BPLB2014-10016/x%2014
PERMIT NO BPLB2014-1001
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78-495 CALLE TAMPICO
LA QUI NTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application
Description:
Property Zoning:
Application Valuation:
Applicant:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
bPLB2014-1001
56795 JACK NICKLAUS
762070010
GAS LINE FOR FUTURE BBQ
O
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty ofpe,jurythat I am licensed under provisions of
Cha pter9 (commencing with Section 7000) of Division 3 ofthe Business and
Professions Code, and my License is in full force and effect.�i
Licensp-Class: LICENSE CLASSIFICATION License No.: / ` �57
Date: l0/ 7� Con ractor:�
OWNER -BUILDER DECLARATION
I hereby affirm under Pena ltyofperjury 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 applicantfor the permit to file a signed statement that he or she is licensed
pursuant to the provisions ofthe Contractor's State License Law (Chapter 9
(commencing with Section 7000) of Division 3 ofthe Business and Professions
Code) or that he or she is exempt therefrom and the basis for the alleged
exemption. Anyviolation ofSection 7031.5 by any applicant for a permit
subjects the applicant to a civil penaltyofnot more than five hundred dollars
($500).:
C_J I, as owner ofthe 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 applyto an owner of property who builds or improves thereon, and
who does the work himself or herselfthrough 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 sa le.).
U 1, as owner ofthe property, am exclusively contracting with licensed
contractors to construct the project. (Sec. 7044, Business and Professions Code:
The Contra ctors'State License Law does not apply to an owner ofproperty who
builds or improves thereon, and who contracts for the projects with a
contractor(s) licensed pursuant to the Contra ctors'State License Law.).
(_J I am exempt under Sec. . B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penaltyofperjury that there is a construction lending
agency for the performance ofthe work for which this permit is issued (Sec.
3097, Civ. C.).
Lender's Name:
IA
View Report
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/30/2014
Owner:
STUART BRISCOE
(
Contra ctor:
HERMOSA LANDSCAPE
54-415 AVE RUB10
LA QU I NTA, CA 92253
(760)831-8749
Llc. No.:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty ofperjuryone ofthe following declarations:
—I have and will maintain a certificate ofconsent to self -insure for
workers'compensation, as provided for by Section 3700 ofthe Labor Code, for
the performance ofthe work for which this permit is issued.
_ I have and will maintain workers' compensation insurance, as required
by5ection 3700 ofthe Labor Code, forthe performance ofthe workfor which this
permit is issued. Myworkers'compensation insurance carrier and policy
number are•
Carrier Policy Number:_
_ I certify that in the performance ofthe work for which this permit is
issued, I shall not employ any person in any mannerso as to become subject to
the workers'compensation laws of California, and agree that, ifl should become
subject to the workers' compensation provisions of5ection 3700 ofthe Labor
Code, I�hall forthwith comply with those provisions.
lrl3� 2a'� p�
D e: A licant:
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 TOTHE
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 fora permit
subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalfthis application is made, each person at
whose request and forwhose benefit work is performed underorpursuant to
any permit issued as a result ofthis 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 orfollowing issuance ofthis permit.
2. Any permit issued as a result ofthis application becomes null and void if
work is not commenced within 180 daysfrom date ofissuance ofsuch permit, or
cessation ofworkfor 180 days will subject permit to cancellation.
I certifythat 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: 6/ r SigtrTe ure (Applicant or Agent): e..
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6P30/2014 Building 'Permit
PERMIT NO BPL62014-1001 View:Report
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FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$90.57
7/1/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
HERMOSA LANDSCAPE
CASH
R234
I AZA
a
Total Paid for PERMIT ISSUANCE: $90.57 $90.57
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$11.92
$11.92
7/1/14
" PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
HERMOSA LANDSCAPE
CASH
R234
AZA
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42401
0
$23.83
$23.83
7/1/14
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
HERMOSA LANDSCAPE
CASH
R234
AZA
Total Paid for PLUMBING FEES: $35.75 $35.75
TOTALS: $126.32 $126.32
I,
1
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67;30/2014 Permit ReNews
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Enter Permit Number !BPL82014-1001
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Lua 4 ,
Permit Reviews
City of La Quinta
.View Report
t. .
Permit Number: BPLB2014-1001 Description: GAS LINE FOR FUTURE BBQ
l
Applied: 6/30/2014 Approved: 6/30/2014 Site Address: 56795 JACK NICKLAUS
Issued: 6/30/2014 Finaled: City, State Zip Code: LA QUINTA, CA 92253
Status: ISSUED Applicant:<NONE>
Parent Permit: Owner: STUART BRISCOE
Parent Project: Contractor: HERMOSA LANDSCAPE
i
Details:
PLUMBING - 11/2 GAS LINE FROM GAS METER TO FUTURE BBQ AND FUTURE FREESTANDING PATIO HEATER PER APPROVED ATTACHED
PLAN. 2013 CALIFORNIA BUILDING CODES.
LIST OF REVIEWS
RETURNEDDATE
SENT DATE
DUE DATE
TYPE
CONTACT
STATUS
REMARKS
Review Group: AUTO i..
6/30/2014
6/30/2014
7/5/2014
NON-STRUCTURAL
BUILDING BUCKET
APPROVED
Notes:
Printed: Monday, 30 June, 2014 1 of 1
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