BPLB2017-011178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPLB2017-0111
DESIGN &.DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address: 80095 VIA VALEROSA
APN: 777230014
Application Description: BRODERICK /.CHANGE BBQ AND ADD GAS LINE FOR FIRE PIT
Property Zoning:
Application Valuation: $2500.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/15/2017
Owner:
PATAICIA BRODERICK
80095 VIA VALEROSA
LA QUINTA, CA 92253
Applicant:fl
Contractor:
A & R POOLS INC A & R POOLS INC
P 0BOX 103 AUG 15 2017 LD P O BOX 103
LA QUINTA, CA 92247 LA QUINTA, CA 92247
CITY OF LA QUINTA (760)772-0752
DESIGN AND DEVELOPMENT DEPARTMENT LIc. No.: 993197
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations:
9 (cornmencirig with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: _ License No.: 993197 of ttW wgek for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: r7 Contractor: .,� �! '' 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:
OWNER -BUILDER DECLARATION Carrier: WESCO INSURANCE COMPANY Policy Number: WWC3206752
I hereby affirm under penalty of perjury that am exempt from the Contractor's State I certify that in the performance of,the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so:as to become subject to the workers'
city or county that requires a permit to construct, atter, 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 ofthe.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 (Chapter9 (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 CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_J I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). 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
(—) I, 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 to the work being performed under or
the Contractors' State License Law.). following issuance of this permit.
U I am exempt under Sec. B.&P.C. for this reason '2. Any permit issued as a result of this application becomes null and void if work is
riot 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:
r I certify that I have read this application and state that the above information is correct.
CONSTRUCTION LENDING AGENCY I agree to comply with -all city and county ordinances and state laws relating to building
I hereby affirm under penalty of perjury that there is a construction lending agency.for' construction, and hereby authorize representatives of this city to enter upon the
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). r above-mentioned property for inspection purposes. �-
Lender's Name: Date:-- Signature (Applicant or Agent):,
/-,
Lender's Address:
Date: 8/15/2017
Application Number:
-
BPL62017 0111
- Owner: -
Property Address
80095 VIA VALEROSA
PATRICIA BRODERICK-
APN:
777230014
80095 VIA VALEROSA
Application Description:
BRODERICK / CHANGE BBQ AND ADD GAS LINE FOR EIRE PIT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$2,500.00
Applicant:
Contractor:
A & R POOLS INC
A & R POOLS INC
' P0BOX 103
PO BOX 103
LA QUINTA, CA 92247
LA QUINTA; CA 92247
(760)77270752
ilc. No.: 993197
Detail: PLUMBING - GAS.LINE FOR BBQ AND FIRE PIT. 2017CALIFORNIA BUILDING PERMITS.
FINAWAA INFORMATION
,,,.. DESCRIPTION ACCOUNTQTY AMOUNT
BSAS S131473 FEE .101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION ,
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT "
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.67 '
'DESCRIPTIO'N
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000.42600 . -
0
$25:33
" Total Paid for PLUMBING•FEES: $38:00
DESCRIPTION
ACCOUNT l
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00, .
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
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Bin#
• ". 1 .City of La Quinta
Y { Building & Safely Division '
+' 78-495 Calle Tampico $ ,
Permit# -
La Quinta; CA 92253 - (760) 777-7012-
1
BuildingPermitApplication and Tracking. Sheet '=
ProjectAddress:
/I e��E
Owne sName:.
AIK
A.P. Number r:
Address: ' I/y ^
t[�
VIA
V o !�'
Legal Description: <_City;
2
ST; Zip: JV
C� tor: �
Telephone:
,� _" _
ININ
Address: ,
Project Description:. '
C!!�, ST' Zip:
Telepho e: �
State Lic. :crn
-- 1- City Lic #:
Arch, Engr., Designer:
Address:
.
City, ST, Zip:
}
Telephone:
Construction Type:
Occupancy:
C
State Lic. #: i-
Proj. Type
New
Add'n
Alter
Repair'
Demo w
Name of Contact:
SgFt: •
#Stories
# Units:
Telephone of Contact:
_ .�. C
Estimated Value of Project:
- : -
AP LICANT- DO OT WRITE ;BELOW THIS LINE.
#
Submittal
Req'd
Rec'd .
TRACKING " '
PERMIT FEES
Plan Sets
Plan Check Submitted
Item
Amount
Structural Calcs
-
Reviewed, ready for corrections
Plan Check Deposit:
Truss Calcs
,'
Called Contact Person
Plan Check Balance:
,
Title 24 Cales
Plans Picked Up
*
Construction:
Flood Plain Plan 1
Plans Resubmitted
Mechanical: ;
Grading Plan
j
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List .
Called Contact Person
Plumbing:
Grant Deed
' . `
Plans Picked Up
HOA Approval . _
Plans Resubmitted -
Grading
IN-HOUSE
3rd Rev, Ready for corrections / •
Developer Impact Fee
Planning Approval
r
Called Contact Person
A.I.P.P.
Pub. Wks. "Apps
Date of permit issue
+
t
School Fees
Total Permit Fees
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