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12-0273 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000273 Property Address: 78365 VIA CALIENTE APN: 604-203-007-75 -23.971 Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1228 T`t!t 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. license Cl ss: C10 C20 C3 $&dfNo.: 81].114 ate: Co actor: - 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: LQPERMIT Owner: STEPHEN ROBBINS 78365 VIA CALIENTE LA QUINTA, CA 92253 Contractor: fI1i CALIFORNIA DELTA MECf1 6052 E. BASELINE RD, MESA, AZ 85206 (866-)692-5273 Lic. No..: 811114 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/21/12 YI3Qlfs 2 G �� 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 workerscompensation insurance carrier and policy number are: . Carrier STATE FUND Policy Number 1697823-11 _ 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 r3377000 of the Labor Code all forthwith comply with those provisions. aD te:Y djplicant: 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 Director of Building and Safety 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 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 building construction, and hereby authorize representatives of/thm Ji� co y t enter upon the above-mentioned property for i on pu pose J3ate: 'nature (Applicant or Agentl: i LQPERMIT Application Number . . . . . 12-00000273 Permit . . PLUMBING Additional desc.. Permit Fee' 22.50 Plan Check Fee 5.63 Issue Date Valuation 0 Expiration Date 9/17/12 -Qty Unit -Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ----------------------------------------- Special Notes -and Comments ------------------------- ---------- INSTALL NEW 48 GALLON GAS WATER HEATER. 2010 CODES. ------------------ =--------------------- Other Fees --------- -------------------------- BLDG STDS ADMIN (SB1473) -- 1.00 Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee'Total 22.50 .00 .00 22.50 Plan Check Total 5.63 .00 :00 5.63• Other Fee.Total 1.00 .00 .00 1.00 Grand Total 29.13 .00 .00 29.13 I Frascri tine Certificate of Compha ice: ,Residential �4'ater 77og+Yn� CF -1R _4Z T-tiYH Contractor (Doeuraentat'ma Anth.or's mespons3bpe Desi WsDec-- Statement) I aatiPy that this Certificate of Compliance daeummtatiou is accurate �d earnplete, I am eligible uinderDivisiai 3 of the California Business audProfesaious Code to ac res this Certificate of Compliance, ponsfbilirj for the bwldin9 dasigu identie on I certify that the mcrgy features end perp neq speerficalions for building design identified oa this Ccrtificate of Compiieacc confoml to the regntrem= of Title 24, Parra I lad 5 of the Califamia Code of Regulations. TAe ceding design featoass idrntificd on this Certif Bale of CompLianee are consistent with the intbmlatioa provided to doeumera this btnlding design oa the other applicable compliance for t;•or]cgheaty oalcuIafi❑ a en/ef%or a ravai wf ijth this building omit cation. ' Plans and apeeLtxcationa submitted to fJte enforcement Name;, / ' f lJ �/ K alai Signature: C0mPau 'Cafiformia Delta Me apical . Date: 7 2-1 iZ Address:6056 E. 13ssefine--Rd., #155 License- City/State/Zip:Mesa, AZ 85206 p'Do°'868-692-5273 G -�'�� naS!:?2'7n!Ci1.0171D�iOnc�COPn7S 1Vfarch 2010 600/600 'd 9L56-696-ZOL 'ON Xdd AN—IVDINVH03W V113C Wd H:10 HA IOZ/IZAM i Bin CIY Of La QuInta �;o # ✓ v "" �� Building U Safety Dlvislon V Pennit # n P,O. Box 1504, 78-495 Calle Tampico 3toM # V 1 0 QUinta, CA 92253 - (760) 777-7012 �'� a' Sulfding Permit Applfcation and Tracking Sheet Projcct,A,ddx=: / 6 S ICA i �yr?�e, Owner's Name: Y) j A. P. Numbec: Address: Legal Dcscri tion: City ST Zip• 07Z Total permit Ireea 600/ZOO *a 8656-69E-ZOG 'ON M. AN-IVDINVH33W V1 13G Wa K:10 HA/Z IOUIZAM Contractor' Iq �Q f totaphone: Address: ��jr6 ga' /SS' ProjeotDeseription: : City, ST, Zip: � � �� 6 Telephone: -�q2 X66 -52�-3 s=. ^t-- w State Lie. f : I City Lie. Io koo y Arch., Pngr„ Designer, - Address: City., ST, Zip: Telephone: ConstrueAlon e: n'p Occupancy: State Lie. #; Project type (circle one): New P:dd'n Altc` = ,epaic Demo Name of Contact Person. rIIM k _ S4. PL: # Stories: # Units: Telephone #E of Contact Person.: 86 6_6 q Z —,7---f 3 $stimaYed Value of Pmject- APPLICANT: DO NOT WIJITrz BELOW THIS LINT; # submittal ReVd . Reed CXtA CI�1G YEitivtX7C lP�S Plnn acts Flan Check submitted Item Amount Structural Cates. Revt—ed,ready. for eorreetlons Rlan Check Deposit Truss Cales, Called ContactForson RlanChecicl3ylanee Title 24 Cake. plans picked up Constructlon Blood plain plan plans resubmitted Mechanical Grading plan 2"" Rentew, ready for corrections/Issue Electrleal Subcontactor List C41ied ContaetPerson Rlurnbing Grant Deed Plana likked up SAA. H.0 ,L Approval plans resubmitted Grading YI\t FIOUSX: - Reylow, ready for correelions/issue Developer Impact Fee Piartnfno Approval Called ConteetPerson Pub, Wks, Appr Date of permit issue Schodl Bees Total permit Ireea 600/ZOO *a 8656-69E-ZOG 'ON M. AN-IVDINVH33W V1 13G Wa K:10 HA/Z IOUIZAM