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14-0390 (PLBG)$,'P.O. BOX 1504 78-495 CALLE TAMPICO ; LA QUINTA, CALIFORNIA 92253 Application Number,: 14-000003 90 Property Address:. 47225 WASHINGTON ST APN: 643-090-026-2 -000000- Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4600 �AApppplliicant: 4 /4 7VPIPAPI Architect or Engineer: r BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ROMAN CATHOLIC BISHOP 1201 E HIGHLAND AVE SAN BERNARDINO, CA 92 r VOICE (760) 777-7012 FAX (760).777-7011 INSPECTIONS (760) 777-7153 Date: 5/06/14 , Contractor: JRS PLUMBING CO P.O. BOX 725 THOUSAND PALMS, CA 92276 (760)343-1861 Lic. No.: 572424 C LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - I hereby affirm under penalty of perjury th am licensed under pr visions ap ,r 9 (commencing with - _ I hereby affirm under penalty of perjury one of the following declarations: • Section 7000) of Division 3 of the Busin and Professionals C e, and y Licen is in full force and effect. - I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided - Lic se Cla 36 Li se No.: 572 4 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is �� (6 4 1,0 issued. Date Contract • .' _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under pent ty y perjury that I am exempt from the Contractor's State License Law for the Carrier FARMERS ' INS Policy Number A20087116 ' following reason (Sec. 70 Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any ma4so become subject [o the worker ' sation laws of California, permit to file a signed statement that he or she is licensed pursuant [o the provisions of the Contractor's State and agree that, if ome subject to [he worker compensati provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of the Laboall forthwit omply wi those provisio that he orshe -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).: vA0 DateApplic (_ 1 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 - WARNING: FAILURE T SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does notapply to an owner of property who builds or improves thereon, SUBJECT AN EMPLO E 0 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or.her own employees, provided that the DOLLARS ($100,00 N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made; each person at whose request and for pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application, - (_ I I am exempt under Sec. , BAP.C. for this reason 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. Date: Owner: 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 CONSTRUCTION LENDING AGENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and statethat the abo information is correct: I agree to comply with all work for which this permit is issued (Ser. 3097, Civ, C.). city and county ordinances and state laws ielati, I, lu buildi . •unstructlon, and hereby a orize rives • of this cou ty t ente upon the above-mentioned propert r inspection pu es. Lender's Name: - ' l Date: Signature (Applicant or Age Lender's Address: LQPERMIT Application Number 14-00000390. Permit PLUMBING 2013 Additional desc . Permit Fee 11.92 'Plan Check Fee .00 Issue Date Valuation . . 0 Expiration Date 11/02/14 Qty Unit Charge Per Extension 1.00 11.9200 LS PLBG GAS SYS,. 1-4 OUTLETS, 11.92 ----------------------------------------------------------- ----------------- Special Notes and Comments INSTALL NEW MED PRESSURE SCHEDULE 40 GAS PIPING (225 FT TO EXISTING (2)FAUS 2013 CPC. - -------------------------------- 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 . J Bin City of La Quinta 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 # V rojectAddress: 7-Ol��(;/�i.-/L70.-� ST wner'sName: s,4J,✓T "�lL9N/S A. P. Number: Address Legal Description: City, ST, Zip: 4,4 (,1� t,.� /� C,4 , �.S %e�/��% Telephone: .. " r..;;•. Contractor: � C�� ............. Address: roject Dcriptiin: City, ST, Zip:��,�('1�A�� i4Cl/Y!S �� (,(� A GIS Telephone -7 - 0 a - 9 � u � State Lie. #: ��D401-4 City Lie.#.- 'lo FAu LJrC.-70,-� Arch., Engr., Designer. G!] Address p -',4.5 City., ST, Zip: ' Telephone: <?`:.l.::..;- ::.:::::::.::::.::.:::::::::.::;.;. P .; Construction Type: Occupancy: State Lie. #: 3 Project type (circle one): New Add'n Alter Repair Demo ame of Contact Person: j, M /G L i Sq. Ft.: # Stories: # Units: elephone # of Contact Person: 1115SItimated Value of Project: 6 D O. 00 APPLICANT: DO NOT WRITE BELOW THIS LINE ff Submittal Req'd Rec'd TRACKING # PERMIT FEES Plan Sets Plan Check submitted tem Amount Structural Cates. 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 correction /issue y 6 Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN IiOUSE: '^' Review, ready for correctionsrissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees LL Total Permit Fees