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10-0146 (MECH)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT I Date: 2/26/10 Application Number: 10-OO600146 Owner: Property Address: 78670 VIA MELODIA GOMEZ DANTE APN: 646-050-047- - 78670 VIA MELODIA Application description: MECHANICAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL ( Application valuation: 2000 -Contractor: D . - Applicant: Architect or Engineer: TELFORDJONES, INC. 25920 IRIS AVE, STE 13A-404 MORENO VALLEY, CA'92551 C 20ig (951)486-0337 J Lic. No.: 856936 G11tlOF .LA Qflily7A Apr LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License.Class: B -C10 -C20- cense No.: 856936 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued: 1�l Date Z6 y?Contra r: _ 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: hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier STATE FUND Policy Number 238 -0005911 - following reason (Sec. 7031 .5, 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 inany manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I should become subj to workers' compensation provisions of Section - - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of th or o 4 r ' h Iy with those provisions. 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) PI cant: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, andthe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The . WARNING: FAILU E TO SECURE KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT ANEMPL YER T INAL 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 ($100,000). IN 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 I, 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, (_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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 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 inform n is c c I agree to comply with all city and county ordinances and state laws r 'ding constru o , an ter y authorize representatives of this county to enter upon the above- bone73 prope 1 fo pur s. �— Oat�� Signature "IAppf ant or A nt 1 LQPERMIT Application Number 10-00000146 Permit . _ _ . . MECHANICAL Additional desc . Permit Fee 33.00 Plan Check Fee 8.25 Issue Date Valuation 0 Expiration Date 8/25/10 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000•EA MECH FURNACE <=100K 9.00 1,.00 9.0000 EA MECH ---------------------------------------------------------------------------- B/C <=3HP/100K BTU 9.00 ' Special Notes and Comments HVAC CHANGE OUT - EXISTING LOCATION LIKE FOR LIKE AC CONDENSOR / 5 TON 13 SEER. --------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary• Charged Paid Credited Due ---------- Permit Fee Total 33.00 ---------- ---------- .00 .00 33.00 Plan Check Total 8.25 .00 .00 8.25 Other Fee Total. 1.00 .00 _00 1.00 Grand Total 42.25 .00 .00 42.25 LQPERMIT V?I/4f!'zvlV IV: 0j I -FIX SEARS—HOME—IMPROVEMENT JONES .0005,/006 i= EHE -2S -2o i m 12 ; 48 AM GARY FP.1 SCH 76® 7211 ® x 9 Rf�• ura u,I l-�• ••w Li,rrvaer rausppOeeTlvi�9rrtothdv�st,rialrortYarea• ffNJhcareroo�7ydm�ies}mehe4dnB {n v( A lingOxWl.ralararn�ub� encs ap opa�lr'"d "� rW #m idlogalta+a- �l u+.a p✓pA frYvlapvnl+rom rr,a)1t4iN hlAlpr r0 ()I# Rlfcipn(m) and 0l1 0l) rhbl,'eyv0411f Jur water rim 1, a,adbj IFr¢nr QS b d14 saanQ - Cixlunsel runt WeicrHaatw.T" Ftcef DliidDU, oTy it N cher to T---j_ti,sasgy Facsa ar tn,ulctlml 1. hMfa a7* ($Wpgv Guy fear Puw& ,wlanma as aq orad 1.tGmlrCltlafR�lytfttsnmtelvfnBrto>tl�+tadw�lGWsnrlr,afsallm !lUC1eQrlanpa�Irlle✓henfsq/fIJO(i1). 7ha Prorcrrplin nQulranlcrf+srfn pot ago* the tmftumknofo►riaif+rnlatft*01or1brdvkdmlkrdaaps. 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Nb:RS Proylev,, am Resldcruial Camp turret Forma ,W1, Received on 2/25/2010 3:30:213 AM ! Bin # City of Ia Quinta Building 8r 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: 7 Owner's Name: �� G A. P. Number: Address: Legai�b��i�fiol%y'� 'YS Ti1?_�S$j y City, ST, Zip: Contractor: T:>;;!!;»>;.;:.;:.:<•;<: ;;:a::<.z;:>:::«z<.:::•:::sa: elephone: Address: */Lx0 Od Project Description: City, ST, Zip: `�jj� Telephone: r State Lie. # : City Lie. #•: — 57Zk—J AL3 Arch., Engr., Designer: v� C / �-v Address: City, ST, Zip: Telephone: h one: Construction on T e• Occupancy: P P cY: State to Lic. #: Project type (circle one • New Add' n Alter a ar Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cates. 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 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:- '"' 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