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BPLB2015-0130Qa."'��^� ® Vi?N 60) 777-7125 Q 78-495 CALLE TAMPICO D al LA QUINTA, CALIFORNIA 92253 60) 777-7011 COMMUNITY DEVELOPMENT DEPART T NOV 1 O 2 WSPE 760) 777-7153 BUILDING PERMIT ""�--�--JJDaT, 11/10%2015 !TAApplication Number: BPLB2015 0130CONIIS?�,�el'ril,�(.Property Address: 54259 SHOAL CREEK O6 KIL'LEENJFID•Y-K TRUSPAfl APN: 775041001 33690 433RD PL Application Description: KILLEEN / 3/4" GAS PIPING TO SINGLE STUB OUT AITKIN, MN 56431 Property Zoning: Application Valuation: $1,200.00 Applicant: A R K PLUMBING 49901 CALLE EL SOL COACHELLA, CA 92236 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 ;T- OWNER-BUILDER sandProfessions Code, and my License is in full force and effect. 'TD -ate: Class: C36 License No.: 921951 \Date: I t ' Ib '' � C�actor: DECLRXAON I hereby affirm under penalty of perjury that I am &empt 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.). (1 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 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. C.). Lender's Name: Lender's Address: Contractor: A R K PLUMBING 49901 CALLE EL SOL COACHELLA, CA 92236 (760)200-7586 Llc. No.: 921951 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. 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, i I should becogl1e subject to the workers' compensation provisions of Section 370of the bor ode, I shall forthwith comply with those provisions. /! Da1-71 _77 J A..Znt: l 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 stat laws relating to building construction, and hereby authorize representatives of this ci to en r up n the above-mentioned property for inspection pur ses. Date: Signature (App scant or Agent): FORMATION .,., Q�, . �' z•n .� 3 4'� ' t;t>� ��i� �.kms. r � 0P [AMUz PAIDy .5 ;DESCRIPTION ,��ACCOUNT YPAIgDA BSAS SB1473 FEE • 101-0000-20306 0 $1.00 $1.00 11/10/15 Nx- M IOD �R CHECK#CL DBY CT:. « s .., i.n I.,.., .., , - ...: c;C-.s�zi`.t , ✓, b... , " , . 7 A R K PLUMBING DEBIT R10732 2015-0130 MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00" $1.00 3.;�sita�Ce i.. �'d+y., - x�x ? <�'/.Yt '.,`f?`ft'G;'°"'.5'':rp,aXsk AMOUNT PAID. PAIf)'aDATE-. ,s.,r;-DESCRIPTION in,,:,e� A~4C,'=UN,1. ... .:. i s PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 11/10/15 PAID�BY� METHOD. CHECK #. ,. axe RECE .T#, A R K PLUMBING DEBIT R10732 2015-0130 MFA Total Paid for PERMIT ISSUANCE: $91:85 $91.85 5 ` a "' ACCOUNT �QT�1( AMOUNT> PA D� 'PAIDfDATE .DESCRIPTION ,� vv.. a r 5 s r..., , GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09. $12.09 11/10/15 :.PAID BY ^.r.. MW an" CT�B' s X METHOD; �zECE#,� CHECK A R K PLUMBING DEBIT R10732 2015-0130 MFA z DESCRIPTION,; ACCOUNT v. PAID�� AID p `M. ...> a N MOUNT DAT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 ' . 0 $24.17. $24.17 11/10/15 y s PAIf)�Blf `-54 z� C IPS#; #y BYE METIOD.R ;F 'CHECK �CL�TD A R K PLUMBING DEBIT R10732 2015-0130 MFA .Total Paid for PLUMBING FEES: $36.26 $36.26 9 11 r 1 . Description: KILLEEN / 3/4" GAS PIPING TO SINGLE STUB OUT Type: PLUMBING Subtype: Status: ISSUED Applied: 11/10/2015 MFA Approved: 11/10/2015 MFA Parcel No: 775041001 Site Address: 54259 SHOAL CREEK LA QUINTA,CA 92253 Subdivision: TR 24317-2 CM 79/57-64 Block: Lot: 2 Issued: 11/10/2015 MFA Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,200.00 Occupancy Type: Construction Type: Expired: 5/8/2016 MFA No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: INSTALL 3/4" GAS LINE FROM EXISTING STUB OUT TO NEW STOVE IN KITCHEN PER 2013 CALIFORNIA BUILDING CODE ,. �� nNNiicv w nNNi vvcu c Approved to Issued Printed: Tuesday, November 10, 2015 9:36:54 AM 1 of 2 Ci SYSTEMS CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT A R K PLUMBING 49901 CALLE EL SOL COACHELLA CA 92236 CONTRACTOR A R K PLUMBING 49901 CALLE EL SOL COACHELLA CA 92236 OWNER KILLEEN JUDY K TRUST 33690 433RD PL