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BMCH2016-04011 1i T4ht 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BMCH2O16-0401 Property Address: 80595 WEISKOPF APN: 762100007 Application Description: GARRISON / CHANGE OUT (3) 16SEER/80AFUE Property Zoning: Application Valuation: $20,000.00 Applicant: TIMO'S AIR CONDITIONING & HEATING INC 72232 CORPORATE WAY THOUSAND PALMS, CA 92276 m V 0 777-7125 6- 11 L7 IECTIONS 60- 53 vQ _- [ e: W/4/2016 Owner: rrT1 TCS P GARRISON a S: C D 163 WOODRIDGE CA S ►ii NEW CANAAN, CT 9i*g p m a rn a ZZ Contractor: m TIMO'S AIR CONDI NING 72232 CORPORATE WAY THOUSAND PALMS, CA 92276 (760)770-4357 Llc. No.: 920062 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: C20 License No.: 920062 /! of the wafk for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Date: A `t6 Contractor: S on 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: OWNER-BUILDE CLA �ON Carrier: NORGUARD INSURANCE COMPANY Policy Number: TIWC721117 I hereby affirm under penalty of perjury that I am exemContractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of a Laborode, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with o rovisions. 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 Date: GL ` Appli 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 WARNING: FAILURE TO SECURE WORK COMPE R} 2OVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (1 I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose I ) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (� I am exempt under Sec. . B.&P.C. for this reason 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. 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 Na Lender's Address: 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, an hereby authorize representatives of this city to enter upon the above -menti o d p perty for inspection purposes. Date: ` Signature (Applicant or �'�— Application Number: BMCH2016-0401 Property Address: 80595 WEISKOPF APN: 762100007 Application Description: GARRISON / CHANGE OUT (3) 16SEER/80AFUE Property Zoning: Application Valuation: $20,000.00 Applicant: TIMO'S AIR CONDITIONING & HEATING INC 72232 CORPORATE WAY THOUSAND PALMS, CA 92276 Date: 11/4/2016 Owner: P GARRISON 163 WOODRIDGE CIR NEW CANAAN, CT 92253 Contractor: TIMO'S AIR CONDITIONING & HEATING INC 72232 CORPORATE WAY THOUSAND PALMS, CA 92276 (760)770-4357 Llc. No.: 920062 Detail: HVAC CHANGE OUT - (3)165EER/80AFUE SPLIT SYSTEMS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES. DESCRIPTION FINANCIAL INFORMATION 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 HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $228.00 DESCRIPTION ACCOUNT QTY AMOUNT HVAC CHANGEOUT- SPLIT -SYSTEM PC 101-0000-42600 0 $114.00 Total Paid for CHANGEOUT: $342.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 Bin # Qty of Ld Quinta 8uildfng U Safety Division P.O. Box 1504, 78-495 Calle T•aMPICO Permit # La Quints, CA 92253 - (760) 777-7012 Building Permit APPlication and Tracking- She, t :. Q e(c$ j[O Owner's Name: ProjectAddr"css: Address: �jIgx_ E' A. P. Number. City, Zips Of Legal Description: � ST, _ . tl,e; c +i�`. Telepho ne: cP/3• a6 F Contractor: liuv Address: _ Dtili-ect Description: �? Proj . - � City, ST, Zip: B ��J s 3 7 �(001sd(Plvc 71 `P ZZ @' tate Lic. # : S ® City Lie. #; Ards, F,ngr., Desi gnta� Address: City, ST, Zip= Occupancy: Construed on Tape; Telephone: #: project type (circle one): New Add'n Alter Repair Demo • State Lic. [sic_ Sq, FL: #Stories: #Units Contact Per n. o Name of oi �y mated Value of Pr, 49 Tolephone; #,of Contact Person: r APPLICANT: DO NOT WRITE BELOW THIS LINE q Submittal Req'd Reed `CRACKING PERMIT FlirES flan Sets Amount Plaa Check submitted Item • Structural Cala. Plan ClrcckDeposit . Reviewed, ready for corrections Plan Check Balance • Truss Glu. Called Contact Person . Titie 24 files. Construction Pians picked, up Flood plain plan Plans resubmitted i4leehanisai - Grading plan 21' Review, ready for corrections/issue Eketrical Subeontactor I!IJ!t Plumbing Called Contact Person, Grant Decd S.M.I. flans picked up _ Ii.O. ApproVal .A Plans resubmitted Grading . "DcvdoPa' Impact Fce 30 RWcw, ready fqr correctionslissue - IN HOUSE: A.U.P. Planning Approval Called Contact Person Pub. Wks. Appr ., Date of permit is;uc School Fees Total Permit Fees