14-0414 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000414
Property Address:
51555 EISENHOWER DR
APN:
773-134-013-1 -000000-
Application description:
PLUMBING
Property Zoning:
COME RESIDENTIAL
Application valuation:
1500
T4ht 4 4 Q"
Applicant: Architect or nglneer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
CENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pe rju th I am icensed under pro isions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu in s and rofessionals Code and my License is in full force and effect.
License Class: B Licens o.: 26190
L; Date:?' 10 " Contra J
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 contractors) 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
----------------------------------------------—
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 STATE FUND Policy Number 9047488-2014
I certify that, in the perform ce of the work for which this permit is issued, I shall not employ any
person in any manner so s to become subject toecom
nsation laws of California,
and agree thaJREO
ul become bject to the
on provisions of Section
3700 of the Lshall fo with complys.
Dat Applica
WARNING: FAILURE TO SECRKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000)• IN ATO 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 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 &informa
ation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that tn is correct. I agree to omply with all
city and countyordinances and state laws relating to buand hereby authori r rese tatives
of this ounty}1to entCeeupon the above-mentioned propeurposes.
Date: ✓ - signature (Applicant or Agent): -�
Date: 4/10/14
Owner:
RW REALESTATE.
P.O. BOX 447
LA QUINTA, CA 92253
(760)619-7611
�'"`\�--
J!
Contractor:
HUITRON CONSTRUCTION1Rr'@
; ryj�jt
50427 RIGO COURT
COACHELLA, CA 92236
Z.ITYP�c
(760)398-3227
�L�J�Ji�ciT�
Lic. No.: 926190
----------------------------------------------—
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 STATE FUND Policy Number 9047488-2014
I certify that, in the perform ce of the work for which this permit is issued, I shall not employ any
person in any manner so s to become subject toecom
nsation laws of California,
and agree thaJREO
ul become bject to the
on provisions of Section
3700 of the Lshall fo with complys.
Dat Applica
WARNING: FAILURE TO SECRKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000)• IN ATO 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 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 &informa
ation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that tn is correct. I agree to omply with all
city and countyordinances and state laws relating to buand hereby authori r rese tatives
of this ounty}1to entCeeupon the above-mentioned propeurposes.
Date: ✓ - signature (Applicant or Agent): -�
' Application Number . . . . . 14-00000414
J Permit PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/07/14
Qty *Unit"Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
11.92
----------------------------------------------------------------------------
Special Notes and Comments
RUN GAS FROM HVAC TO DRYER CONNECT DRAIN
TO EXISTING CLEAN OUT DRYER TO VENT
OUTSIDE APPROVED PLANS PER JJ & CPC
2013.
----------------------------------------------------------------------------
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
0
LQPERA1IT
' Bin. .:
City. of La Quinta
BtdVmg ar Safety Maw
i Permit # P.O. Box 1504,78-495 Calle Tampico
1 a-Qutnta, CA 92253 -:(760) 777-7012
Building Permit' Application'and Tracking Sheet
ProjectAddtess: J �j rj .� Sj'-y) �c vAC OwneesName:. — � .�J
I
A. P. Number. Addica s: 4�
j Legal Description: City, ST, Zip:
Contractor. L Q -'J\) D Telephone: y
Address:Project Description:
o' (OV V)
City. ST, Zip. CD
Telephone. 'I bbl Mal.f1
State Lia # : city Lie.. #; �►2/att . '
Arch., Engr., Designer.klk
Address:
City, ST. Zip:
Telephone: Construction Type: , Occupancy:
State Lia #: '2 (e Project type (circle one): New Add'n Alter Repair Demo
Name of Commix Person C s Skoo /) Sq. Ft.: #Stories # UnitF.
Telephone # of Contact Person Estimated Value of Project pQ• O o
i
APPLICANT: DO NOT WRITE BELOW THIS UNIE
M submittal Req'd Reed TRACKING PERMIT FEES-
Plan Sete Plan Check submitted Itrdi Amount
Structural Cala Reviewed, ready ter corsecdous Ptan Check Deposit. .
••
Truss Gies. Called Contact Person Pias Check Balance
•
Tide 24 Calci. Plans picked up Constracdon
_._
bmitted --
—.
_•o.at
---
Giading plan
V Review, ready for eorree ioneLssue
Electrical
Sabcostacter List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Pians resubmitted
Grading
INHOUSE-
'"' Review4 ready for correctinnsAssae
Devdoper Impact Fee
Planning Approval
Called Contact Person
A.U.P.
Pub. Wks. Appr '
Date of permit issue
school Fees
Total Permit Fees
it
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BUILDING & SAFETY DEPT.
APPRVED
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CITY OF* LA QUINTA
BUILDING & SAFETY DEPT.
APPRVED
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