BPLB2016-012978-495 CALLE TAMPIC0
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2016-0129
Property Address: 80710 WEISKOPF
APN: 762160017
Application Description: DAVIDSON / CHANGE OUT (2)GAS WATER HEATERS
Property Zoning:
Application Valuation: $2,900.00
Applicant:
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #t69
INDIO, CA 92201
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: C36 License No.: 930133
Date: !I \ 30- A10 Contract
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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
STEVEN DAVIDSON
80710 WEISKOPF
LA QUINTA, CA 92253
Date: 11/18/2016
UJI
O
N
Contractor: C
TOMMY ROOTER PLUMBING IN a
80975 INDIO BLVD #tB9
INDIO, CA 92201 Z
(760)574-4444
Llc. No.: 930133
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'
c nsation, as provided for by Section 3700 of the Labor Code, for the performance
o e w k for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
3700 of the Labor Code, for the performance of the work for which this permit
is issued. My.workers' compensation insurance carrier and polity 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. //�
Date: I (—.30 —` b Applicant- Q
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 Jaws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned
��property for inspection purposes. f�
Date: "2v ^I Signature (Applicant or Agent): LJ
Application. Number:
BPLB2016-0129
Property Address:
80710 WEISKOPF
APN:
762160017
Application Description:
DAVIDSON / CHANGE OUT (2)GAS WATER HEATERS
Property Zoning:
Application Valuation:
$2,900.00
Applicant:
TOMMY ROOTER PLUMBING
INC
80975. INDIO BLVD #tB9
INDIO, CA 92201
Date: 11/18/2016
Owner:
STEVEN DAVIDSON
80710 WEISKOPF
LA QUINTA, CA 92253
Contractor:
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD q139
INDIO, CA 92201
(760)574-4444
Llc. No.: 930133
------------------------------------------------------------------------------------------
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Detail: WATER HEATER CHANGE OUT - (2)50GALLON/GAS [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION.
2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
,. DESCRIPTIONACCOUNT . 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
$25.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WATER HEATER/VENT PC
101-0000-426000
$15.20
Total Paid for PLUMBING FEES: $40.54
1 11V TTA --f C yw l f l"T
PLUMBING WORK ORDERANVOICETO
Y RMYrER `� 2696fi
_' `' a< :• HELPING THE DESERT
�+' .
ONE FRIEND AT ATIME CoAMOUNT
OTY. ITEPA OR PART DESCRIPTION
UP. -IT
_ pN�,o}rkr�DratroClearaing6FJelteisvealallst Inv.#.�i5�•%��
So 6a l i-,
80975 Indio 6Nd:, SE9 At1ti1.�' 1� Zb
^- « Indio, CA 92204
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,F 760.574-4444
Fax 760-444-2717
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TOTAL, MATERIALS
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DESCRIPTION OF %1j'0RK
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557 SZ'
10 OUR CUMMERS: SeNce men are requwW to have aarkslip signed, DRAIN CLEANNG
This is Lane h, ardaT to X&ct• you, the walvrren, and wwNes and to ADM FOOTAGE
t_
'
enable us ho gAe your ahsdute satisfachM servke. You are Tespectfuiy AUDI. FIXTURES
khan before trmlaneo leave
1-
regaStad tD wTr£ne material and st iteritwi
If you everyMy sat)slactary, okay this ticlmt. If sevice is PLUMBW tAB4A
the job, andou ri
�1 { MCI�'
unsaWtory, In any vW, P}am phone our Oft Immedla*.. PARTS
A PENAf7Y WU B8 CF6AftBED AT T}E RATE OF 1'w% PER MOM ON PR IJOTW EATGEf1T
WPAA BMMCE5 AFIER3D t Mof �91FOlC WE ANMD PR C6DRABE
TOTAL LABOR
