11-0385 (PLBG)• \r�
-P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO 1 ' FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
. 'BUILDING PERMIT
n o
Date:18/11
Application Number: 11-0 0 0003 85. Owner.
Property Address: 44150 SWEETBUSH LN ABAJIAN MELVIN R APR 0 2011 1� �
APN: -604-081-019=111,-22982 - 44150 SWEETBUSH LANE- �J
Application description: PLUMBING LA QUINTA, CA 92253 �'� t_* ��
Property Zoning: LOW DENSITY RESIDENTIAL f '��e:.itJiA
Application valuation: 979
'Contractor:
Applicant Architect or Engineer: CALIFORNIA DELTA MECHNICAL INC
6052 E.'BASELINE-RD, #155
MESA, At 85206
- (866)692-5273
Lic ., No'.. 811114
-
---- - - - - - -_ -- - -- - - - - -- - - - - - - -- - - - --- .
LICENSED CONTRACTOR'S DECLARATION • . WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I -hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License.Cl ss: B' C10 -C36 - License No.: 811114 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. - -
.Date: 'Contractor: '• _ — 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 .
OWNER -BUILDER DECLARATION insurance carrier and policy number are: -
I hereby affirm under penalty of perjury that lam exempt from the Contractor's State License Law for the :Carrier STATE FUND Policy Number 1697823
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to A_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
_ construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State • and agree that, if.1 should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business:and Professions Code) or 700 of the Labor Code, I sha rttlwit omply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by .. /h)y/(� ,
. any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)•: Date: •' Applicant:
1—) 1, 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 WARNI G: FAILURE SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an ownerofproperty who builds or improves thereon, SUBJECT -AN EMPLOYER TOCRIMINALPENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the'work'himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are.not intended or offered for sale. If, however, the building or improvement is sold within,- SECTION_ 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
' one year of completion, the owner -builder will have.the burden of proving that he or she did not build or
improve for for the purpose of sale.)•_APPLICANT ACKNOWLEDGEMENT,
1, as owner of the property, am exclusively, contracting -with licensed contractors to construct the project (Sec. - IMPORTANT Application is hereby, made to the Director of Building and Safety for a permit. subject to the
7044, Business and Professions Code: The Contractors'.State License Law does notapply to an owner of conditions and restrictions set forth on this application.
' property who builds or improves thereon; and who contracts for the projects with a contractor(s).licensed 1. Each person upon whosebehalf.this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). _ - whose benefit work is performed under or.pursuant to any permit issued as a result of.this application,
. (_) I am exempt under Sec. - , B.&P.C. for this reason -- the owner, and the applicant, each agrees to, and -shall defentl, 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. -
Date: Owner: 2. Any permit issued asa 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 .
CONSTRUCTION LENDING AGENCY permit to cancellation.: - - -
- I hereby affirm under penalty, of perjury that there is a construction lending agency for the performance of the - 1 certify that I have read this application and state that the above information is correct. I agree to comply with all '
work for which this permit is issued (Sec. 3097, Civ. C.). - - city and county ordinances and state laws relating to building co tr�iour
hereby authorize representatives
of this c unty enter upon the above-mentioned property sp es.
Lender's Name: - - -
Data: Signature (Applicant or Agent):
Lender's Address:'(. -
LQPERMIT - ,
Application; Number,_.
11-0000038.5
Permit PLUMBING
Additional .desc
Permit Fee .22.50
- Plan Check
Fee
5.63
Issue.Date
Valuation.
0..
Expiration Date:.' 10/15/11
Qty Unit- Char( -Per
Extension.
BASE
FEE
15.00
1.00. 7.,500.0 EA PLB
WATER HEATER/VENT
7.50
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Special Notes and Comments
' INSTALL NEW 40 GALLON GAS WATER
HEATER.
2 010. CODES : '
-----------------_------------------------------------------.---------
Other Fees
BLDG.STDS ADMIN_(SB1473)
1.00
Fee summary Charged
Paid
-----
,Due
---------------------------'
--
Permit Fee Total 22.50
.00
00
22.50
Plan Check Total •5.63
.00
.00
5.63
Other -Fee Total .. 1.00
.0000
1.00
. Grand Total. .29.13
0.0
.00
29.13 .
LQPERMIT
rresarl five Certificate of COM Ilagce: RealdentSat . WATER IMAM
g
Date: Enfarcararnt Agency: Clime ne # # of Stories
Site Address:
Buildin a Single Familyo Multi Family.
NOTB: This o»n is not to be used fqr N�ul Constructed Brtildln s orAdditiorrs
r,
Cl' -IX -ALT -Water heater ;J
Permit #
• Z aartif' under penalty of pedmy. under the leas of the Strata of Callf mla, the lnfbrmadon provided an this farm is accurate
and wmplate.
• . i certify that the energy featwu and performance specifications idendflad ori this Card.ticate of co nonce conform to the
rt utrements of TIt1e 2 Parts I and 5 of the California Code of la6ona.
Name: Sigaatur
N Q inn A �Rr✓D ►c
Company:
E l i1�1 E ►{ i s
Address•
��� E• � � � R-�� ISS License: S1I l I.`j
City/Stata/Zip: Pbone:
M �2 CAI LITZIS
For assistance oe questions regarding the Energy Standards, contact the Energy Hotline at 1-800-772-3300.
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Din #
City Of ' La Quin ta
Building &r Safety Dtvislon
Pennit # P.O. BOX 1504, 78.495 Calla Tampico
La Qulhra, CA 92253 - (760) 7777012
Building Permit Application and Tracking Sheet
Project Address; mmm�
OwnarlaName: 1-j'AJ)NJ4
A. P. Number: Address:
Lci;al Descrlption: City, ST, Zip; if
F-3
Contractor;
Address: 6Q5S L-5:5— Project De=`Iptio'n;
-�7 I.—
City,ST, Zip:✓ aq
Telephone: g�6 )Z�� --
a,
State Lim hl: City0,301 004
Arch,, Rngr., Designer: - ----------
Addreas,
City. ST, Zip:
Telephone:
Construction *pe: occu'pancy;
Staw Lick #: Projeottypa (0(rcls 008), New Addln Alter pemo
Naino of Contact Perspn: # 0 units.,
Sq
Telephone #of Contact Person: f66 --6 q 135d- Aterl V111116 of PMJeQt L?1 0
APPLICANT. DO NOT WRITE 13ELOW THIS LINE
N Submittal Reqld Reeld TR&CMG PERMIT FM
Plan gots PIRO Check submitted Item Amount
Structural Coles. Reviewed, ready for cgrreetignp Plan Check Deposit
Truss Cciles. Called Contact pirsou Plan Check Balance
—7 11fic 24 Caleg, Plans picked up Construction
Flood plain pion Plans reaubjul'tted Mechanical
Grading plan 2'!Revlewready for corrections/issue Electdcal
-------------
Subcontactur Uat Called Cuntactparaon Plumbing
Grant Deed -Plans oldiad up
H.O.A. AppraVal Plane resubmitted .'Grading
lNRQU8E:- -'l-Rayltiv, ready Por correclions/isque DtiveloperrmplietRee
Planning Approval Called Contnetperson 41P.P.
Pub. Wks, Appr Date orpermlt issue
School Fees
Tow Permitil,,
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