BPLB2014-103278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BPLB2014-1032
Property Address:
52420 AVENIDA JUAREZ
APN:
773251010
Application Description:
PROPANE GAS LINE 127 LF
Property Zoning:
Application Valuation:
$900.00
Applicant:
ROADRUNNER PLUMBING
27380 MOLANITE DR
CATHERDRAL CITY, CA
T4ht 4 4 Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 Clas : C36. C20 License No.: 7555283
Date:dhJ Contractor: r�.M lie vLt ..._
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).:
(� 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 ) 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.).
L
Lender's Name:
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/3/2014
Owner:
CLAUDIO CORMONS
52420 AVENIDA JUAREZ
LA QUINTA, CA 92253
Contractor:
ROADRUNNER PLUMBING
27380 MOLANITE DR
CATHERDRAL CITY, CA
(760)322-3800
Llc. No.: 755283
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. N
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:_ Polity 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 hose provisions. 4,1
Applicants' ,
r IF de
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 enter upon theabov�
mentio//nrej/d/property for inspection purposes. ///� � •�
Date: q Q / Signature,(Applicant or Agent):
FINANCIAL ••
,�.:�-DESCRIPTION' ACCOUNT
•
QTY
AMOUNT PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $1.00
11/3/14
PAID BY. METHOD
RECEIPT # CHECK #
CLTD BY
ROADRUNNER PLUMBING DEBIT
R2627
MFA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
11/3/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
ROADRUNNER PLUMBING
DEBIT
R2627
MFA
Total Paid forPERMIT ISSUANCE: $91.85 $91.85
DESCRIPTION •
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$12.09
11/3/14
PAID -BY
METHOD
RECEIPT #
CHECK#
CLTD BY
ROADRUNNER PLUMBING
DEBIT
R2627
MFA
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$24.17
11/3/14
PAID BY
METHOD -
RECEIPT #
CHECK #
CLTD BY
ROADRUNNER PLUMBING
DEBIT
R2627
MFA
Total Paid forPLUMBING FEES: $36.26 $36.26
TOTALS: $129.11 $129.11
Description: PROPANE GAS LINE 127 LF
NAME TYPE
Type: PLUMBING Subtype:
Status: APPROVED
Applied: 11/3/2014 MFA
Approved: 11/3/2014 MFA
Parcel No: 773251010 Site Address: 52420 AVENIDA JUAREZ,CA
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 8
Lot: 13
Issued:
UNIT 1
ADDRESSI
CONTACTS
CITY
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $900.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
CATHERDRAL
CITY
Details: INSTALLING 127 LF OF PROPANE GAS LINE FOR FUTURE TANK, BBQ, AND POOL HEATER. SCREEN WALL FOR TANK MUST BE IN PLACE
PRIOR TO FINAL.2013 CALIFORNIA BUILDING CODE.
(
CONTRACTOR
ROADRUNNER PLUMBING
27380 MOLANITE DR
CATHERDRAL
CITY
CA
(
OWNER
CLAUDIO CORMONS
52420 AVENIDA JUAREZ
LA QUINTA
I CA
92253
(
Printed: Monday, November 03, 2014 9:10:28 AM 1 of 2 C
SYSTfti1S
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD,
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
11/3/14
R2627
DEBIT
ROADRUNNER
MFA
PLUMBING
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
11/3/14
R2627
DEBIT
ROADRUNNER
MFA
PLUMBING
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$12.09
11/3/14
R2627
DEBIT
ROADRUNNER
MFA
OUTLETS
PLUMBING
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$24.17
11/3/14
R2627
DEBIT
ROADRUNNER
MFA
OUTLETS PC
PLUMBING
Total Paid for PLUMBING FEES: $36.26 $36.26
TOTALS: $129.11 $129.11
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL"
Printed: Monday, November 03, 2014 9:10:28 AM
BOND INFORMATION
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