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BRES2014-112778-49! `CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 �r 4.1�Qu&rw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE (760) 777-7125. FAX (760) 777-7011 INSPECTIONS (760) 777-7153. Date: 10/14/2014 Application Number: BRES2014-1127 Owner: Property Address: 49835 PATTI CT MICHAEL MASSIE APN: 602390025 230 FRANKFORTAVE Application Description: OUTDOOR FIREPLACE AT REAR YARD HUNTINGTON BEACH, CA 92253 Property Zoning: Application Valuation: $1,000.00 Applicant: Contractor: MICHAEL MASSIE 230 FRANKFORT AVE• HUNTINGTON BEACH, CA 92253 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 f 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.: 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 (SS 0).: I, as owner of the property, or my employees with wages as their sole cGinpensation, 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 Yhe r 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 Y/1 I am exempt under Sec. . B.&P.C. for this reason 11W.-icio-W 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 Lender's Address UOC t 14 2014 Llc. No.: CIiYOFLA()UINTA COMMUNITY nm-, WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one rf 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: Carrie :Policy Number: I certify that in the performance ofthe 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 _.70 of the Labor Code, I shall forthwith comply with those provisions. D40 o/ `7 Applicant: WARNING: FAILURE TO SECURE WORKERS' CCIM P E NSATIO N COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMILIAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FO 2 IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . I 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 appltation 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 owns r, 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 st=ate 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 properttyfforinspection purposes. Date: W4ignature (Applicantor Agent): FORMATION � 8 DESCRIPTION ' ACCO.IINT 7' 7 wx' QTY : * AMOUNT.• g x ..PAID _ BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 ��a a,' '' rff PAID BY F > is RECEIPTr# CHECK # `? CLTD BY P t .METHOD �€ Dt .': y } E. n . .:ifi^'y . S.�°5-a- .N, sb. a. 3' vfiesn,. f-.. .s S %id-. ff .t.Li ,Nr h < :N -e` 4-"�'^' .�Sbrw f•D.. ab_ Total Paid forBUILDING STANDARDS ADMINISTRATION. BSA $1.00 $0.00 "j,X Pg.-:-� 3• -.'.. Y <DESCRIPTION � ' Xe.:-.< Y,T r.':: .•. r : h c, ACCOUNT r QTY> HP Y = iAMOUNT' F t RAID PAID DATE: ., �, y FIREPLACE 101-0000-42400 0 $145.03 $0.00 fp § t; : PAID BY METHOD " RECEIPT # z a 64, , ,�aCLTD "�*� g DESCRIPTION ` t '�P, , •, ACCOUNTS QTY • , AMOUNTS PAID f x�� DATE; ..:.... " a� ;PAID FIREPLACE PC 101-0000-42600 0 $217.55 $0.00 3r , - RECEIPT# iA �:; CHECK # BX`,• �;.PAIDBY,r�. # �Y�,METHOD''* k > CLTD Total Paid for FIREPLACE: $362.58 $0.00 *aDESCRIPTIONr ` ' a ACCOUNT QTY AMOUNT; x <; PAID PAID DATE; �. ,_..'a� r u. r t. R gx SMI — RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 " CiECKMETHOPAID_BY 'CHECK CLTDBY = Total Paid forSTRONG MOTION INSTRUMENTATION SMI $0.50 $0.00 TOTALS:4.0i00 Description: OUTDOOR FIREPLACE AT REAR YARD Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED Applied: 9/26/2014 AOR Approved: 9/26/2014 AOR Parcel No: 602390025 Site Address: 49835 PATTI CTLA QUINTA,CA 92253 Subdivision: TR 29053-3 Block: Lot: 8 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 -No. Unites: 0 Details: OUTDOOR GAS FIREPLACE AT REAR YARD [CONVENTIONAL] THIS PERMIT DOES NOT INCLUDE ELECTRICAL INSTALLATIONS. 2013 CALIFORNIA BUILDING CODES. ..:.CHRONOLOGY TYPE STAFF•„NAME ACTION;DATE':, COMPLETION DATE,: `. ".`, .NOTES EMAILED APPLICANT THAT PLANS ARE APPROVED AND E-MAIL AJ ORTEGA 9/26/2014 9/26/2014 PERMIT IS READY TO ISSUE. a ;xtRM ! trt'.t'�. NAME CITY r STATE ZIP w PHONES FAX; REMAIL -. +t .,.NAME .x3 ..:.... .. ,.: 1 :ADDRESS1.<- u ' R APPLICANT MICHAEL MASSIE 230 FRANKFORT AVE HUNTINGTON CA 92253 BEACH OWNER MICHAEL MASSIE 230 FRANKFORT AVE HUNTINGTON CA 92253 ` BEACH FINANCIAL INFORMATION Printed: Tuesday, October 14, 2014 12:36:43 PM 1 of 2 147%, DESCRIPTION G t za'S^ �M' e±.`.. a j ^ ' ' {- -a?'. R.: 'SRECEIPT ¢ °``_:...;-:.;,.. ci #i"J"`R �H '* _'i' x ; CLTDI k� y a ,..x,. Y,:A000UNT c iCITY ',AMOUNT _ PAID= PAID'.DATE #„ CHECK`# METHOD., PAID BYE - .a -� BY w. it m .s . BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for•BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: FIREPLACE 101-0000-42400 0 $145.03 $0.00 FIREPLACE PC 101-0000-42600 0 $217.55 $0.00 Total Paid for FIREPLACE: $362.58 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMt $0.50 $0.00 TOTALS:i 00 INSPECTIONS-:':::-' PARENT PROJECTS ..BQNL)1NI-URMMi0N Printed: Tuesday, October 14, 2014 12:36:43 PM 2 of 2 - Bib # .project Addn=; A. P. Number - ME Addrt= . thy, ST, Zip. Talephoae: /S�ti�eEej� IA..0: Eva., D"Ww City, STI Zip- • Telcphoac: Sbft Lic. II: Name of Cab w pemn:. Tcl of Conlad %am : 0 seb4lad Int.. see S&Uet*ml C67, Tram Cadm n"d pbb Plat G""ft 1 ! MCOILUCM Ust GrnetOtd ILO -A- Approvtl IN HOm;' Punning ApptDsol Pub, Wks.Appr SO" Fees City of La uInta.- 81A MS 9C safety LNvl W P,a. BOX 150 4, 78-495 G(le?ampko JU Qn*lra, G4 92253 , (760) 777,7012 BuNding Peimk Applicadon and Tracking Sheet _ F Add=- ��, C' ra r { ( City, ST. Zip t^1 A, r. l l i n �•r Tel unc . Project i)esCriptiam: An Fcts PrfljeQ type (eitcle ane): Nasw M -d n Mtei Repir Demo snores:�r : dlunits:&mod Tn—!l, Val%--ofPmjmt AMJCANT; DO NOT WMTE BELOW THIS file 'a 'I ItACKiAtG PERmr Fm Pbs Check nbm ktod Eben Alnoant Iterlewe4 rR@y /tar eotrecdow rin C�ek Depobfk. Lamed Ibntitx I'<lfol MR C m k $tiaata P11,08 Odmd up may p41rs mmbmltbed M tiG1 22'Review, tdtdy far =nxcS6mvjww >4ectdai COW Coabct Pry I7atabin� Float plow up S -KL Phos reamba ttd, Grtioling mew+ tud9 f' Da .eloper ltnpsct Frc Cl kd Conbet P"Von Date of permit Mme Fcts '40 �4//i��e�9�rc 1.10 r ' - 39.77 r Nq 40. A c, D (1 j CITY F LA 0 a BUILDING & SAFETY DEPT. 4 _�- APPROVE .FO�STRUCT N AIL DATE q BY `_ . • .�; , r ,Y _ .,. ', �, .. ds't0•Ns• �nsr1�'f� a�►ur � rlv.QL�. �.� � `. 4. 7W , • o' ML It LQ -� • ��Y V PA �r `��r� r x� i �1 � t IA ' . •!t � �) 4 i . • rr—_ �i n _'ors ._ �..�`-.T V„J . • _ I1j _ .. . , _ � ,y y�N r ' �.�y . _ •� . IIID . A Ll tve- S`ti`/ F � MA tJ l4P -9 Gt- PIS. t , i m r t ` / i z. CITY OF LA OUINTA BUILDING & SAFETY DEPT. APPROVED FOR t'UCTION DATE BY . 6. , f )vui,, k vw-& Aq p.w[� m;f\, a.C�t� `3rtUt 1��x OL o -y -41%