BPLB2015-011578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
BPLB2015-0115
48111 VIA HERMOSA
Tity, 4 4 Q" -
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
I IIIIII VIII IIII IIII
25
646100016
WASHINGTON / DEMO SHOWER INSTALL NEW FAUCET AT SINK
$2,000.00
Applicant:
LOUIS R GUILBAULT
53-501 AVENIDA DIAZ
LA QUINTA, CA 92253-3582
pQ ° D
OCT 2 0 2015
CITY OF LA QUINTA
Y DEVELOPMENT 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: C54 License No.: 830611
Date: 64- 20 2011; 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).:
(J 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.).
(J 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 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: 10/20/2015
Owner:.
JULIUS WASHINGTON
Contractor: SCANNED
LOUIS R GUILBAULT
53-501 AVENIDA DIAZ
LA QUINTA, CA 92253-3582
(760)899-7011
Llc. No.: 830611
WORKER'S COMPENSATION DECLARATION
I her by affirm under penalty of perjury one of the following declarations:
1 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.
--/51 1 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:
1 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: 6Ct Z V Zo 15 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 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: 6 C'_\ Z U 2-0 KSignature (Applicant or Agent): :
DESCRIPTION
FINANCIAL
"ACCOUNT
1 .
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 for BUILDING 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
FIXTURE/TRAP
101-0000-42401
0
$24.18
$0.00
PAID BY
METHOD - ::
RECEIPT #
CHECK #
CLTD BY'
DESCRIPTION
ACCOUNT
QTY.
i . AMOUNT
PAID
PAID DATE
FIXTURE/TRAP PC
101-0000-42600
0
$24.18
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER SYSTEM INST/ALT/REP
101-0000=42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $72.54 $0.00
TOTALS:00
Description: WASHINGTON / DEMO SHOWER INSTALL NEW FAUCET AT SINK
Type: PLUMBING Subtype: Status: APPROVED
Applied: 10/16/2015 SGU
Approved: 10/20/2015 JJO
Parcel No: 646100016 Site Address: 48111 VIA HERMOSA LA QUINTA,CA 92253
Subdivision: TR 20052-1 Block: Lot: 16
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
TELEPHONE CALL
Details: DEMO THE SHOWER. INSTALL NEW FAUCET AT SINK. REBUILD NEW CEMENT BOARD. -INSTALL NEW SHOWER PAN. PER 2013
CALIFORNIA BUILDING CODE
ADDITIONAL SITES
Applied to Approved
FINANCIAL INFORMATION
Printed: Tuesday, October 20, 2015 2:17:44 PM 1 of 2
CIIRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES
TELEPHONE CALL
JIM JOHNSON
10/20/2015
10/20/2015
CALLED MARGO GUILBAUHT TO INFORM HIM PLANS ARE
READY TO ISSUE
• •
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
PHONE
FAX
EMAIL
STATE
ZIP
APPLICANT
LOUIS R GUILBAULT
53-501 AVENIDA DIAZ
LA QUINTA
CA
92253-
3582
CONTRACTOR
LOUIS R GUILBAULT
53-501 AVENIDA DIAZ
LA QUINTA
CA
92253-
3582
OWNER
JULIUS WASHINGTON.
17503 LORI ANN LN
CERRITOS
CA
92253
FINANCIAL INFORMATION
Printed: Tuesday, October 20, 2015 2:17:44 PM 1 of 2
PARENT PROJECTS
ATTACHMENTS
Printed: Tuesday, October 20, 2015 2:17:44 PM 2 of 2
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BI Y
BSAS SB1473 FEE
101-0000-20306.
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
FIXTURE/TRAP
101-0000-42401
0
$24.18
$0.00
FIXTURE/TRAP PC
101-0000-42600
0
$24.18
$0.00
WATER SYSTEM
101-0000-42401
0
$12.09
$0.00
INST/ALT/REP
WATER SYSTEM
101-0000-42600
0
$12.09
$0.00
INST/ALT/REP PC
Total Paid for PLUMBING FEES: $72.54 $0.00
TOTALS. 00
PARENT PROJECTS
ATTACHMENTS
Printed: Tuesday, October 20, 2015 2:17:44 PM 2 of 2
Bin # Clay of La Q Grin to
Building &' Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pr6ject Address: %� R R 8 JC Owner's Name: u
A. P. Number:
Address: kly,9111 Os
Legal Description: 5"60
City, ST, Zip: -� aaS 3
Contractor: i S
T ele h ne•
P o .
Address: ()
��
Project Description:
City, ST, Zip: '
ne:
Telephone
P
it E
State Lic. # :
City Lie. #t
V
Arch., Engr., Designer:
Address:
City, ST, Zip:
one:
Telephone: h
Con truction Type: Occu Pan cy:
State Lic. #:
type a circle one): New Add'n Alter Repair Demo
J ) P
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contaet P
42a0b
Estimated Value of Project: 6 Q 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
I/ Submittal Req'd Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°"Reviciv, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
Jrd 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 Fees
Total Permit Fees
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"AN ADEQUATELY SIZED DEBRIS CONTAINER
IS REQUIRED ON THE JOB SITE DURING ALL
PHASES OF CONSTRUCTION AND MUST BE
7NIPTIED AS NECESSARY. FAILURE TO DO SO
,,Y r NSE THE CITY TO HAVE THE CONTAINER
AT THE EXPENSE OF THE OWNER/:. .
T ACTOR."
A RE -INSPECTION fft'OF $721.5 2,
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARL" ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION
NO EXCEPTIONS!
CONSTRUCTION HOUM
October 1st - April 30
Monday - Friday: 7:00 a.m. to 5:30 p.m.
Saturday: 8:00 a.m. to 5:00 P.M.
SId fir: None
.-nr-n4- Code Holidays: None
r Mit S :p t,-rn ger 30th
ridgy: 61:00 a.m. to 7:00 p.m.
Y: 8:00 a.m. to 5:00 p.m.
a No,..3e
nt it Code Holidays: None
4
Construction is NOT PERMITTED
on the following Code Holidays:
New Year's Day
Dr. Martin Luther KingJr. Day
President's Day
Memorial Day
Independence Day
Labor Day
Veteran's Day
Thanksgiving Day
Christmas Day