add'n Alter Repair Demo
Name of Contact Person: S.t eVeh S'c
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: �g- 735-%� %(o ,
Estimated Value of Project: 700 x C4_->
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cluck Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Zed Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'rd Reyiew, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees