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BMCH2016-0405 (2)78-495 CALLE TAMPICO t4 . LA gUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2016-0405 Owner: Property Address: 44385 E SUNDOWN CREST DR RICHARD CURRIER APN: 604110016 747 W TAFT AVE Application Description: HVAC CHANGEOUT/ 14 SEER HEAT PUMP AND AIR HANDLER ORANGE, CA 92253 Property Zoning: Application Valuation:' $7,300.00 Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153, Date: 11/7/2016 Contractor: COMFORT AIR 4803 E SUNNY DUNES RD PALM SPRINGS, CA 92264 (760)320-5800 Llc. No.'AEC343 • -----------------------------------------------------------------------------------=--------- 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: _ License No.: AEC343 s � (Date; lkbk, . `ontractor:L 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.S.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 Ghe 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 tJ 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: 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 t ork 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: _ Policy Number: _ I certify that in the performance of the work for which this permit is issued, l 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 3700 of the Labor Code, 1 shall forthwith comply with those provisions. . Date: I1 % 1 pplicant: 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. 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 this city to enter upon the above-mentioned property for inspection purposes. Date: ILo Signature (Applicant or Agent): f t Date: 11/7/2016 • Application Number: BMCk2O1&0405 Owner: Propev Ad`dress`.` 44385 E SUNDOWN CREST DR RICHARD CURRIER APN: 604110016 747 W TAFT AVE Application Description: HVACtHANGEOUT/ 14 SEER HEAT PUMP AND AIR HANDLER ORANGE, CA 92253 Property Zoning: Application Valuation: " $7,300.00 ' Applicant: Contractor: IE INC COMFORT AIR 31225 LA BAYA 4803 E SUNNY DUNES RD WESTLAKE VILLAGE, CA 91362 PALM SPRINGS, CA 92264 (760)320-5800.. Llc. No.: AEC343 Detail: HVAC CHANGE OUT- 14 SEER 3 TON HEAT PUMP, AIR HANDLER, AND CONDENSER [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.