13-0686 (PLBG)P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000686
Property Address: 78095 CORONADOS CIR
APN: 646-210-016-1 -000000-
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2450
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MARIANNE NOUSKAJIAN
7809 CORONADOS CIRCLE
LA QUINTA, CA 92253
(626)818-7123
Contractor:
Applicant: Architect or Engineer: SCHROEDER PLUMBING
54950 CAMINO DEL CIELO CT
`A� J YUCCA VALLEY, CA 92284
(760)401-4240
Lic. No..::873873769
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 Professionals Code, and my License is in full force and effect.
License Class: C36 n License No.: 873769
Dater Contractor/i.
OWNER -BUILDER DECLARATION
it, ereby 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).:
(_ 1 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.).
(_ 1 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.). t
(_ 1 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.I.
Lender's Name:
Lender's Address:
I.QPERI%IIT
VOICE (760) 777-7012
FAX (760),777-7011
INSPECTIONS (760).777-7153
Date: 6/03/13
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.
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 EXEMPT Policy Number EXEMPT
rl 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 C e, I shall for with comply with those provisions.
Date: 3- i Applicant:
�.
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 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 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 coVty ordinances and state laws relating to building construction, and hereby authorize representatives
of this coupty to enter upon the above-mentioned property for inspectio purpo es.
Date: !� ��'3 Signature (Applicant or Agee f
Application Number . . . . . 13-00000686
Permit . . . . . PLUMBING 2013
Additional desc .
Permit Fee 11.92 Plan Check Fee
.00
Issue Date . . Valuation . . .
. 0
Expiration Date 11/30/13
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
11.92
----------------------------------------------------------------------------
Special Notes and Comments
PLUMBING - INSTALL 11OLF OF 1" GAS LINE
TO BBQ AND -FIRE -PIT ONLY. EQUIPMENT
SHALL BE INSTALLED IN ACCORDANCE WITH
MANUFACTURER SPECIFICATIONS. 2010.
CALIFORNIA BUILDING CODE.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
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 91.57 .00 .00
91.57
Grand Total 103.49 .00 .00
103.49
LOPE• RMIT
Bin N
City Of La QUinta
BuOding 8z Safety Division
P.O. Box 1504,78-495 Calle TamplCID
14.Qtdnta, CA 92253 -{760) 777-7012
Building Permit Application and Tracking Sheet
Permit # 14a
Udo
Project Address: 7 j lc;
O� wiier's Name:.
IA. P. Number.Address:%49al
[1(,City,,--ST;Zip:/–,,,,
Description:
con G1 / ? �aDEjZ PC_Gl Mil I U c:,--
Telephone: - �
Address: C3ih i up Cje4o(' %
ty,STZielephone:-%6t�'l--L{ate
rT1
e
�Proje�;Deseription:� l
I ic:_#4��=/�j 7 co City Lic, 0,
- –
O.�
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): Now Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
j " Y—
Estimated Value of Project:-1-wZ ,15–,! 3
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Plan Sets
Req'd
Recd
TRACMG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mccharikal
Grading plan
2" Review, ready for correct-ioramue
Electrical
Subcoutaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Revtew,' ready for correctionLquac
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appy
Date of permit issue
School Fees
Total Permit Fees
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CITY OF IA QUINTA
-7 gO C1,5 GOP�OQADOI5 BUILDING & SAFETY DEPT.
APPROVE® '
LA QU W TA _ESTXT(5. FOR CONSTRUCTION
PRBL14114
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