RATE 18%FIEIIlfiNBDCFITA:ItFEE $.Z 00. VIDE01NSPECTION
find the time and meierlel charged at7ove s993cWq and agree b pay HVDR0.1ET1ER
4
°❑ WARRANTYNOTES
for same anpresentafonoflnvaice,and kvtwragreetopay reasorkWe PNIIIJEIT£R
0 5 Day ❑ 1 Year
ctwrged 1rr moacoon induftg attorneys lees fn the eventof my dolaull. LINEII.EAK LOCATION
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NOTICE TO TO OTrAR' (69003 7M9C*NtXhora Lkan99 Lar) u9tm ft
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.PUJAPSEPT)rAREASE
WARRA NTY CADS
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atm a0rts m► vroDMr urdrr ere raw. you m ry vM.-t gorrad1 grind 9reh cWjm 99 ffkwi
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TOTAL
pHhm� mrtree► oordl)grrel Por Fn hA of na m ed oumns
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plrtiscr� e� .a� Na[>ices Relic dH CF. R
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�: ih�etn�rnd waren rarl�ar+d l shall be fnsutated to ntrel7he n uir,Enienir a lS
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�q tractor or Hoeowner (Documeatalt"i AutSos'g/Rcspo�ibie Bailing
mpealgtrefr's; P.n '
` s'fieetiio triet this Celt fiCate of Compliarte�'dbrirmentation
s arri Aijible..uadm Dixistotr 3 of . the C�tifomia eus9tiess and Professions Code to accept responsibility for 'tht bµildiiig deign
idenHttr on this C.ertiitcme of Campilance_.,, Y .' "lance
for the;°luifdiftg"design identified on alts CeiiitieaEe o! Copi
.i SPt11i`Y_iitat tjt¢. eitergj► feoturas and petfv*iia = speclicctione` - : •:° ` ,'..':
tle.�4;t'8rt[arid6ofiltcCalifot'niaCodeoflte8ntsu
cpnEorin.io 'the i rteertta this
-`: 11m building destga feafltres idetjdfied on' �ertlfcau:of tlam¢ltari irDecor►di3teirt :and_ ifiC419. `xa the
Iraifi irig "d stgri 'dii the othEt a ptfci6le compt"imtce fQtir ° worltsdeet •cakvlations�,piana spec 19ns..stl . ,
r:.:.•:<
•:.:',.::nforcetrienta en .:for- rovatwiththis.buil lti rndt Icacbn. 5"
Nsfriet: =.r : Signa)b
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m� �.oo
,:. � Llcewe?
.�
Cityl5tat6/Ip: ^A `11
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&A --if 17A 1A
06/06/2013 THU. 15109 PAR La Quinta Bldg 6 Gafety 001/001
City of La ' puinta
Wftgt Safety DMft
PAt Box 1304, 76495 dage DMPIm
p Quk4 CA 92253 - (760) 777-7012
Building Permit Appitcation and Tracking Sheet
Penh
PraJcot Address 1 Vo i Owr►ar's Nemec hDY
A. i'. NumbW,, Addrm, P
Ddsor�tiD>x , 9T, Zip: A
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Cam�s°tor`� bY`cl �1f1 C5&Y- - u trlb 1 T
Adam= �� Prg9ectDeacriptioa:
7
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SaaDeLlaL� f . Ib UO
AteL. Engr. Designer:
:• _
Address:
C11y.. ST, 21p -
Tdepbo= Cwst<sesi T.ypoi, Oc4w, y:
Stato Lia #: project type (cimk one): New Add'n Alter Repair D=o
Name dCamYw=; Sq. Ft.: t4 3Qor= g Unita
T hone i# prion . Esfi mawd value a?Fto e= b.
APPLICANT: DO PLOY WiJM BRLOW THIS LINE
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Sabmiil i
Wed
Deed
TBACIf�G Y)d1tiKRf 1i+EE$
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Plan Cfie& aubaftted Idem Amom
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Caged Contact Peraoa Pfau Check Rdsuec _
-'fide 24 Cift
lgaaa picked up Conattnctlaa
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P! Renew, rea4y for due Fdedrie d
$irheo riforI1st
PamcoahctPersoa Plapt4ing
Grant Deed
Pisan ptdred np S M -L
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''' Reyim mady for cotrectlax9b rte I?ttvetoptr Itupact Pee
Pixatd?gAgprvVsll
Called CamsctPeraoe Ad.B.P.
pub. W!kri A"r
Date ot.pcnait Saaoe
• � Tobtl permit Bees