BMCH2014-106478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BMCH2O14-1064
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address:
80425 TORREON WAY
Owner:
APN:
777330059
MWH INV
Application Description:
REPLACE (1) COMPLETE SYSTEM
22315 WHITE PEAKS DR
Property Zoning:
BEND, OR 92253
Application Valuation:
$8,400.00
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Applicant:
MASTER TECH MECHANICAL INC
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6742 GALVESTON PLACE
ALTA LOMA, CA 91701
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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.: 739284
Dom- Contractor:
4511,
/ 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).:
(_J 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 Name:
Lender's Addre!
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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.
69s1 1' 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 perm t
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 issues, 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 forthwitl-
comply with those provisions.
Date , _ �� Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFU_,
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 COD[,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT:Appfication is hereby made to the Building Official for a permit subject t7
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, a ad
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, a -1d
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 o
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 ente uponthe above-
mentioned property for inspection purposes.
Date:/mss/ :3 w / Signature (Applicant or Agen
Date: 9/3/2014
Owner:
MWH INV
22315 WHITE PEAKS DR
BEND, OR 92253
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Contractor:
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MASTER TECH MECHANICAL IN
6742 GALVESTON PLACE
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ALTA LOMA, CA 91701
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(909)466-6540
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Llc. No.: 739284
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.
69s1 1' 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 perm t
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 issues, 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 forthwitl-
comply with those provisions.
Date , _ �� Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFU_,
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 COD[,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT:Appfication is hereby made to the Building Official for a permit subject t7
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, a ad
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, a -1d
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 o
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 ente uponthe above-
mentioned property for inspection purposes.
Date:/mss/ :3 w / Signature (Applicant or Agen
. SCRIPTION.T-
FINANCIAL INFORM.
; '-ACCOUNT
`.QTY3
, AMOUNT
+'a:' PAID, '`'.'
ION
BSAS SB1473 FEE
. SCRIPTION.T-
FINANCIAL INFORM.
; '-ACCOUNT
`.QTY3
, AMOUNT
+'a:' PAID, '`'.'
'.PAID DAT=:
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00''
' PAID,BY r
k
'' `' METHOD`
RECEIPT # ,
CHECK # - =`
CLTD BY;
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
' DESCRIPTION « r
_z :�:.: ACCOUNT t '` r I'�
QTY
_a o 'AMOUNT..
�� -PAID'
PAID DAT=
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$71.50
$0.00
.,. -
r • . 7. :' PAID BY =:. ,
�{ METHOD T'
_
•� RECEIPT#`
CHECK#
CCTD BY-.,
.".DESCRIPTION - • °.
`'s ~ACCOUNT
QTY
AMOUNT °- wt
'- PAID
.PAID.DAT='
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$35.75
$0.00
y `* "PAID BY °`'';
4 x '� METHOOD r 4: fi
z �"` ''RECEIPT #
CHECK # k -.,'
CLTD BYv
Total Paid forCHANGEOUT: $107.25 $0.00
=r�,'r DESCRIPTIONS
.� .. �. ",
', y '. ACCO' NT i
QTY
t� 'AMOUNT,,:
:.
j }. PAID { c "
zPAID DATE-
PERMIT ISSUANCE
101-0000-42404
0
$90.57
.$0.00
•
4 >pti PAID BY'
a
METHOD " i`
-!
` ' _RECEIPT #
:';CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 4 $0.00
TOTALS:00
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Descriptio6: REPLACE (1) COMPLETE SYSTEM
CONDITIONS
Type: MECHANICAL Subtype:
Status: SUBMITTED
CONTACTS
Applied: 9/3/2014 SKH
App�rovecl:
Parcel No: 777330059.., -Site Address: W425 TORREON WAYLA QUINTACA.92253
Subdivision: TR 31349Block:
Lot: 143
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Issued.:
City -
STATE
Val�abon: ;8,400.00 Occupancy Type:
Construction Type:
AIL
Expired:
No. Buildings: 0 No. Stories: 0,
No. Unites: 0 -
Details: H VACCHAN GE OUT - 13SEER/78AFUE SPLIT SYSTEM [2013 ENERGY] CA RBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
v�
City -
STATE
IIRIN
FAX
AIL
APPLICANT
MASTER TECH MECHANICAL INC
6742 GALVESTON
ALTA LOMA
CA
91701
GLEN@MASTERTECH.BI
PLACE
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CONTRACTOR
MASTER TECH MECHANICAL INC
6742 GALVESTON
ALTA LOMA
CA
91701
GLEN@ MASTERTECH.Bl
PLACE
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OWNER
MWH INV
22315 WHITE PEAKS DR
BEND
OR
92253
' . .
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- Phn�ed�vvedn ' September'0�ZO144�Z�3 zof2 _ ' -"
�. . . . �—___--_---_ '
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, September 03, 2014 4:32:43 PM 2 of 2 c
SYSTEMS
CLTD
DESCRIPTION N , 4.
:
ACCOUNT'- ..
CITY
AMOUNT,
PAID
'PAID DATE
RECEIPT #
CHECK #
'METHOD,.
PAID BY �`
BY
BSAS SB1473 FEE
101=0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$71.50
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0.
$35.75
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $107.25 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
Total Paid for PERMIT ISSUANCE: $90.57 $0.00 j
• o 00
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Wednesday, September 03, 2014 4:32:43 PM 2 of 2 c
SYSTEMS
Bin #
Permit #
Project Address: 901,-25"' • To
City of LQ Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico . .
La Quints,CA 92253 - (760) 777.7012
Building Permit Application and Tracking Sheet
Owner's Name: c n v
A. P. Number: . •
Address:
Ya o
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address: y
Project.Description:
City, Zip:
Zi . (fa ell %0
Telephone: 0 9- We-
ii Yii :i:
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Q��
State Lic. #: 3 . ! 02
City Lie.: #.:::
Arch., Engr, Designer: "
Address:
City., ST,'Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person:
Sq. Ft.:.
#Stories:
#Units:
Telephone #,of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACHING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance,
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrcctionsrissue
Electrical
Subcontactor List
'1
Called Contact Person
Plumbing
Grant Decd
Plans picked"up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrcctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
.:
Total Permit Fees