11-0393 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000393--%7 r
PropertyAddress:
48895 -VISTA ESTRELLA
APN:
649-5707021- - -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1263
Applicant:
Architect or Engineer:
A
01K
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
OWner: !ID
t
DAVID INGRAM )i
48895 VISTA ESTRELLA SIf
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7.153
ate: /18/11
APR 2 0 2011
j5 63: uk i4WN IA�
Contractor:
CALIFORNIA DELTA MECHNICAL INC
6052 E..BASELINE RD, #155.
MESA, AZ 85206
(866)692-5273
Lic. No.: 811114
------------------------------
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 Professi nals 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
Li se Class: B -C10-6 License No.: 811114
for by Section 3700 of the Labor Code, for theperformance of the work for which this permit is
XDat.: ontmctor:
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
OWNER -BUILDER DECLARATION
_
insurance carrier and policy number are: '
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the -
Carrier .STATE FUND Policy Number 1697823
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 in any 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 subject to the workers' compensation provisions of Section
. License Law (Chapter 9 (commencing with Section 7000) of Division 3 aftheBusiness and Professions Code) or
700 of the Labor Codd forthwith comply 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).:
ate: plicant:
1—) 1, 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL.
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL 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 (5100,000). 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
(_) 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,
• (_) 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:
LQPERM IT
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 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 co my to nter upon above-mentioned properttpectio purposes.
Date: ignature (Applicant or Agent): `
Application Number
11-00000393
Permit PLUMBING
Additional-desc
' Permit .Fee. 22.50
Plan Check
Fee .;.
5.63
Issue. Date -.
Valuation
0
Expiration Date 10/15/11
Qty. Unit Charge Per
Extension
BASE
FEE
15.00
1.00 7:5000 EA PLB
WATER HEATER/VENT,
1-50
-----
Special.Notes and Comments'
INSTALL NEW 75 GALLON. GAS WATER
HEATER.
2010 CODES.
-------------------_----------------------------------
' Other Fees
---------
BLDG`STDS ADMIN (SB1473)
1.00
Fee summary Charged.
Paid Credited
Due
-- - - - - - - - - - - - - - -----------
Permit..Fee Total 22.50
00 ..00
22.50
Plan Check Total 5.63
.00
.00
5.63
Other Fee Total 1.00
.00
:00
1.00
Grand Total 29.13'
.00
.00
29'.13.
LQPERMIT
premed Hve Certifccate of Cats liance; Residential �W.A,TER MTER
Date: Enforc ent Agency: Climate Zone # # of Stories
v'nJ
�•�5 • / 1wCS:
Site Address;
4 ' -
Building a Sin le Famil 0 Multi Family.
1V07 : This ora; is not to be used for NewlyCorzsirricted Buildlnps orAdditic
CF -IR -ALT -
Permit #
• I certify under penalty of podury, under the laws of the State of
and complete. Calltbtnla, the lafartsettna provided on this form ill accurate
• . I Der* that the enemy fealun's and performance spee}fimdone idendfrad oa this Certificate of Co fiance confbrm to the
re ufremmts of 11113 24 Parts 1 and 6 ofythe Callfbmia Code of Regulations.
Name: p(1 a mQ .
Company: ate:
E i nnE K I
Address:
(husk E , 1i E, (Z LIt- ISS License:
City/state/Zip: , Phone:
M �Z U�v Co)CoQ 2. 5'x 7 3
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at 1-800-772-3300.
16/6 d ti 2 'ON 3A31S WVS0 6 l lq .'Sl 'a ay
' I Din #
I ! Total Permit Feel
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8
City of La Quinta
Building 8r Safety Dlvtaion
Permit + n 3
P.O. Sox 1504, 78.495 Calle Tampico
-3
La Qulnra, CA 92253 - (760) 777-7012
BU11ding Permit Application and Tracking Sheer;
Projt et Address:
Owner's Name:
A- P. Number:
Address: Y•
Legal Description.,
City, ST, Zip:
Contractor: �'
� � �
Telephone; ��
.-
Address: Eos
project Description:
City, ST, Zip:
2— .05?z 6
Telephone: 966
3
G{ �vi.f�3'l
State 1,[a fl :
City Lia tSl l� 1{OD �{
t
Arch., Engr., Designer
7.
Address:
!
City, ST, Zip:
Telephone:
Construction *pe; pwu per'
Stara Lia M.
PMJeottype (olccle ane): Now Add'n Altta=Dew
Name of Contact Par on:
t
V •
Sq• Ft:
'
# Stories;
Telephone # of Contact person 966-6 q 7-5W43
#Unita:
t;maftd Varus of ProJert (Q
APPLICANT: DO NOT WRITBELOW THIS UNE
#
Submittal
q'dRecd
•
TRACIMG
P�14IIT 8'18
Plan Seta
Plan Check submitted
Itam
Structural CRiee.
Reviewed, ready fbr corractiooe
Plan Check Deposit
Amount
Truax Calle.
Called Contact Perron
)flan Check Balance
Title zd Calle.
Plana picked up
Construction
plan
Pian resubmitted
Mechanical '
Gradingan
2° Review, ready for correctlone/laaue
Electrical
oCalled
!Gment
ContactPoraonPtambing
Plan ptctred up
roval
Plane resubmittedGlrading
-
Review, reRdy for corrections/ince
Developer Impact gee
Planning approval
Called ContactPerson
A.iP.P.
�Pub, ks. Appr
Date of permit issue
S0,dr1rFee4
I ! Total Permit Feel
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8