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BPLB2017-012978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: IE INC 4dwQ�rw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT PLUMBING/ BPLB2017-0129 47165 VIA ANTIBES 643160022 POULSEN / WATER SOFTENER / ECOWATER ECR 3700 R30 $6,546.00 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 fcommencing with Section 7000) of Division 3 of the Business'and Professions Code, and my License is in full force and effect. License Class: C55 License No.: 925031 Date 2_0 t, 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 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).: ( 11, 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, 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 Address: VOICE (760) 777-7125 FAX (760) 777 -7011 - INSPECTIONS (760) 7.17-7153 Date: 9/20/201 Owner: RON POULSEN 47165 VIA ANTIBES LA QUINTA, CA 92253 Contractor: YANCHEWSKI & WARDELL ENTERPRISES, INC DB 1351 DISTRIBUTION WAY STE 9 VISTA, CA 92081 (760)754-1960 Llc. No.: 925031 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 oitlae work for which this permit is issued. �.-=ate 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 f. issued. My workers' compensation insurance carrier and policy numberare: Carrier: SENTINEL INSURANCE COMPANY LTD Policy Number: 76WEGRT5551 I certify that in the performance of the work for which this permit is issued, l not employ any person in any manner so as to become subject to the workers' pensation laws of California, and agree that, if I should become subject to the cers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith ply with those provisions. nt:�� 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 3106 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 nct 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 abover mentioned property for.inspection purposes. ��--� Dater Signature(Applicant or Agent): Date: 9/20/2017 Application Number: BPLB2017-0129 Owner: Property Address: 47165 VIA ANTIBES RON POULSEN APN: 643160022. 47165 VIA ANTIBES Application Description: POULSEN / WATER SOFTENER / ECOWATER ECR 3700 R30 . ' LA QUINTA, CA 92253 Property Zoning: Application Valuation: $6,546:00 Applicant: Contractor: IE,INC YANCHEWSKI & WARDELL ENTERPRISES, INC DB 31225 LA BAYA 1351 DISTRIBUTION WAY STE 9 WESTLAKE VILLAGE, CA 91362 VISTA, CA 92081 (760)754-1960 LIc. No.: 925031 Detail: INSTALL ECOWATER ECR 3700 R30 WATER SOFTNER LOCATED IN GARAGE: NO CVWD RESPONSE REGARDING GUIDELINES FOR INSTALLATION. WE WILL APPROVE WATER SOFTNER ON CASE FOR CASE BASIS UNTIL- PROPER RESPONSE 15 GIVEN. PER 2016 CALIFORNIA PLUMBING CODE. G f FINANCIAL AFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS S131473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: •. $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 .0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTYI AMOUNT FIXTURE/TRAP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING FEES: $25.34 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000=43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Bin.# ak of la Quinta . Building 8L Safety Division P.O. Box 1504,78-495 Caile.Tampico 1.4.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 47165 Via Antibes Owner'sName:.Ron Poulsen A. P. Number. AddreSS: 47165 Via Antibes Legal Description: Contractor: Ecowater Systems of San Diego City, ST, Zip. La Quinta, CA 92253 Telephone: 760-564-4193 Address: 1351 Distribution Way Suite 9 Project Description: Install Ecowater ECR 3700 R30 City, ST, Zip: Vista, CA 92081 water softener inside garage Telephone: o s.. P • 760-754-1960 ;:.,,;�;., ;��-- "� State Lic. # : 925031 City Lic M. • Arch., Engr., Designer Address: City., ST, Zip: Telephone: •; Y State Lia #:." ,...rw�� Name of ContactPersoin: Steven Schnierer Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq.Ft.: #Stories: #Units: Telephone # of Contact Person: 818-735-7876 Estimated Value of Project: $6,546.00 APPLICANT: DO NOT WRITE BELOW THIS LINE • 9 Submittal Req'd Recd TRACMG PERMT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Titre 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted Mecharitcal Grading plea 2'a Review, ready for correctioaslissue Electrical Subcontaetor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review, ready for correctionsrissuc Developer Impact Fee Planning Approval Called Contact Person Ad.P.P. Pub.. Wks. Appr Date of permit issue School Fees Total Permit Fees