BPLB2014-104378-495 CALLE`TAMPICO
D 4v VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/1/2014
Application Number: BPLB2014-1043 Owner:
Property Address: 79200 NUEVO DR STEPHEN SHARPE
APN: 604263023 8490 WEAVER CRES
Application Description: REPLACE (1) 40 GALLON GAS MISSION BC CANADA V2V, R3 92253 z
Property Zoning: c�
Application Valuation: $1,200.00 N i
Applicant: Contractor: 'a w
a
HARRISON ENTERPRISES INC DBA G HARRISON ENTERPRISES INC DBA ® 0 0
31-170 RESERVE DRIVE STE A 31-170 RESERVE DRIVE STE A lu _� o
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276 v>=
z
(760)343-7488
Llc. No.: 686310 ,
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: C20 License No.: 686310
Date: 1 )`# Contractor: S n �Ce_
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.).
(_J 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
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 Code, I shall forthwith
comply with those provisions.
P
Date: ) > >� Applicant: a
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 orpursuant 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 to enter upon the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
DESCRIPTION '
FINANCIAL INFORMATION
�- ACCOUNT QTY
AM
., UN '- PAID
O T
PAID DATE
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $0.00
>tPAID BY • „ -
H " _METHOD = " RECEIPT # CHECK #
CLTD BY `
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1:00 $0.00
r 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
DESCRIPTION .
ACCOUNT
QTY
AMOUNT
2 -.PAID
PAID DATE:
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
PAID BY",,'METHOD-
-• „'RECEIPT#
CHECK #' `
CLTD BYµ'
I - -DESCRIPTION . Y` ' -
ACCOUNT
QTY
;'AMOUNT
:' PAID
PAID DATE
WATER HEATER/VENT PC
101-0000-42600
0-
$7.25
$0.00
.
PAID BY r -
- METHOD,'
RECEIPT #.
•
CHECK # ' : -
CLTD BY_
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:• •-
Description: REPLACE (1) 40 GALLON GAS
Type: PLUMBING
Subtype:
Status: SUBMITTED
Applied: 12/1/2014 SKH
Approved:
Parcel No: 604263023 Site Address: 79200 NUEVO DR LA QUINTA,CA 92253
Subdivision: TR 23913
Block:
Lot: 8
CONTACTS
Issued: "
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
t
VAMEr:t;; ��r
Finaled:
Valuation: $1,200.00
Occupancy Type:
Construction Type:
'T" "PHONEi
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
,a,
f..r
Details:
-' -,4S'..
-
CONDITIONS
CONTACTS
t
VAMEr:t;; ��r
"ADDRESSl' r:.s
=:CITY
"STATE
S �N
ZIP'
'T" "PHONEi
FAX
'""'ENTAIL
�i....r_-.i' --
S l._n. - ili �,.� .. - . ayA:': .'.. �:. t -' •.
,a,
f..r
-' -,4S'..
.l.!
J f!
APPLICANT
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
"
'
STE A
PALMS
CONTRACTOR
HARRISON ENTERPRISES INC DBA G
31-170 RESERVE DRIVE
THOUSAND
CA
92276
STE A
PALMS
OWNER
STEPHEN SHARPE
8490 WEAVER CRES
MISSION BC
R3
92253
CANADA V2V
FINANCIAL INFORMATION
Printed: Monday, December 01, 2014 2:10:05 PM 1 of 2 C
- SYSTEMS
DESCRIPTION"` t '
.7777
ACCOUNT
QTY
AMOUNT
PAID`•
PAID '
DATE
RECEIPT
CHECK
METHOD
ID BY
PA -
,
CLTD
BY'
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
- $1.00 $0.00
BSA:
PERMIT ISSUANCE
101-0000-42404
1 0
1 $91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
WATER HEATER/VENT
101-0000-42401
0
$12.09
$0.00
WATER HEATER/VENT
101-0000-42600
0
$7.25
$0.00
PC
Total Paid for PLUMBING FEES: $19.34 $0.00
TOTALS:00
ATTACHMENTS
Printed: Monday, December 01, 2014 2:10:05 PM 2 of 2 C§F
SYSTEMS
INSPECTIONS
DU- LED
SCH E
Da ,4
E S "u
RESU?
OJ�REMARKSSE
-COMPLETED
�Q.' FI,. 2+t�i ,S f •f _ � . r A
DATE' DATE'
7NS ?a
y c
PLUMBING FINAL"
ATTACHMENTS
Printed: Monday, December 01, 2014 2:10:05 PM 2 of 2 C§F
SYSTEMS
' Bin #
`
City of La QUinta
Building St Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
NL???01 +' )01f
Project Address: 200
Owner's Name: N.r ]PC-
eA.
A.P. Number:
Address: 7 q ZOC>N V e -v o 'br
Legal Description:
City, ST, Zip: L CA 27-. ;3
Contractor:Tele
hone: j — 'Zy
Address: 311%0 �e
Project Description:
City, ST, Zip: '�
1h0�sa e� .AtZz-7e
;�e, 1c:Lc-< yO Gc,M
Telephone:.
... .......:...............:..
State Lie. # : 6863 1 U
City Lie. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
:.: � •'�`-
'Construction Type: Occupancy:
Project type (circle one): New Add,n Alter Repair Demo
State Lie. #:
;:�:r ::< :r;K>xziriz;. ><4>:r•;::s?:
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone #,of Contact Person:
Estimated Value of Project: C'r-7
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Rcq'd Iced TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
'Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrcctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctionsi;ssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Prt scri tive Certificate of Compliance: Residential Water Heating CF -IR -ALT -WH
general Information
Site Address: 'Z
QQO 'N U eve Climate Zone: Date: 1Z ],I"
NOTE: Thisorm is only used or alteration or addition of water heating systems.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydropic space heating. Individual dwelling DHW
heaters must be gas or propane fired, and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the
kitchen(s) and on all underground hot water pipes is required in all component packages in all climate zones.
Energy Factor or
Water Heater Type / Distribution Type Number of Tank Capacity Thermal External Tank
Fuel Type' (Standard)' System al Efficiency Insulation R-Value3
Sko .59 $
1. Indicate Type (Storage Gas, Heat Pump, Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of 150(n). The Prescriptive requirements do
not allow the installation of a recirculating water heating system for sinele dwelling units.
3. The water heating tank and pipes shall be insulated to meet the requirements of 1506).
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name: `
���
Signature: ---
�
GY4r
Z�
Company: /, /�
l7�er0.� Air 1.
Date:
Address:
31170 � cse-rv� 1b. e-
License:
686310
City/State/Zip: •--
1hOusGv,d, 1 G•�mS CA gZZ"7<.
Phone:
7(20-3y3-7qa
2008 Residential Compliance Forms March 2010