AITKIN MN 56431 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT I PAID J.PAIDDATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 11/10/15 R10732 2015-0130 DEBIT A R K PLUMBING MFA Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 BSA: $1.00 Printed: Tuesday, November 10, 2015 9:36:54 AM 1 of 2 Ci SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 11/10/15 R10732 1 2015-0130 DEBIT A R K PLUMBING MFA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 GAS SYSTEM, 1-4 101-0000-42401 0 $12.09 $12.09 11/10/15 R10732 2015-0130 DEBIT A R K PLUMBING MFA OUTLETS GAS SYSTEM, 1-4 101-0000-42600 0 $24.17 $24.17 11/10/15 R10732 2015-0130 DEBIT A R K PLUMBING MFA OUTLETS PC Total Paid for PLUMBING FEES: $36.26 $36.26 TOTALS: ATTACHMENTS Printed: Tuesday, November 10, 2015 9:36:54 AM 2 of 2 C#? SYSTEMS Bin # City of La Quinta Building u Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:s �- 1TSR S C Owner's Name: i A. P. Number: Address: Legal Description: City, ST, Zip:' In i CN - actor: Contractor: Telephone: ....1.. Address:' v\ O �� © Project Description: V 11 �,.` City, ST, Zip -.CC • C' '� eif TelePh on7 0-20 C .o ri State Lic. # : City Lic..#;( k -)l qve a IK �Iq rrim t - Arch., Gngr., Designer: 1 Address: City, ST, Zip: h one: Telephone: eP Can tructi n Type: Occupancy:an cY ic. # State Project (circle one): Add'n Alter Repairair Dem o Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd 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 Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person . Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrcctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees 11/10/2015 ;Rr9ty-Aihencan t.-- myFirstAm' Property Profile Property Profile - myFirstAm C 54259 Shoal Crk, La Quinta, CA 92253 Property Information Imp Value: $239,000 Owner(s): Killeen Judy K Trust Mailing Address: 33690 433rd PI, Aitkin, MN 56431 Owner Phone: Unknown Property Address: 54259 Shoal Crk, La Quinta, CA 92253 Vesting Type: Personal Trust # of Units: 1 County: Riverside APN: 775-041-001 Map Coord: #Rooms: Census Tract: 045608 Lot#: A402. Block: Air: Subdivision: Style: Tract: 24317 Legal: Unit A402 Cm 079/057 Int In Common Lot Por Of 2 Mb 213/74-75 Tr 24317 ' Parking / #: Property Characteristics Imp Value: $239,000 Exemption Type: Sale / Rec Date: Use: Condominium Year Built / Eff.: 1990/ Sq. Ft.: 1627 Zoning: Lot Size Ac 1 Sq Ft: 0.04/1742 # of Units: 1 Bedrooms: 2 Bathrooms: 1 Fireplace: Y #Rooms: 'Quality: Above Average Heating: Central Pool: Air: Y Style: Stories: 1 Improvements: ' Parking / #: Detached Garage / Gross Area: 1627 Garage Area: 400 Basement Area: Sale and Loan Information Imp Value: $239,000 Exemption Type: Sale / Rec Date: 05/07/2008 / 06/16/2008 *$/Sq. Ft.: $226.80 2nd Mtg.: Sale Price: $369,000 1st Loan: $295,200 Prior Sale Amt: $214,500 Doc No.: 326257 Loan Type: Conventional Prior Sale Date: 03/08/1993 Doc Type: Deed Transfer Date: 06/16/2008 --I Prior Doc No.: 0000094235 Seller: Hardy Ray E Trust A Lender: Homeservices Lending Llc Prior Doc Type: *$/Sq. Ft. is a calculation of Sale Price divided by Sq. Feet. Tax Information Imp Value: $239,000 Exemption Type: Land Value: $128,000 Tax Year/ Area: 2014 / 020021 Total Value: $367.000 _ Tax Value: $367,000 Total Tax Amt: $4,303.86 Improved: 65% 4 Property Profile .54259 Shoal Crk, La Quinta, CA 92253 11/10/2015 This report is only for the myFirstAm user who applied for it. No one else can rely on it. As a myFirstAm user, you already agreed to our disclaimer regarding third party property information accuracy. You can view it here: www.mvfirstam.com/Security/ShowEULA. ©2005-2015 First American Financial Corporation and/or its affiliates. All rights reserved. https://www.myfirstam.com/PolygontMapSearch 1/1 cr C- A ---5. -0L' .r KlTcwt3 � New A CITY OF LA QUINTA BUILDING & SAF=ETY DEPT. APPROVED FOR CONST CTiON DATE a Molts _ 71