BRES2015-026878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
QuintT4,tivl- 4 Irv:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2015-0268
Property Address: 48111 VIA HERMOSA
APN:: 646100016
Application Description: WASHINGTON /SHOWER PAN AND (3) FIXTURES
Property Zoning:
Application Valuation: $5,000.00
Applicant:
LOUIS R GUILBAULT
53-501 AVENIDA DIAZ
LA QUINTA, CA 92253-3582
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: C54 1 License No.: 830611
Date: - 1 Contractor: =��w
VOICE (760) 777-7125
FAX (760) 777=7011
INSPECTIONS (760) 777-7153.
Date: 7/14/2015
Owner:
Carrier:- Policy Number:
JULIUS WASHINGTON
_
412 1 certify that in the performance o- the work for which this permit is issued, I
`nowt
0 p�
any structure, prior to its issuance, also requires the applicant for the permit to file a
a;
signed statement that he or she is licensed pursuant to the provisions of the
E2 C
Contractor:
I�
LOUIS R GUILBAL LT'gyp-
Date: Applicant:
53-501 AVENIDA DIAZ
2
LA QUINTA, CA 9?253 3582
v cs
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIM INAL PENALTIES AND CIVIL FINES UP TO
(760)899-7011
ONE HUNDRED THOUSAND DOLLARS ($100,11)0). IN ADDITION TO THE COST OF
Llc. No.: 830611
+
WORKER'S COMPENSAriON DECLARATION
I hereby affirm under penalty of perjury one df the following declarations
I have and will maintain a certificare of consent to self -insure for workers'
compensation, as provided for by Section 370 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' ompensation insurance, as required by
Section 3700 of the Labor Code, for the perfo mance of the work for which this permit
is issued. 'My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier:- Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
_
412 1 certify that in the performance o- the work for which this permit is issued, I
`nowt
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
stall employ any person in any manner sc• 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 the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
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: Applicant:
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 WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIM INAL PENALTIES AND CIVIL FINES UP TO
I ) I, as owner of the property, or, my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,11)0). 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
(_J 1, 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 contractors) licensed pursuant to
employees for any act or omission related tc 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 app'ication 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 Name:
Lender's
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, and hereby authorize representatives of this city to enter upon the above•
mentioned property for inspection purposes /
Date- -7I Signature (Applicant or Agent)_2/= Gf
FINANCIAL •R•
_
g DESCRIPTION ACCOUNT AMOUNT PAID '` PAID DATE:
. , r r z
BSAS SB1473 FEE 101-0000-20306 0
$1.00 $0.00
BYx g',�•`[' METHOD, ' RECEIPT# `CHECK#
CLTD BY
:PAID pT
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIf?TION� f #
y ACCOUNT`
pQTY
PATO
PAIf)xDATE'
t.,
n:
;AMOUNT`
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY =a
t METHOD `s
` g RECEIPT #
CHECK #CLTf)
BY
P
,
� �3
r
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
;ZESCRIPTION��� � � � x
:t ACCOUNT`'
QTYk
+.AMOUNT S ;�
, 'PAID iPAID%DATE
�
,
FIXTURE/TRAP
101-0000-42401
0
$24.18
$0.00
:S &t '•t' .m`z�"�"'�. fiff 't[ 7`�'a
'' `x PAIf); �
- s' e +.`,+' .t
< METHOD "
'. -r
'` RECEIPT#� L
x q'
CHECK #
CLTD BY x`
* BY , _
,
I
E DESCRIPTION
,<
ACCOUNT
QTY
� ,AMOUNT
PAID `
PAID DATE4:
a.
,
FIXTURE/TRAP PC
101-0000-42600
0
$24.18
$0.00.
kPAID BY4e
METHOD r
#A
HEC
F C K #:_u
CLTD BY
: x
d_
.RECEIPT
a
f7ESCRIP,TION`
a s rg ACCOUNT
r=` AMOUNT'x ''
�3PAIUPAID'DATE=
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$12.09
$0.00
'aPAID'BY �j` ` "�
r€" ' METHOD
} _:qr
at #
CHECK #
CLTD BY
..
