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BMCH2014-110278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Td4t 4 4'0" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BMCH2O14-1102 78920 CABRILLO WAY 646410008 RELOCATE CONDENSING UNIT $2,000.00 Applicant: CLEAN ROOMS WEST, INC. OUTSIDE CITY LIMITS OCT 0 3 2014 CITY OF LA QUINTA COMMUNITY 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: _ License No.: :LIC -762373 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 alleg� 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) 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/3/2014 Owner: ALLEY STEVE 78920 CABRILLO WAY LA QUINTA, CA 92253 Contractor: CLEAN ROOMS WEST, INC. , J • f OUTSIDE CITY LIMITS Llc. No.: :LIC -762373 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 Co I s II forthwith comply with those provisions. 'Date: Applicant: 4LEL-1— 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 thiscity4, ! �o enter upon theaboye mentioned property for inspection purposes. ; Date: Signature (Applicant or Agent) DESCRIPTION FINANCIAL .• l• 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 HVAC CHANGEOUT - FURNACE ONLY 101-0000-42402 0 $36.26 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - FURNACE ONLY PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT # CHECK•# CLTD BY Total Paid forCHANGEOUT: $77.35 $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 TOTALS: $170.20 $0.00 F 'rte, ,`�'-'�� / � "� � •-. •, � j .. .. .. d .:'�'i�..�' .ice \ © � • Am 110 Description: RELOCATE CONDENSING UNIT Description: Type: MECHANICAL Subtype: Status: SUBMITTED Applied: 10/3/2014 AZA Approved: Parcel No: 646410008 Site Address: 78920 CABRILLO WAY LA QUINTA,CA 92253 Subdivision: TR 28343 Block: Lot: 8 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 Details: HVAC - RELOCATE CONDENSING UNIT PER APPROVED ATTACHED PLANS. 2013 CALIFORNIA BUILDING CODES. Printed: Friday, October 03, 2014 3:25:38 PM 1 of 2 VVL_"ff"". �\ #t: ► ter;; ° -:-�-�. �r.t� •�l�'lJ �C �.�OY�`Q� OF l.`- BMCH2O14-1102 1� DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY HVAC CHANGEOUT - 101-0000-42402 0 $36.26 $0.00 FURNACE ONLY HVAC CHANGEOUT - 101-0000-42600 0 $24.17 $0.00 FURNACE ONLY PC HVAC CHANGEOUT - 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION HVAC CHANGEOUT - 101-0000-426000 $4.83 $0.00 1 REPAIR/ALTERATION PC Total Paid forCHANGEOUT: $77.35 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 • i 00 BOND INFORMATION Printed: Friday, October 03, 2014 3:25:38 PM 2 of 2 cvcrFsc Bin # City of La Quinta Building 8i Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #u1 l' PK N �I /�� Project Address: 'Owner's Name: A. P. Number: — Address: Legal Description: i City, ST, Zip: ,Contractor 1. Telephone: -/ Address: 40Y Project Description: oC, dnf a City, ST, Zip: �pi1 - ne TeleP ho . U #3>?< State Lic. # SQ.7 0City Lic. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: Project a 'circle Add'n Alter 1 h'P �( ) Repair Demo -� State Lic. #: `:s::>:%;:°:>:::>::<>;;< Name of Contact Person:/S # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: CJ�J w� APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING _PERMIT FEES Plan Sets Pian Check submitted Item �Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss C21cs. Called Contact Person Plan Check Balance. Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2' Review, ready for correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"' Review, ready for correctionsliissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue school Fees Total Permit Fees 1) X Ir -T. 1®R'.1- LOCATiDN lyq�i­ CU-3 A' 5LAD E) J-5ox NEW J-115OX FOC (F) GU-? _Frm_)__ELF_ T— ELI= _AL FZrm - Lor-ATED GU-3 F10C LINE RJN LINFS la' NEW LINE SEff BELOW TO LINE BE IN 31 DRAIN FIFIC 4 JACI<r7l ­4! MO. 5CALE: 1/4' - P- Zr� CITY OF LA QUINTA B U IL D I IN G & S Af ___ E TY [KEPT_ AIPPROVED DATE A / O z L JOB DATE 013-25-14 DRAWN IDA. CHECKED S.A. SHIEET TITLE PIPIN'S PLAN A-1