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BPLB2014-1052LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.: :LIC -0105285 Date: /� — jSr—/ y contractor: ��v/ 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 of the Business and Professions Code) or that he or she is exempt therefrom and the lye 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, 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: WORKER'S COMPENSATIO 4 DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate o. consent to self -insure for workers' compensation, as provided for by Section 3700 o1 the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' com )ensation 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 orrier and policy number are: Carrier: _ Policy Number: _ _ 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 -o become subject to the workers' compensation laws of California, and agree that, 61 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -Date: /C— I�—/ N Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I WFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAI PENALTIES AND CIVIL FINES U .O ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 119 SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWIEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this aoplication. 1. Each person upon whose behalf this applica-ion is made, each person at whose request and for whose benefit work is performer 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 applicaton 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 cancella: ion. I certify that I have read this application and staff 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 representati-es of this city to enter upon the above- mentioned property for inspection purposes. DDke: —/� / Signature (Applicant o Agen M.NIIC(/ 4 VOICE (760) 777-7125 78-495 CALLE TAMPICO 78 495 CALLE TAMPICO D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/18/2014 Application Number: BPLB2014-1052 Owner: Property Address: 60441 WHITE SAGE DR KATHI BRATZER APN: 764330034 60441 WHITE SAGE Application Description: 3/4 "GAS LINE 25 LN FT FOR BBQ LA QUINTA, CA Property Zoning: Application Valuation: $1,000.00 Applicant: Contractor: D V S PLUMBING OUTSIDE CITY LIMITS D V S PLUMBING OUTSIDE CITY LIMITS LA QUINTA, CA 92253 LA QUINTA, CA 92253 E71 (760)910-2010 ------------------------ ENT Llc. No.::LIC-01052E5 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.: :LIC -0105285 Date: /� — jSr—/ y contractor: ��v/ 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 of the Business and Professions Code) or that he or she is exempt therefrom and the lye 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, 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: WORKER'S COMPENSATIO 4 DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate o. consent to self -insure for workers' compensation, as provided for by Section 3700 o1 the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' com )ensation 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 orrier and policy number are: Carrier: _ Policy Number: _ _ 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 -o become subject to the workers' compensation laws of California, and agree that, 61 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -Date: /C— I�—/ N Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I WFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAI PENALTIES AND CIVIL FINES U .O ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 119 SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWIEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this aoplication. 1. Each person upon whose behalf this applica-ion is made, each person at whose request and for whose benefit work is performer 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 applicaton 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 cancella: ion. I certify that I have read this application and staff 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 representati-es of this city to enter upon the above- mentioned property for inspection purposes. DDke: —/� / Signature (Applicant o Agen FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY , Total Paid for PERMIT ISSUANCE: $91.85 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT - PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT - PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $36.26 $0.00 TOTALS:00 Description: 3/4 "GAS LINE 25 LN FT FOR BBQ NAME Type: PLUMBING Subtype: Status: SUBMITTED Applied: 12/18/2014 PJU Approved: Parcel No: 764330034 Site Address: 60441 WHITE SAGE DR LA QUINTA,CA 92253 Subdivision: TR 30023-1 Block: Lot: 78 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CA Details: 3/4" GAS LINE FOR BBQTOTAL OF 25 LN FT PER APPROVED PLANS & ARMAND. 2013 CALIFORNIA PLUMBING CODES. NAME TYPE NAME ADDRESS? CONDITIONS CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT D V S PLUMBING OUTSIDE CITY LIMITS LA QUINTA CA 92253 (949)725-1740 CONTRACTOR D V S PLUMBING OUTSIDE CITY LIMITS LA QUINTA CA 92253 (949)725-1740 OWNER KATHI BRATZER 60441 WHITE SAGE LA QUINTA CA (949)725-1740 FINANCIAL• • DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Thursday, December 18, 2014 12:42:05 PM 1 of 2 CN?WYSTEMs INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE PLUMBING FINAL" REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES DATE Printed: Thursday, December 18, 2014 12:42:05 PM 2 of 2 CRW.srsTEMs Is CM DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 GAS SYSTEM, 1-4 101-0000-42401 0 $12.09 $0.00 OUTLETS GAS SYSTEM, 1-4 101-0000-42600 0 $24.17 $0.00 OUTLETS PC Total Paid for PLUMBING FEES: $36.26 $0.00 TOTALS:• •• INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE PLUMBING FINAL" REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES DATE Printed: Thursday, December 18, 2014 12:42:05 PM 2 of 2 CRW.srsTEMs Is 'SIDEYARD: 5 FEET PEAR -YARD:, 10 FEET NflNUYiUM EACH SIDE KNEAUM FRONTYARD: 20.FEET MII�IIl1�IiJN,i � I I . i I ' I AREA TO $E i LAI SCAPED i i �- PROPERTY LINES CITY. OF LA QUI'NTA BUILDING& SAFETY DFPt APPROVE FOR CONSTRUCTION CURBLM Din # , City Of La Quints I b " Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico. La Quinta, CA 92253 - (760) 777-7012 Application and 'Tracking Sheet Building Permit PP Perm 't # l `` Project Address: d6 pc/y/ wi4 1,.e— Owner's Name: A. P. Number: Address: 60e_ Legal Description: City, ST, Zip: (,,,4 �aas3 Contractor: �•✓cS. ? \`•.'`:' Telephone: ��q /�5 — YD ' :•vr;;:<: Addressf ,62,34 V Project Description: City, ST, Zip: O R�a.� 04 Telephone 6�gJQ aOIZ ....::>:::>;<::::::< ...........:... . State Lic. 4: 0 /aq11(z9— City Lie. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: 'zc?<":>:>:ri<:.>.>:::::>:z:=::< ..<.a;>.:k>::: h< - <r::::::r ;:::: = #» v:..... ........................... Construction Type: Occupancy: State Lic. #: Project type (circle one): New Aden Alter Repair Demo Name of Contact Person:Sq. Ft.: #Stories: # Units: Telephone # of Contact Person: Estimated Value of Project �. GK:) APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES. Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Che_k Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrcctionsrssue Electrical Subcontactor.List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN I10USE:- '`" 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 Pc mit Fees