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BPLB2017-0103O�i aw. 78-495 CALLE TAMPICO C� D LA QUINTA, CALIFORNIA 92253 " DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2017-0103 Property Address: 79425 STONEGATE APN: 776040013 Application Description: JONES RESIDENCE / HOT WATER HEATER CHANGE OUT Property Zoning: . Application Valuation: $2,885.00 Applicant: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE THOUSAND PALMS, CA"92276 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, C36 License No.: 686310 Date: 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).: (� 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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/1/2017 Owner: DAVE & JULIE JONES 79425 STONEGATE LA QUINTA, CA 92253 Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 LIc. No.: 686310 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. 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 insurance carrier and policy number are: Carrier: INSURANCE COMPANY OF THE WEST . Policy Number: WS05031658 I certify that in the performance of the work for which this permit is issued, I I 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 kers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwitk ply with those provisions. Date: 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 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, znd 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 builc5ng construction, and hereby authorize representatives of.this city to enter upon the above-mentioned property for inspection purposes. Date: Signature (Applicant or Agent): W Date: 8/1/2017. Application Number: BPLB2017-0103 Owner: Property Address: .79425 STONEGATE DAVE & JULIE JONES APN: 776040013 79425 STONEGATE Application Description:. JONES RESIDENCE / HOT WATER HEATER CHANGE OUT LA QUINTA, CA 92253 Property Zoning: Application Valuation: $2,885.00 Applicant: Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276 (760)343-7488 Llc. No.: 686310 Detail: 50 GALLON WATER HEATER CHANGE,OUT [GAS] - CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 2016 CALIFORNIA BUILDING CODES FINANCIALIN FORMATION 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 Credit Card Fee 101=0000-43505 0 $2.21 Total Paid for Credit Card Fee: $2.21 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 101-0000-42600 0 $7.60 Total Paid for PLUMBING FEES: $20.27 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 . Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 A TOTALS.