The URL can be used to link to this page

BPLB2016-0101Applicant: A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 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 a rof ons Code and my License is in full force and effect. License Class: C36, C42r.,A License No.: 765155 ate M Y 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: Q ALLEN SHAPTERFFIUL 92253 2 g 2015 CITYQFLA QUINTA" COMMUNiW D -'VE' CP1,4_pITDEP9RP.iEM Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C 96S RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 (901)271-9700 Llc. No.: 765155 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. �� 1 have and will maintain workers' compensation insurance, as required by Section 3r100 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: LIBERTY INSURANCE CORPORATION Policy Number: WC7631508631 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 workers' compensation laws of California, and agree that, if I should beco ubje workers' compensation provisions of Section 3700 of the L Cod fo comply with thoje provisions. 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, 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above informatio rre I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws rel b ' g the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to e r on above-mentioned property for inspection purposes. Lender's Name: Dates + Signature (Applicant or A Lender's Address:"' �Ntili�Cl/ 78-495 CALLE TAMPICO V LA QUINTA, CALIFORNIA 92253 DESIGN && DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2016-0101 Property Address: 44296.W SUNDOWN CREST DR APN: 604110066 Application Description: GUY SHATTER / REPLACE WATER SERVICE Property Zoning: Application Valuation: $5,130.00 Applicant: A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 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 a rof ons Code and my License is in full force and effect. License Class: C36, C42r.,A License No.: 765155 ate M Y 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: Q ALLEN SHAPTERFFIUL 92253 2 g 2015 CITYQFLA QUINTA" COMMUNiW D -'VE' CP1,4_pITDEP9RP.iEM Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C 96S RIDGE LAKE BLVD SUITE 201 MEMPHIS, TN 38120 (901)271-9700 Llc. No.: 765155 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. �� 1 have and will maintain workers' compensation insurance, as required by Section 3r100 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: LIBERTY INSURANCE CORPORATION Policy Number: WC7631508631 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 workers' compensation laws of California, and agree that, if I should beco ubje workers' compensation provisions of Section 3700 of the L Cod fo comply with thoje provisions. 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, 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above informatio rre I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws rel b ' g the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to e r on above-mentioned property for inspection purposes. Lender's Name: Dates + Signature (Applicant or A Lender's Address:"' Date: 7/28/2016 ' Application Number: BPLB2016-0101 Owner: Property Address: 44296 W SUNDOWN CREST DR ALLEN SHAPTER APN: 604110066 Application Description: GUY SHATTER / REPLACE WATER SERVICE 92253 Property Zoning: Application Valuation: $5,130.00 Applicant: Contractor: A R S AMERICAN RESIDENTIAL SERVICES OF C A R S AMERICAN RESIDENTIAL SERVICES OF C 965 RIDGE LAKE BLVD SUITE 201 965 RIDGE LAKE BLVD SUITE -201 MEMPHIS, TN 38120 MEMPHIS, TN 38120 (901)271-9700 Llc. No.: 765155 Detail: 30 FT OF 1 INCH WATER LINE. 2013 CALIFORNIA BUILDING CODES. `i INANCIALINFORMATION'. 