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BPLB2017-0046LICENSED 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: C36 License No.: 930133 Date: 14 �� Contractor: i2l \ D XJ, � 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).: (-1 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. C.): 'Lender's Lender's WORKER'S COMPENSAT®N 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 3700of the Labor Code, for the performance :En rk for which this permit is issued. Ihave and will maintain workers'compensation insurance, as required by 00 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: NORGUARD INSURANCE COMPANY Policy Number: TOWC851139 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:—2la—'1 \ Applicaa-:�?)- \ X n� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 FORIN 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 thisapplication. 1. Each person upon whose behalf this appliotion 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 cancellbtion. I certify that I have read this application and st.-te 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 representaives of this city to enter upon the above-mentioned property for inspection purposes. Dater Signature (Applicant •:)r Age VOICE (760) 777-7125 78-495 CALLE TAMPICO D FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-71S3. BUILDING PERMIT Date:' 3/21/2017 Application Number: BPLB2017-0046 Owner: v N "_Vcil Property Address: 79755 DANDELION DR MELISSA ANNE HGLLIS — APN: 604482003 79755 DANDELIOM DR Application Description: HOLLIS /CHANGE OUT (1)50 GALLON GAS WATERHEATER LA QUINTA, CA 92253 p Property Zoning: D Application Valuation: $1,340.00 t i p E3 ��T•-- C� � Applicant: Contractor: D � m fJ TOMMY ROOTER PLUMBING INC TOMMY ROOTER PLUMBING�%IQ__� N o 80975 INDIO BLVD #B9 80975 INDIO BLVL #89 C:)D ti INDIO, CA 92201 INDIO, CA 92201 a (760)574-4444 Z Llc. No.: 930133 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: C36 License No.: 930133 Date: 14 �� Contractor: i2l \ D XJ, � 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).: (-1 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. C.): 'Lender's Lender's WORKER'S COMPENSAT®N 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 3700of the Labor Code, for the performance :En rk for which this permit is issued. Ihave and will maintain workers'compensation insurance, as required by 00 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: NORGUARD INSURANCE COMPANY Policy Number: TOWC851139 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:—2la—'1 \ Applicaa-:�?)- \ X n� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 FORIN 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 thisapplication. 1. Each person upon whose behalf this appliotion 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 cancellbtion. I certify that I have read this application and st.-te 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 representaives of this city to enter upon the above-mentioned property for inspection purposes. Dater Signature (Applicant •:)r Age Application Number: BPLB2017-0046 Property Address: 79755 DANDELION DR' APN: 604482003 Application Description: HOLLIS / CHANGE OUT (1)50 GALLON GAS WATERHEATER Property Zoning: Application Valuation: . $1,340.00 Applicant: TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #B9 INDIO, CA 92201 Date: 3/21/2017 Owner: MELISSA ANNE HC LLIS 79755 DANDELIOPd DR LA QUINTA, CA 92253 Contractor: TOMMY ROOTER PLUMBING INC 80975 INDIO BLVC #B9 INDIO, CA 92201 (760)574-4444 Llc. No.: 930133 ----------------=----------------------------------------------------------------------------- Detail: 50GALLON WATER HEATER CHANGE OUT [GAS) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINALANSPECTION. 