BPLB2016-008578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
R
.4 QUM&'
COMMUNITYDEVELOPMENT DEPARTMENT
BOILDING PERMIT
I
4
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/8/2016
Application Number:,
BPLB2016-0085
Owner:
Property Address:
80940 VISTA GALOPE
VERNON NUSSBAUM .
APN:
777020017
80940 VIA GALOPE
Application Description:
NUSSBAUM RESIDENCE / PROPANE TO GAS CONVERSION
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $10,000.00 D
Applicant: "'� Contractor: JUN o 8 2016
RITETECH pp RITETECH
80610 WILLOW LANE JUN U 6 2016 80610 WILLO LA1V7
F_
RITETECH
INDIO; CA 92201 INDIO; CA 92 A4MUNITYDEVELOPMENTDEPARTMENT
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT. (760)989-9695
Llc. No.: 1000185
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 (commencing 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: C36 License No.: 100018 \
of the work for which this permit is issued.
A
I have and will maintain workers' compensation insurance, as required by
Dat ey
Contract o
Section 3700 of the Labor Code, for the performance of the work for which this permit
issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER ECLARATION
Carrier: Policy Number: -
I hereby affirm under penalty of perjury that I 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. 1031.5, 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, 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
t
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
Date t
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' C PENSATION COVERAGE IS UNLAWFUL,
($500).:'
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� 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'improvement's
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 contractor(s) 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.
(_) 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
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 N
Lender's Add
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 ci to enter upon the .
above-mentionq property for inspection purposes.
Da Signature (Applicant or Agent
UMBE
b. P e, On it DeO i I s„ PERMIT N
e
'01 008,
1`6
a.
yam. City of L Quin
Description: NUSSBAUM RESIDENCE / PROPANE TO GAS CONVERSION
Type: PLUMBING Subtype:' Status: ISSUED
Applied: 6/8/2016 MFA
Approved: 6/8/2016 MFA
Parcel No: 777020017 Site Address: 80940 VISTA GALOPE LA QUINTA,C4 922S3'
Subdivision: TR 14104 Block: Lot: 17
'
Issued: 6/8/2016 MFA
Lot Sq Ft: 0. Building Sq Ft:.O Zoning:
Finaled:.-
Valuation: $10,000.60 - Occupancy Type: Construction Type-
Expired: 12/5/2616 MFA
No. Buildings: 0 No. Stories: 0 No. Unites: 0
92201
Details: *.PROPANE, TOGAS CONVERSION FOR ENTIRE MAIN HOUSE AND CASITA% GAS LINE TO BE SLEEVED WHERE REQUIRED. LEAVE LINES
EXPOSED UNTIL INSPECTED. PER 2013 CALIFORNIA BUILDING CODE.
owPrinted,:. Wednesday, June 08, 2016 11:44:30 AM 1 of 2 C SYSTEMS
APPLICANT
RITETECH
'JMApproved
tbIssued ti, -,*-j
14�
INDIO
CA
92201
(760)863-1011
ritetech6gmaii.com
CONTRACTOR
RITETECH
80610 WILLOW, LANE•
INDIO
CA
ADDITIONAL
SITES
ritetech@gmaii.com
OWNER
VERNON NUSSBAUM
80940 VIA GALOPE
LA QUINTA
CA
CHRONOLOGY
(760)863-1011
CONDITIONS
CONTACTS
-:NAME TYPE 4 71
....... .... .. ...
. ..
.......... .. ..........
owPrinted,:. Wednesday, June 08, 2016 11:44:30 AM 1 of 2 C SYSTEMS
APPLICANT
RITETECH
80610 WILLOW LANE
INDIO
CA
92201
(760)863-1011
ritetech6gmaii.com
CONTRACTOR
RITETECH
80610 WILLOW, LANE•
INDIO
CA
92201
(760)863-1011
ritetech@gmaii.com
OWNER
VERNON NUSSBAUM
80940 VIA GALOPE
LA QUINTA
CA
92253
(760)863-1011
owPrinted,:. Wednesday, June 08, 2016 11:44:30 AM 1 of 2 C SYSTEMS
Printed: Wednesday, June 08, 2016 11:44:30 AM 2 of 2
SYSTEMS
7
7
'77
INSPECTIONS
�11)ESCF
ACCOUNT.