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 $91.85 Total Paid for PERMIT ISSUANCE: $91.85 DESCRIPTION ACCOUNT' QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 DESCRIPTION. ACCOUNT QTY AMOUNT V WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 Description: GUY SHATTER / REPLACE WATER SERVICE _ Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 7/28/2016 RSE Approved: Parcel No: 604110066 Site Address: 44296 W SUNDOWN CREST DR LA QUINTA,CA 92253 Subdivision:,TR 19903 Block: Lot: 102' Issued: Lot Sq Ft: 0 Building Sq Ft: 0 ' Zoning: Finaled: Valuation: $5,130.00 ` Occupancy Type: Construction Type: Expired: ~ No. Buildings: 0 . No. Stories: 0 No. Unites: 0 CONDITIONS Details: 30 FT OF 1 INCH WATER LINE. 2013 CALIFORNIA. BUILDING CODES. , CONTRACTOR, A R'S AMERICAN RESIDENTIAL 965 RIDGE LAKE BLVD MEMPHIS TN 38120 ANALLEN@ARS.COM SERVICES OF C SUITE 201 OWNER ALLEN SHAPTER 92.253 ` FINANCIAL INFORM TION' Printed: Thursday, July 28, 2016 11:24:16 AM 1 of 2 ' - SYSTFAAS 4l 411' .'l• 1 ;" it 11'11, Itl I.. ll�Uff .1. 1 V..'��,1 i��; i'A'1F 1V' �,,,,anr�lNa ....: '... " �. -. _ .. � h _ ",,,�,;fi I`� r�f��'1 i� y .�� 1.. e< , ...... -IN i7i 117 CONDITIONS - '�i i�i�� ii�� i " 151TACTS° d. , .. . CONTRACTOR, A R'S AMERICAN RESIDENTIAL 965 RIDGE LAKE BLVD MEMPHIS TN 38120 ANALLEN@ARS.COM SERVICES OF C SUITE 201 OWNER ALLEN SHAPTER 92.253 ` FINANCIAL INFORM TION' Printed: Thursday, July 28, 2016 11:24:16 AM 1 of 2 ' - SYSTFAAS DESCRIPTION ACCOUNT4 UU I AU). ?111OU3 V3 DATE, XECEIPT#A.,, 4CK " - "METHOD' CLTD` ,QTY J-, PARENT PROJECTS Vis; .......... .. .. ...... . ..RETURNED,';STATUS, ,' FEMA(�j, I REVIEW TYPE::. REVIEWER 81060.0831 TE A R S AMERICAN . BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 7/28/16 R17462 1 CHECK RESIDENTIAL SER RSE Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: PERMIT.ISSUAN CE 101-0000-4240 4 0 $91.85 $91.85 - 28/16 7/ R1 74U' 81060 0831 CHECK S AMERICAN* RSE, 1 RESIDENTIAL SER Total Paid for PERMIT ISSUANCE:, $91.85 $91.85 WATER SYSTEM 101-0000-42401 0 $12.09 $12.69 7/28/16 R17462 810600831 CHECK A R S AMERICAN "RSE INST/ALT/REP 1 RESIDENTIAL SER WATER SYSTEM 101-0000-42600 0 $12.09 $12.09 7/28/16 R17462 810600831 CHECK A R S AMERICAN RSE INST/ALT/REP PC RESIDENTIAL SER Total Paid for PLUMBING FEES: $24.18 $24.18 Printed: Thursday, July 28, 2016 11:24:16 AM 2 of 2 cmwlysrrms UU I AU). ?111OU3 V3 PARENT PROJECTS Vis; .......... .. .. ...... . ..RETURNED,';STATUS, ,' FEMA(�j, I REVIEW TYPE::. REVIEWER 4. E TE D NOTES 4 F . ............ . Printed: Thursday, July 28, 2016 11:24:16 AM 2 of 2 cmwlysrrms BIR #' City. O • La Quinta Building a Safety Division P.O. Box 1504,78-495 Calle Tampico ta.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application' and Tracking Sheet Permit # Project Address: H 41�6( W sAftvo — Owner's Name: . A. P. Number. Address: C4 4aefc0 Legal Description: City, ST, Zip: Contractors • CU2. � Telephone: 7 �'% ys� ..>� ;�.�..�<'�' '>`s•;,.:y . Address: S ,O yi Project Description: City, ST, Zip: � ( Cl/Q i e G �� ' t� � r J c c� Telephone: State Lic. # : %(�5 (�s City Lie. #: Arch., Engr., Designer-, Address: City., ST, Zip: Telephone: P Y� � ; • „ State Lie. #: ;y' Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: ?j CD. APPLICANT: DO NOT WRITE BELOW THIS LINE p Submittal Req'd 'Rec'd TRACKING PERMTFFEES Plan Sets Plan Check submitted.item Amount Strgctural Cales. Reviewed, ready for corrections Plan Check Deposit. . Trun Calcs. . Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2id Review, ready for correctiomfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O-A. Approval Plans resubmitted Grading IN HOUSE:. 20 Review; ready for correctionsAnue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr - Date of permit issue School Fees - Total Permit Fees