A S .:RECEIPT �>
;
DESCRIPTION >}
{„+r ACCOUNTS ;r- h
QTY
:, AMOUNTy
Mfg' 'PAID �'+
PAID�DATE
n r
WATER SYSTEIVI.INST/ALT/REP PC
101-0000-42600
0
$12.09'.
$0.00
PAID< BY, '; #
a METHOD y: T
t
` RECEIPT #
s e z
CHECK #
CLTD BYE
T
Y P
y pY
Total Paid forPLUMBING FEES: $72.54 $0.00
• 00
Description: WASHINGTON / SHOWER PAN AND (3) FIXTURES' . .
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: UNDER REVIEW
Applied: 7/14/2015 SKH ,
Approved:
Parcel No: 646100016 Site Address: 48111 VIA HERMOSA LA QUINTA,CA 92253
Subdivision: TR 20052-1
Block: Lot: 16
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,000.00
Occupancy Type: Construction Type'
Expired:
No. Buildings:`0
No. Stories: 0... _ No. Unites: 0
'
Details: REMODEL BATHROOM - (2) FIXTURES AND SHOWER. 2013 CALIFONRIA BUILDING CODES.
3582
CONTRACTOR LOUIS R GUILBAULT 53-501 AVENIDA DIAZ LA QUINTA CA 92253-
- .. w .7502
OWNER JULIUS WASHINGTON 17503 LORI ANN LN CERRITOS CA 92253
INFORMATIONFINANCIAL
r h� � Y~w `fie _. r -'� _ • i _ .. i
Printed: Tuesday, July 14, 2015 1:46:38 PM 1 of 2
- _ - CRW.IYSTEMS
Printed-.- Tuesday, July 14, 2015 1:46:38 PM .2 of 2
cmwSysirms
A
V'11�
NIN-
QTY.,K�,
1'..' #
METHOD
�1
13
7-:
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00,
BSA:
PERMIT ISSUANCE
101-0000-42404
0.
$91.85
$0.00.
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
FIXTURE/TRAP
101-0000-42401
0
-$24.18
$0.00
FIXTURE/TRAP PC
101-0000-42600
0
$24.18
$0.00
WATER SYSTEM
101-0000-42401
0
$12.09
$0.00,
INST/ALT/REP
WATER SYSTEM
101-0000-42600
0
w $12.09
$0.00.
INST/ALT/REP PC
Total Paid forPLUMBING FEES:. $72.54 $0.00
TOTALS: $165.39 $0.00
Printed-.- Tuesday, July 14, 2015 1:46:38 PM .2 of 2
cmwSysirms
FIXTURE FLOW RATES
FIXTURE TYPE
MAXIMUM FLOW RATE
Showerheads
2 gpm @ 80 psi
Lavatory faucets
1.5 gpm @60 psi .
Kitchen faucets
1.8 g m 60 psi
Water closets .
1.28gallons/flush
Urinals
0.5gallons/flush
Din #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit '#
Project Address:
Owner's Name: l As
A. P. Number: Azfi@
Address: ' (4'L^ ,Eoeln D
Legal Description:
g(�(J
City, ST, Zip:
Contractor
Telephone:
hone:
............:....:...........::::::::::::::::
Address:
Project Description: S'-) too 1Y1
City, ST, Zip: 44
L)n
— %qif F(�
Telephone: 7 v-
-a •4O
..........:........................................:.
State Lic. # : 10
#;
City Lic.22
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone: ;.
e ne:
P 0
•
on
C structi n Type:
e: ane
Y P Oc u P Y:
State Lic. #• 0 40l 1
r
ect type (circle '
cle one w : New Add'n Alter Ale Rep it Demo
Name of Contact Person:
Sq. Ft.:
# Stories: -
# Units:
Telephone # of Contact Person:
Estimated Value of Project: A,
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check D•.posit
Truss Calcs.Called
Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2p. Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
`
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees