BPLB2016-0315VOICE (760) 777-7125
78-495 CALLE TAMPICO C] 0 V
1 FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/2/2016
Application Number: BPLB2016-0135 Owner:
Property Address: 43245 PARKWAY ESPLANADE W BRIAN CARIS
APN: 609610071 43245 PARKWAY ESPLANADE %P2
Application Description: CARIS / CHANGE OUT (1) 50 GALLON GAS WATER HEATER LA QUINTA, CA 92253 Z
Property Zoning: a
Application Valuation: $1,635.00 _n
rn
Applicant: Contractor: rm— TO __70
TOMMY ROOTER PLUMBING INC TOMMY ROOTER PLUMBINA �
80975 INDIO BLVD #B9 80975 INDIO BLVD #B9 c
INDIO, CA 92201 INDIO, CA 92201 —1 o
1=1rn v pay
(760)574-4444 �1
LIc. No.: 930133
m
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.: 930133
Dite: //� � Contracto \
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:
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 orkfor which this permit is issued.
yl I have and will maintain workers' compensation insurance, as required by
700 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: NORGUARD INSURANCE COMPANY Policy Number: TOWC765159
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 3700 of the Labor Code, I shall forthwith
comply with those provisions. %\
Da l --�L/1 ^� . 1 Applica,,,L / y
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.
Dat ignature (Applicant or Ag
�/
a.Mruis�Jr:Al
Application Number: .
BPLB201&0135
Property Address:
43245 PARKWAY ESPLANADE W
APN:
609610071
Application Description:
CARIS / CHANGE OUT (1) 50 GALLON GAS WATER HEATER
Property Zoning:
Application Valuation:
$1,635.00
Applicant:
TOMMY ROOTER PLUMBING
INC
80975 INDIO BLVD #B9
INDIO, CA 92201
Date: 12/2/2016
Owner:
BRIAN CARIS
43245 PARKWAY ESPLANADE W
LA QUINTA, CA 92253
Contractor:
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #IB9
INDIO, CA 92201
(760)574-4444
Llc. No.: 930133
---------------------------------------------------------------------------------------------
Detail: WATER HEATER CHANGE OUT - SOGALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013
CALIFORNIA BUILDING CODES.
.DESCRIPTION
.Y
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.
$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
i
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er homeowner (Documentatiota,Au&oe5/RegpoWible Dnigner's Deet egtf 5tF*t ::::. '
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PLUMBING WORK ORDERANVOICE T0MM�r U A6LOft V �
HELPING THE DESERT 27200
Co.AA 114,11
ONE FRIEND AT A TIMEITE,'il
OR PART DESCRIPTIOW
PAroWh,g, Dretn Cleanhvgd letwspeafadst Inv.#
W975 Indio Blvd., #B97v
' =° Indio, CA 92201 AUU I.
760-574-4444
In
Fax 760-444-2717
`AMCleari" WWW.TOMMYROOTER.COM Out
.y CA LIC. O M0133
NAME+
DATE DlA
G!
SIRE
L" TE ?IP
PHONE
❑ WARRAWY
❑ 001fTRACT
❑ S"VICE CONTRACT
MAKE IAMEL SERIAL NUMBEFI
❑ ItOR1dAL .
' TOTAL MATERIALS
OF%VORK
. .-r �d
t
•TO
0
OUR CUSTOMERS: Service mea are rm9red to jwe work sTp signed
DRAM CLEANING
.
This Is done 11 order to prdect you, the urorkmn, and ourselves and m
ADDe L FOOTAGE
enable us to gine ypur alogalu� saes--iactory servke, You are TespeCituAy
mquastscl to man Irie maWal and labor sWenwt bebre worlamen leave
ADD!oiru ES 0
PLUMBM LABOR
C e
the job, and 0 you fcrd.everytttlpg sal[Wa�rp, okay Hits tfrl�s if serAce Is
arisatial'xi in any way,. please phone our Ww Imme�ly-
y,
.
A PENAL7Y V11111 BE M3 UMD, AY THE. RATE OF 1'm% PEA MM ON
UIPMRALArmAFTER 30DAYS OFINNICEOUITEAi WALPE�7TM
PARTS
PRODUCTSMEATIS"T
TOTAL LABOR .
RATE 118Y., RETUANM CltEMFEEMM
VIDEO NSPECTK)N
❑,WARRANTY NOTESIRECOW-111E,MATIONS
IllndlhetkneandmaterlatchargedabovesaWaactoryand agneiopay
HYOFD4JILII i
miNIJETfEA
❑ sDay ❑ 1 Yew
foraemeonpreaentaGon(if Invoke, and hrtheragree topay reamable
❑ 3 Altyt4h p No
eharged fair cdleetlon inckdlrg attorneys fees to the awns aI my default.
LINEREAH LOCATION
❑ 6AIorylh
vlo O'I
:'N0IICE TO OVNER" l8aafte 7018-CoMractora Limnos Lary) under w
woutw U1n law" 9fir oaraeaat 2tbWti8=, WXin, in9Nit31 Q *bf *tV 409
PUAIPSEPMCIGf0EAS£
4
.
WARRAWYCALLS.
Mn petem
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OTHER
AAE SCHEDULED
tem e�ta1 yea prcQe3p areae Ste Iso f� �/ [� 90�� ag9h� oudi a iry I91g,
baSrnartrtsxlt3ssntiata'rypserwr�t as a[�oxeat hr unxaA atrnpu�vrae v a
FROM M-FSAWPE1
rtiQeeu9p9W,99tte allteo9t9bJweppl9ray 1wretEepmyvy%�isuedL+d
TAX
�ratrg tttetavy t)e di1LlCa lt9Y5.. efmPGeY�iAalfil
nay iota aen [icy � nrheat sort, fi mean ovugbra hr the
pe m ua p.9ynVa In h' ar ne of en �
y hb- i 1
TOTAL
x�-
MENT fiECEIYED-
srrru9us� °"�
1nfNafs ❑ CASH [I C.C. ❑ BLL ECK+Y ❑X
PAYMENT DUE
03±K OPfJEBm BN
-