:PAIDPAID
DAT
iRECEIPT#
METHOD,
PARENT
PROJECTS
Z R
RiEW W S'
7-�' 71
'��_REVUEW TYPE
REVIEWER 4..11-
ElY.T.-DATES
i 4.
Y:
PERMIT ISSUANCE
101-0000-42404
-0
$91.85
$91.85
6/8/16
R16074 •
191671
DEBIT
RITETECH
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
G AS SYSTEM, 1-4
1
.
.
101-0000-42401
0
$12.09
$12 .09
6/8/16
R16074
191671
D EBIT
RITETECH
MFA
OUTLETS
GAS SYSTEM, 1-4
101-0000-42600
0
$24.17
$24.17
6/8/16
R16074
191671
-DEBIT
RITETECH
MFA
OUTLETS. PC
-WATER HEATER/VENT
101-0000-42401
0
$36.27
$36.27
6/8/16
R16074
191671
DEBIT
RITETECH
MFA
WATER HEATER/VENT
101-0000-42600
0
$21.75
$21.75
6/8/16
R16074
191671
DEBIT
RITETECH
MFA
PC
TotalPaidfor PLUMBING FEES: $94.28 $94.28
Printed: Wednesday, June 08, 2016 11:44:30 AM 2 of 2
SYSTEMS
TOTALS- 5187.13
INSPECTIONS
PARENT
PROJECTS
Z R
RiEW W S'
7-�' 71
'��_REVUEW TYPE
REVIEWER 4..11-
ElY.T.-DATES
ATE:
ml k, 1670
1111 ffel !j kyj Fill 9 ral 0
Printed: Wednesday, June 08, 2016 11:44:30 AM 2 of 2
SYSTEMS
Bin #
U�
City of La Quinta
Building 8t Safety Division
78-495 Calle Tampico
-La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # (
-Utp
o"3e"ct Address:41.LEM-rher's
Name:
A. P. Number:'1A'ddress:
a� Oil, `0
Legal Description:
tib
City, ST, Zip:y �oZ S3
2o�ctor:
�
iT ele hone• 7 3
.........................................:.::
Ass: 0`
Pro eet Descr' _ teen.4-0
City, ST, Zip:
T eleh
phone:
P o . -
�S7t'?ee Lic. #
(� a� I
SVIA
YJ (\,J A IA l
ykk-0-0� )
col�E'J
Arch., Engr., Designer:
AJOA
Address:
Vr
City., ST, Zip:ILllw—
Telephone: 0
ne:
o n tract' Y
C s i nT e•
0 P• Occupancy:
P Y:
State te Lic. # •
Project nPa (circle one • New
Add'n Alter Repair r De m o
Name of Contact Person:Sq.
Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
AJ
stimated Value of Project: -Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes. .
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 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 ROUSE:-
'^! 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 Fecs,
Total Permit Fees
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' ` 1 (� tea•. NOTES: '
.,ADDRESS NU_.BER}. „'\ ;- PI N !NOTES:
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INDEX
EN. RJ 6i9RP•°.u•Y •J,,'-`..
( A.1 SITE PLAN e. 1 AP IChTIN^ u T
y -'F3L � . �# O((j 4_•� - x. .� 1/ - i ��" ,: �071P:>i1A NiP,,•LRNI RIDOERiP,,. --� - _ANDS... EL' 4.L gr,
-+ v ♦. • _ v� \ %J~ �,I�' A.'1 DIMENSION PLAN CHO C6ELL ONTROL .
wa \ -lJ,.. ?yc♦ 1 s : ? s bd \`1)��\�i vlu . ♦ 1� R5` r tom:'. wwmul4wlwl A.Z FLOOR PLAN -
S•.. q r -' 1 1(EPlwr .* ' '• A.4 ELEVATIONS („ - • ! 4ND5C4?E AREAil•�IC< E -:HAL" e Y
! l..s ., I / ,X• YI•� a tlN.aDL`f DoE _ BE ,`WiVIDED W.rUL LG /EFA6° nU
oexuros+-sNwr - _ A,5 sEcnoNS +n - _ - • ;
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e:r + ..,.
r' 4V •� - o 3 `r ry* * •. 87`6L ROOF PUN
yE Y'B:t • +• ` A% GUEST N� , • I14RIrA,oN -Y -H h'4F-ROVE
.k » w. .,� ih. r z. yJ/" . • ,p �k" L' <' - , ® " SE BOOR PIAN E
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