Loading...
13-0880 (PLBG)=tv P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000880 Property Address: 53310 AVENIDA NAVARRO APN: 774-095-003-22 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 2900' Applicant: Architect or Engineer: 4 BUILDING &-SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter,9 (commencing with Section 7000) of Division 3 of the ss and Professionals Code, and License is in full force and effect. License Clayss: C21 C42 Lic se 82180 GDatel5 f fZW Contractor O NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I a xempt 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):: 1 _ I 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.). , ( 1 I am exempt under Sec. - , BAP.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: LQPERMIT Owner: DONAL KARASEVICZ 53310"AVENIDA NAVARRO LA QUINTA, CA 92253 (310)376-7621 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/15/13 Contractor: D ALMS UNDERGROUND CONST, I 38703 VISTA DRIVE JUL• '15 2013 CATHEDRAL CITY, CA 92234 (760) 324-1911 C'TMOF LiC. No.: 482180 Iets....AQVINTA --————————————————————————————————————————————— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 BARRET BUS SRVC Policy Number 2246 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, ' should become subject to the workers' compensation provisions of Section - 3700ofthe La e, I shall fortwith comply with ho rovisions. ,,Date/ gr�` /Applican • • WARNING:" FAILURE TO SECURE WORKER 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 Director of Building and Safety 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 shalldefend, 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. certify that I have read this application and state thhe above information is correct. I agree to comply with all city and county ordinances and state laws relating t buc Ing construction, and hereby auth iz presentatives of this county to enterr upon the above-mentioned pr or inspectio urpose Date/ r { Signature (Applicant or Agent Application Number . . . 13-00000880 Permit PLUMBING 2013 Additional desc . Permit Fee . . . . 11.92 Plan Check Fee :0.0 Issue Date Valuation 0 Expiration Date 1/11/14 Qty Unit Charge Per Extension 1.00 11.9200 EA • PLBG BUILDING SEWER' 11.92 Special NoteE and Commantc SEPTIC ABANDON SEWER CONNECT. 2010 CALIFORNIA BUILDING CODES. -------------------------------------------------- Other Fees . ... . . . . BLDG STDS ADMIN, (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 - PLAN CHECK, PLUMBING 11.92 Fee summary Charged" Paid Credited Due Permit Fee Total 11.92 .00• .00 11.92 Plan Check Total .00 _ .00 .00 .00 - Other Fee Total 103.49 .00 .00 103.49 Grand Total 115.41 .00 .00 115.41 LQPERMIT Bin #. ity of LQ Qu►ntd Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �j Project Address: 533/0 v e , / YAv a rir6 Owner's Name: -,D4. A J'<a 170- S e A. P. Number: Address: S 3 3 / l7 Ave— ve-Legal LegalDescription: City, ST, Zip: L - Contractor: I m S VL 11 d r s✓o K e u � �-ons`f' Telephone: 3 /0 - .374% 76' 2 / c e - f ` Address: Project Description: 0 K e.:�ti D ti City, ST, Zip: CKEd r,0 Ct CiA . 9 223 V -Telephone: e h ne 7 Y P 0 3 / j... State Lic. # :� L ,Z I �j City.Lic. #•: %� 9 Arch., Engr., Designer: Address: City., ST, Zip: Telephone: Construction Type: Occupancy: a St to Lic. # rProJect type (circle one • New Add'n +.lterRe aiDemo Name of Contact Person: v L4 41 A 1 �" s Sq. Ft.:#Stories: #Units: Telephone # of Contact Person: 760 � 578b - /5/(D ce Estimated Value of Project: 14�2 9 00 . APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Ballance. Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for corrections/issue Developer Imp act Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees LTota Permit Fees