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BPLB2017-0093r . 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4t�p 4 4 Qu&Z DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2017-0093 Property Address: 51770 AVENIDA CARRANZA APN: 773165001 Application Description: STEVENSON RESIDENCE/ SEWER CO Property Zoning: Application Valuation: $4,000.00 Applicant: LA QUINTA COVE PLUMBING INC PO BOX 1207 LA QUINTA, CA 92247 JUL 11 2017 CITy0FLAQU1TA C05--=i`�l1'��FT1,Of''•`�' z',! '_o,CTOfF?.;�?'.;f �T LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C36 License No.: 910274 Dater -74/-17 , 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 11, 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/11/2017 Owner: ROGER STEVENSON 51770 AVENIDA CARRANZA LA QUINTA, CA 92253 Contractor: LA QUINTA COVE PLUMBING INC PO BOX 1207 . LA QUINTA, CA 92247 (760)777-9916 Llc. No.: 910274 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: FALLS LAKE FIRE AND CASUALTY COMPANY Policy Number: FLA001054 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: ` —`l / 7 - 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct. I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this city to enter u on the above-mentioned property for inspection purposes. Lender's Name: Date: Y7—� l'.l 75ignature (Applicant or Agent): a4e Lender's Address: Date: 7/11/2017 Application Number: BPLB2017-0093 Owner: Property Address: 51770 AVENIDA CARRANZA ROGER STEVENSON APN: 773165001 51770 AVENIDA CARRANZA Application Description: STEVENSON RESIDENCE/ SEWER CONNECT LA QUINTA, CA 92253 Property Zoning: Application Valuation: $4,000.00 Applicant: Contractor: LA QUINTA COVE PLUMBING INC LA QUINTA COVE PLUMBING INC PO BOX 1207 PO BOX 1207 LA QUINTA, CA 92247 LA QUINTA, CA 92247 (760)777-9916 Llc. No.: 910274 Detail: SEWER HOOK UP AND SEPTIC ABANDONMENT. PER 2016 CALIFORNIA BUILDING CODE I U I ALZO: ,145.33 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 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 BUILDING SEWER 101-0000-42401 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $17.73 Total Paid for PLUMBING FEES:' $43.06 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 I U I ALZO: ,145.33 Bin #. City of, La Quinta Building &r Safety Division 78-495 Calle Tampico. La Quinta, CA 92253.- (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: - Z D Ca rra Owner's Name: o e vee SO/1 A. P. Number: Address:'5 17 -7 . lice, r ran 2a Legal Description: City, ST, Zip: L� �C, C [& tr�� Contractor: E L � 1 d it Telephone - Address: O O 19-07 Project Description:S e.[.�.: e r CO � �1 o /*� City,. ST, Zip: U` `[tea C /�t�j a l�7 f s[� �` . 'f`a i! �L �oai d D /l eICA -" Telephone: P - 77 , State Lic. # : f ©p? -/ City Lic. #-, Arch., Engr., Designer Address: City, ST, Zip: Telephone: Construction Type: Occupancy: cy:= State Lic. # Project tYPa (circle one New Add'n n Alter Repair Demo Name of Contact Person: Sq. FL:#Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: o 0 O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. 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 correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A: Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees