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.