14-0378 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000378
Property Address:
81972 DANIEL DR
APN:
764-270-999-10 -300232-
Application description:
PLUMBING
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
450
Applica Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect.
License Class: C2((7,�(( License No.: 857801
Date�29�1_( Contractor: /•
,
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjur . 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/07/14
Owner:
BROWN RESIDENCE
81972 DANIEL DRIVE D
LA QUINTA, CA 92253
(
.F4 e L 11,
Contractor:
WESTLAKE LANDSCAPE
P.O. BOX 5175
LA QUINTA, CA 92248
(760)399-1506
LiC. No.: 857801
-----------------------------------------------
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.
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 WESCO INS CO Policy Number WWC3071717
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 subje to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forth i comply with those provisions.
Date:7nPf/<- /L4 Applicant:
WARNING: FAILURE TOS ORKERS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES 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 andrestrictions 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, hereby authorize representatives
of this county to enter upon the above-mentioned prope y f ectio oses.
Date:? G6ignature (Applicant or Age "'
'Application Number . . . . .
14-00000378
Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92
Plan Check Fee
.00
Y Issue Date . . . .
Valuation . . .
. 0
Expiration Date 10/04/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG
GAS SYS, 1-4 OUTLETS
11.92
----------------------------------------------------------------------------
Special Notes and Comments
INSTALL GAS LINE FROM METER TO
NEW FIRE
PIT 18" HT LOCATION BACKYARD 100
IN FT X
1" PIPE PER APPROVED. PLANS PER
B°.H. 2013
CBC 2013 CPL.
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
23.83
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total 11.92
.00 .00
11.92
Plan Check Total .00
.00 .00
.00
Other Fee Total 115.40
.00 .00
115.40
Grand Total 127.32
.00 .00
127.32
LQPEIN1IT
Qin #
City of La QCutntd .
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
\Q ^ ��
Project Address: 7� A % et L r
Owner's Name: C wy-,
A. P. Number:
Address: l Z ba , ! q L i
Legal Description:
City, ST, Zip: 4)Cif Kiac, cc, Z 2.5' 3
Contractor: �n Q
2t C�es�l2
Telephone: - �
Address: �� 7<
Project
City, ST; Zip: `Gt U[ 922
"Description:
/—i ci i"" -�(� • . Ci �/'� r j �.
Telephone: 7&o L .
`f
'Lj %G CC' / ! /U
State Lic. #: S7 O
City Lie.`#.
L i t .
Arch., Engr., Designer.
��j A e, t,)
Address:
Cetc,
City, ST, Zip:
Telephone:
:
Construction type: Occupancy:
State Lic. #:
Project (circle one): New Add'n Alter Repairair Demo
Name of Contact Person:&YLA�l
Sq. Ft.:
# Stories:
#Units:
Telephone *,of Contact Person:
Estimated Value of Project: S�
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Pian Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance •
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dced
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
P.
S
rT�,.
4L
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B I -n Westlake Landscape,, Inc
ra
Briar, Westlake
Owner
Post Office Box 5175
La Quinta, Ca. 92248
760. 50.2924 Phone
760.625.1359 Fax
bwlandscape@gmail.com LANDSCAPE, INC.
Lic.# 857801
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DRAWN BY
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DRAWING NUMBER