BPLB2016-0133%8-49S CALLE TAMPICO D VOICE (760) 777-7125 .
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/29/2016
Application Number:
BPLB2016-0133
Owner:
Property Address:
79280 SIERRA VISTA
LUIS ROBERTO ALONZO
APN:
604440028
79280 SIERRA VISTA
Application Description:
ALONZO /CHANGE OUT (1) WATER HEATER
LA QUINTA, CA 92253
Oj
Property Zoning:
Z
Application Valuation:
$1,480.00
Q
Applicant:
Contractor:
TOMMY ROOTER PLUMBING
INC
TOMMY ROOTER PLUMBING INC O T 6"
b
80975 INDIO BLVD #B9
80975 INDIO BLVD #B9
a
INDIO, CA 92201
INDIO, CA 92201
z C NJ
—I Z cz)�
C_ -3
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(760)574-4444
Llc. No.: 930133
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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 /Clasr/s:��C36 License No.: 930133
Dat:-'"t-05� �� Contrac9of: ��
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.).
(_) 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
ef'T"ork for which this permit is issued.
I"have and will maintain workers' compensation insurance, as required by
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: NORGUARD INSURANCE COMPANY Policy Number: TOWC765159
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.
11
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 Building Official for a permit subject tc.
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, an J
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 buildirig
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Dat ab r� Signature (Applicant or Agent) "
Rl C -Q A
Date: 11/29/2016
Application Number: • BPLB2016-0133
Owner:
Property Address: 79280 SIERRA VISTA
LUIS ROBERTO ALONZO
APN: 604440028
79280 SIERRA VISTA
Application Description: ALONZO / CHANGE OUT (1) WATER HEATER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,480.00
Applicant:
Contractor:
TOMMY ROOTER PLUMBING INC
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #89
80975 INDIO BLVD #J139
INDIO, CA 92201
INDIO, CA 92201
(760)574-4444
Lic. No.: 930133
Detail: WATER HEATER CHANGE OUT- 50GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO.FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT QTY AMOUNT
BSAS SB1473 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
QTY
AMOUNT
WATER HEATER/VENT
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-426000
$7.60
Total Paid for PLUMBING FEES: $20.27
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rf rinucanra do not dUwthe lrwralWrnnofa:secirrulating'ware><h�o $ "fav for. jingle dwVIMi:•torlr�, . ;.
3: 7'hrtcte�rtc waMr•heart ..rank.aad i shall be Insulated to hirer Jh rotwn i o' • IS
ntractat or Homegwgar (Documentation Autbor's/Reaposwible BuMng DmjMti #il.
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• '1 cc lfP !6t this Ccdfic�a of Complianceewuinentation is nc¢itrki in&Vdinpletew
•..f.4tunf egiObie .undec. Divisiort. 3 9f ,the Colforn1w Business and Professions Code to accept responsibility for the' bu441tig design
ideiiMi .oa this Cadfigate of Compliance..
•...I cet �l :that. te.enerj;y foatures:artd perfom ince SpeciPfcat�ons'Priretie`iniililiitg design Identified oti this' Ceitificaie of gPnp�lancx
nfoiTfilo the requirements of Title 74, Pon and hof iit6Ciitifotltta:Code of'Itegulativns:_..._.. :.: °_"
Thelitti1ding:duslg'Wfoslltte writmed consim6t with tiie i pi drd•td itoc(fitie this
Wfidittg f�esign on the oVWr-;ppHcabie complimwe--form,—worlwheats, calcut2tions,'pi3ns .and .specificat#Pra sum! -io the
eitfoflrrftiottt a enc. >.tbs.p rovaE with this buildiall perivIt icatian.
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V Quirk. CA 92233 - (960) 777-7012
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Building Permit Application and Trackln$ Sheet
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APKICANT; Do N07: MME BROW THIS LINE '
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Amount
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Pub. wiq Appy
Date of pt mit Isue
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PLUM.BING WORK ORDERANVOICE
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❑ WARRANTY
D 5 Day O f Yeas
O 3 MorAh- 0 --NO
❑ 6ldordh
WARRANTY CALLS
AAE SCHEDULED
FROMM-FOAM-6PU .
InhIaL4
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02.
TOTAL MATERIALS
TOTAL LABOR
❑ CASH ❑ CC. O BILL JOCHECK
❑X
MS
go
61:7
50
ME
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TOMMY K4 R'� �j
HELPING THE D ERT �i�n��"
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80975 Indio IBfvd., AB9 AuthlSVS-ayg
Indio, CA922O1
760-574-4444 in
Fax 760-444-2717 f
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TO OUR CUSTOM M SeRte men are required to hare sulk slips read
DRAIN CLEANING
Tt3Is is done In order la pr*U you, the wttriot m% and mrselvas and to
enable us to ghee W r ahsdute satifttxy service, You are fespeclfufty
tequesled to erarrima materla! and labor statement before -wort men lean
ADEA FOOTAGE
ADD'L FIXTURES O
PURABING LABOR
the jab, and If you End eteT)Nrq sa%aclnry, stray tins Wxt. If se>(ue Is
ansatsfamy, In any way. dm Mone our office Immedlatety.
A PBUIETY WW. 9E GRA9001 AT TIS RATE OF I ta% IM IAO1iIIf ON
PARTS
UNPAIDBALAtiBESAFTHi30DAYS O.FWRICEDATE, PJ84UALPERCENWE
PRODU03 fREAT7AENT
VIDED INSPECTION
RATE 11896 RETURNM CEKK FEE $15KINIL
find the time and meteM charged above salisfactory and agree to pay
HYDROJETTER
WM JETTER
!a same on pfesemta6on of invoice, and lurther agree Io pay reasonable
UNDLEAALOGATION
,
cbargedforcotecionlncludIngatwwysfees iIbeeverdolmydefaaD.
"NOTICE TO OW MW (Sodlom •70113-Cwtmekra Llcenee Lew) ung nw
PUfAPSEPTPMREASE
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OTHER
TAX
—TOTAL
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IENT RECEIVED
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YMOaDEFEDaC s+�fATlifa DATE
PAYMENT DUE
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