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BMCH2015-041202 78-495 CALLE TAMPICO 4 VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT � INSPECTIONS (760) 777-7153 BUILDING PERMIT Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: �- Date: 10/26/2015 BMCH2O15-0412 - __ _ p'� Owner: 78381 W DEACON DR FRAN DAVIDSON 770210023 � 78381 DEACON DRIVE WEST DAVIDSON RESIDENCE / HVAC CHANGE OUT(,, _._ � � � � `�;LA QUINTA, CA 92253 1 i $19,303.00 - Applicant: IE INC 31225 LA BAYA WESTLAKE VILLAGE, CA 91362 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: C20. C36 License No.: 686310 Date: 1012(,116 Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the 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 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).: (_) I, 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 Contractors' State License Law does not 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 are not intended or offered for sale. If, however, the building or improvement is sold within 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.). (_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. . B.&P.C. for this reason 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. Q. Lender's Lender's Add Contractor: HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE THOUSAND PALMS, CA 92276 (760)601-3500 Llc. No.: 686310 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 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 insurance carrier and policy number are: Carrier: Policy Number: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 1OI2-icII5 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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 city to enter upon the above-mentioned property for inspection purposes. Date: L421611_S (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT. PAID , PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM 101-0000-42402 0 $145.04 $0.00 PAID BY METHOD . RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HVAC CHANGEOUT - SPLIT -SYSTEM PC 101-0000-42600 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for CHANGEOUT: $217.56 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY. Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:0.40.00 Description: DAVIDSON RESIDENCE / HVAC CHANGE OUT Type: MECHANICAL Subtype: Status: APPROVED Applied: 10/26/2015 MFA Approved: 10/26/2015 MFA Parcel No: 770210023 Site Address: 78381 W DEACON DR LA QUINTA,CA 92253 Subdivision: TR 28611 Block: Lot: 9 Issued: Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: - Finaled: Valuation: $19,303.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 STATE Details: (2) HVAC CHANGE OUT- 14.5 SEER/80AFUE SPLIT SYSTEMS [2008 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. PER 2013 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION Printed: Monday, October 26, 2015 9:05:23 AM 1 of 2 r SYSTEMS • • NAME TYPE NAME ADDRESS1 CITY STATE FAX -EMAIL ZIP PHONE APPLICANT IE INC 31225 LA BAYA WESTLAKE VILLAGE CA 91362 (206)730-7599 CONTRACTOR HARRISON ENTERPRISES INC DBA GENERAL AIR 31170 RESERVE DRIVE THOUSAND PALMS CA 92276 (206)730-7599 OWNER FRAN DAVIDSON 78381 DEACON DRIVE WEST LA QUINTA CA 92253 (206)730-7599 FINANCIAL INFORMATION Printed: Monday, October 26, 2015 9:05:23 AM 1 of 2 r SYSTEMS PARENT PROJECTS "' Printed: Monday, October 26, 2015 9:05:23 AM 2 of 2 SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY . BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total. Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: HVAC CHANGEOUT - 101-0000-42402 0 $145.04 $0.00 SPLIT -SYSTEM HVAC CHANGEOUT - 101-0000-426000 $72.52 $0.00 SPLIT -SYSTEM PC Total Paid for CHANGEOUT: $217.56 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:• 00 PARENT PROJECTS "' Printed: Monday, October 26, 2015 9:05:23 AM 2 of 2 SYSTEMS Bin # Qty Of La QUI n' ta Miding & Safety Division P.O. Boz 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 7777012 Building Permit'AMication and Tracking Sheet Permit # 78381 Deacon Drive West Owner's Name:. Fran Davidson ENumber Address: 78381 Deacon Drive West n: Contractor: General Air Conditioning City, ST, Zip: La Quinta, CA 92253 Tel hone• 206-730-7599 fs = ' Address: 31170 Reserve Drive Project Description: Replace (1) 4ton A/C, (1) 2.5ton A/C, City, ST, Zip: Thousand Palms, CA 92276 (1) 4ton Coil, (1) 2.5ton Coil, (1) 90,000 BTU Fumace, Telephone: 760-343-7488 :� ,r'_ &-(1 70,000 BTU Furnace State Lic. # : 686310 City Lia 9, Arch., Engr., Designer. Address: City., ST, Zip: Telephone:`. State Lic. #: —101 j �- Construction Type: Occupancy: Project type (circle one): New Add'a Alter Repair Demo Sq. Ft.: # Stories: #Units: Name of Contact Person: Steven Schnierer Telephone # of Contact Person: 818-735=7876 x 1 Estimated Value of Project: 19, 303.00 . APPLICANT: DO NOT WRITE BELOW THIS UNE N Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submittedItem Amount Stmetaral'Cales. Reviewed; ready for corrections Plan Cheek Deposit. . Truss Cates. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction ' Flood plain plan Plans resubmitted' Mechanical Grading plan 2i6 Review, ready for correctionsrLme Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Review; ready for correetionslssue Developer Impact Fee Planning Approval. Called Contact Person Pub. Wks. Appr ' Date of permit issue School Fees Total Permit Fees