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13-0672 (MECH)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000672 Property Address: 81790 LA PAZ CT APN: 764-280-999-96 -300237- Application description: MECHANICAL - Property Zoning: MEDIUM HIGH, DENSITY RES Application valuation: 13987 Applicant: eo4 Architect or Engineer: 4 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 ano, Profeininnala r'rvfn, 2nd my Lioc, c 13 lir iuii luree Ahd effect. LioaMao 06,,,. C20 - License No.: 686310 •� � Da " Contractor---L,LI.t/2� ��.. 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).: (_ 1 1, 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.). (_ 1 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 contractors) licensed pursuant to the Contractors' State License Law.). (_ 1 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 �- 5/29/13 Owner: HOLMES THOMAS D 81790 LA PAZ CT LA QUINTA, CA 9225 MAY 2g 2013 ( OF Contractor: GENERAL AIR CONDITI 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)343-7488 Lic. No.: 686310. ------------------ WORKER'S COMPENSATION DECLARATInN I hereby nff ,rn undar ponahy 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. Sb -("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 v insurance carrier and policy number are: Carrier ZENITH INS CO Policy Number Z071741502 _ I certify that, in the performance bf 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. Date gk9 Applic. ,C:A 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 Ouinta, 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 county to enter upon the above-mentioned property for inspection purposes. Date: -She -kits Signature (Applicant or A, gent��r.•t.at.P2�� � ' LQPERMIT Application Number 13-00000672 Permit . . . MECHANICAL 2013 Additional desc . Permit Fee . . . . 71.50 Plan Check Fee .00 Issue Date . . . . Valuation 0 Expiration Date 11/25/13 Qty Unit Charge Per' Extension 1.00 35.7500 EA MECH FURNACE 35.75 1.00 35.7500 EA MECH CONDENSER/COMP 35.75 -------------------------------------------------------------------=-------- Special Notes and Comments HVAC CHANGE OUT (1) 4 TON A/C 90 K BTU. FURNACE & COIL 2010 CBC CODES. CARNON .MONOXIDE ALARMS TO BE INSTALLED PRIOR TO FINAL INSPECTIONS. ---------------'------------------------------------------------------------- Other.Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PERMIT ISSUANCE M/P/E 90.57 PLAN CHECK, MECHANICAL 47.66 Fee summary Charged Paid Credited ------------------------------ Due --------------------------- Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Other Fee Total 139.23 .00 .00 139.23 Grand Total 210.73 .00 .00 210.73 r sin.# City Of La Quints Bu11d1ng 8L Safety Division Box 1504, 78-495 Calle Tampico La- Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. X�� 740 Project Address: �t O q O Owner's Name:. h X0.5 F 10I m E:s A P. Number. Address: $ I—) a Q Lc L. 2 C-} . Legal Description: 1 1 Contactor. ` �� ` h\ai TiO City, ST, Zip: Lc, Qu: CA CCZZ5, Telephone:- Ufa Address: 3\1 -70 Project Description: City, ST, Zip: I r\OV �� S CtZZ.7Q, C -G �1 Dk- 3TU Telephone: --)(00_ -3L43--X4Fur r_ State Lic. # : (08631 V City Lic. #I- ;Arch., Arch.,Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. #: Construction Type:. Occupancy: Project type (circle one): New Add'a Alter Repair Demo Sq. Ft.: # Stories: #Units: Name of Contact Person: Telephone* of Contact Person: Estimated Value of Project ! 3 q $ 7, 00 APPLICANT: DO NOT WRITE BELOW THIS UNE 10 Submittal Req'd Rec'd TRACMG PERMITFEES Plan Sets Plan Check submitted Item Amount Structural Calci. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.' . Mechanical Grading plan 2`! Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S M.1, H.O.A. Approval Plans resubmitted Grading IN ROUSE:- ''d Review', ready for correcdonsrmueDeveloper Impact Fee Planning Approval Called Contact Person A,I.P.P. Pub. Wks. Appr Date of permit issue Schod) Fees Total Permit Fees