BPLB2015-003578-495;CALLE TAMPICO
LAQUINYT,. LIFORNIA'.
r
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
,T`tM'4,(u'Qwnfw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPLB2015-0035
53335 AVENIDA JUAREZ
774034016
ATTOUN/REPLACE PROPANE GAS LINE BETWEEN HOUSE AND TANK
$1,000.00
Owner:
CHRISTINE ATTOUN
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/4/2015
Applicant: Contractor: q
PREFERRED AIR CONDITIONING DBA PREFERRED AIR CONDITI DDA -
P O BOX 5120 P O BOX 5120 S r-
PALM SPRINGS, CA 92263 PALM SPRINGS, CA 92263 it
(760)863-08132
Llc. No.: 457554
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: C36, C16, C10, C20 License No.: 45755
Date: 3 Zq11 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
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, 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
Lender's
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 tK37'00
k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Seca 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 370 of the Labor Co 1 shall forthwith
comply with those provisions.
Date:_ � � Applicant:
py .
WARNING: FAILURE TO SECURE WORKERS' COMP
ON 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 tdnter upon- a e
mentioned property for inspection purposes. , / i
r
Date: 3 `� 5 Signature (Applicant or Agent
11V ♦v A1�✓ � i�..�v.VV 1 1�1 � '
SAMB 12:30:00 PM
Contract Plan Types:
l'iw
AMi
CIT Y OF
LA QU'
IN
IA
BBI DING & SAFETY DEFT.
PROVE
FOR CONSTRUCTION
DATE �IBY
DESCRIPTION
FINANCIAL INFORMATION
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 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 forPERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $36.26 $0.00
TOTALS:00
Description: ATTOUN/REPLACE PROPANE GAS LINE BETWEEN HOUSE AND TANK
Type: PLUMBING Subtype: Status: UNDER REVIEW
Applied: 3/4/2015 SKH
Approved:
Parcel No: 774034016 Site Address: 53335 AVENIDA JUAREZ LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 182 Lot: 4
Issued:
UNIT 18
NAME TYPE
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $1,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
PREFERRED AIR CONDITIONING DBA
Details: PLUMBING -REPLACE 28LF OF PROPANE GAS LINE BETWEEN HOUSE AND TANK. 2013 CALIFORNIA BUILDING CODES.
i
CHRONOLOGY
CONDITIONS
'file MAT
NAME TYPE
NAME
ADDRESSI
CITY
STATE ZIP PHONE FAX EMAIL
APPLICANT
PREFERRED AIR CONDITIONING DBA
P O BOX 5120PALM
SPRINGS
CA 92263 (
CONTRACTOR
PREFERRED AIR CONDITIONING DBA
P O BOX 5120
PALM SPRINGS
CA 92263 (
OWNER
CHRISTINE ATTOUN
(
Printed: Wednesday, March 04, 2015 3:04:30 PM 1 of 2
SYSTEMS
DESCRIPTION
ACCOUNT
QTY y
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
GAS SYSTEM, 1-4
101-0000-42401
0
$12.09
$0.00
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$0.00
OUTLETS PC
Total Paid for PLUMBING FEES: $36.26 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
s
PLUMBING FINAL"
BOND INFORMATION
Printed: Wednesday, March 04, 2015 3:04:30 PM 2 of 2 CSYSTEMS
Bib #
Permit.# .
City of La Q'U inta
Building 8t Safety Division
-P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
-Buildink Permit Application and Tracking Sheet
Project Address:`°:: S4 A L
Owner's Name: C 11 R 1371 AW #1770LIW
A. P. Number:'' '
Address: 33335 4V D w �1REz.
Legal DesciiptiR¢ _
City, ST, Zip• LA QuiAf79 CR IA26r 3
rr.0--tir; Conditioning dba
Con efor:.P>^e.ferr'e.c Pluiltbi'n Heatin &Ai
Telephone:
`2C`Ad*.SO
, P5.1
Project Description: %lE /SCE l�ROOAN
City;$':Zp 92263
GAS iwE %gETwEEN O
Telephone.(76Qr).>:863-0832 `1
T/1%1q p hl`dv5C
State Lie... :, :4:7
City Lic. #: 2.2 2 9
Arch,;: Etigr:;Designer; ; '
E t r //u. IL C_ l ri
Address::..
Telephone;.;: ';::".:`:'.•! :.
State,LiF:
E
Construction Type: Occupancy:
Project type (circle one): New Ad&n Alter Repair Demo
Name of,ConacC;.Peo� ,.: t1.0 E
SM i H
Sq. Ft:'
#Stories:
#Units:
Telephone:#'o;Coiitactl3ersqu :760 �l0 3 �0 �.� a
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
# .
`Submittal;•;>`-:.: ''`
.'>Req'd
. Recd
TRACKING i
PERMIT FEES
Plan Check hi titted
Itcn
Amount
Structural:Calfs..
Reviewed, ready for corrections
Plat Check Deposit
Trnss'Calcs. .'
Called Contact Person
Plain Check Balance
Energg al `' :
Plans
Plans Ricked up
Con itruction
Flood plain plan ,
Plans.resubmitted
Me'c innical
Grad[ng pian' '
2"d Review, ready for'correctious/issue
Elec vical
,Subcontaetor List
Called Contact Pergon
Flu bang
Grant Deed .' '
Plans picked up
S.M L
]LO.A..'Approyay.
Plans resubmitted
Gra ling
I11I HOUSE:=
'"' Review, ready for correctionsrssae
Dev toper Impact Fee
Ylsnritrlg Apprbval.
Called Contact Person
.P.
Pub. Appr '
Date of permit issue
School Fccs
Tot PermltFees •