2016 CALIFORNIA BUILDING CODES. I ..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 WATER HEATER/VENT 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT WATER HEATER/VENT PC 101-0000-42600 0 $7.60 Total Paid for PLUMBINGIFEES: $20.27 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 Prescri tine .Ce :a �ate:o� •Com liance: Residential CF-IR-ALT-DHW Rexidenrta' t Alterations ``' Page I of t Pro'etiClimate Zone:.... r C3enerul Cnfoimutiotl Site Address:: Buildin T-• ,:,Sin'-te f'amil 'OTMulti-Famil .. tfor¢eitient•A enc.': - roleetType: Eptacement''or Ch. Dates a Out, ., Water ffeuter �$ SA CQ„4ttt actoi or homeowner (Documentation Author's/Kesponslble Butldl Desi er's°Dedaiw,00 Sttitesnent).. Z.7st'if6a 0,' ihs7i�lled*water"heaters and -boilers for both-dorntStiC-hot ivarir..'`lieartra'(O$Ylt and hydmnic space head NewlvKiastalled DWH'heaieriimd-bwfltrstnrcrt•be as;• ro ane..or..rtse.the..exf tf. tel Distri4n0pa Type .. Water:HcutrY. ` l�taridardc N.umbcr In ... Tank- Fsietoe �e ` 'thermal trntctuul Tank mo i. Pype�..... :: _ ::. :,caculatin :.•.. ,. System..:. Capacity (dap HtFlcieecy R=�Vaittie' Address: ticen CitynSts ewp: Phone: Ic �jtdecate Type (Stornge'Gar:-Hebl Pump: fnstar{{,pncous, etc.) : - Z.'Recfrctt/dtiag systems serving multiple dwelling units shall i»eeC the reciiru/itffoM:'requlreri encs of j -!SO n): `T/ie'.:P. rruriptive rcquire!nenta do not alloiv the ingtdltation of a. recirculdting.water' headng.systenr forsingle divellntg:imltx _ 1S 3, The•extmial water hewin .tank andpipes shall be insulated to "see? the rr ulrunenta 4§150(1). �$ SA CQ„4ttt actoi or homeowner (Documentation Author's/Kesponslble Butldl Desi er's°Dedaiw,00 Sttitesnent).. •' 1' certif)ytl is this Cettini aie of Compliance documentation is io Ciurnte and complete, . l: am;eiigible..under.. Division 3 of .the California• Business • and Professions Code to accept responAbUlty for the building design identified on this Certificate of Compliance. : , 1 certifj .that tha energy features and performance specifications for the. building design identified on this Certificate of Co�itpliame conform to the requimc rants of Title 24, Pant and 6 of the California Code of Regulations + The building design features identified on this Certificate of Compllance are lld consistent with the ifiietidn p'rovidea'tadocuf6eni this building" .design on the other applicable compliance forms. -worksheets, calculations. plans and. specifications submitted to the enforcement n enc ..fora rovak with this building rmit 22Mication. AQW Company: Address: ticen CitynSts ewp: Phone: TOMMY ROOTER PLUMBING WORK ORDER/INVOICE 28345 q HELPING THE DESERT AT A TIME CO. ONE FRIE14D • • DESCRIPTION • pritmNyle, Drain Cdealft & letter Specigis Inv:all — t3g ^ ° 80975 Indlo Blvd., #R9 Auth.f ' 15�::; '� Indio, CA 92201 I 750-574.4444. •.:...z,-."; Fax 7sIn a444-2717 ; ct�!/ �— �• g €"`S WWW-TOMAIYROOTER.COM � "AI! pearl` CA LIC. #930133 tic NAME STR£ET^ n L % a PHONE CITY STATE IP ) WARRANTY L4 rk, C) CONTRACT pYLKE LI EL SERIALNUMBER ❑ SERVICE CONTRACT ❑ N17Hr1AL COMM. ❑ AES. ❑ TOTAL-. MATERIALS ❑ Mr ❑ COMPLETE DESCRI PTIO N OF •• K• Q C '•t' �` Q Q • �> 3' W � CT� 5'Cta� � P�4Nb' � \ VL �"�,:�� I inert 0' aw. L.J or •Fo ,-ek 'J ee'`C i er t� R.I ti 9 0 l • • TO OUR CUSTOUEAS: SeRflw. men are rowked to have wkwk sill signed. DRAIN CLEANIMLAB • This is dune In ordw W protect you, ft IvtTlarlen, and olds Ws and tD Af)DLFOOTAGE ADD L FIXTURES elab)e us to ghc Ibu absoble safisfaMry wrote. Ym are semaltully " labor before vAakmen leme requested to examine IrWerbl statement PLUMBING LABOR the Pb, and If you Find e1witHFng satsfecin akay this f dwL If sar4D Is Ifm imrnedlab*. t77 PARTS misidsfaclory, in arty unt, grew pt our aftDce A PEVAJY VnLL BE CItJIROEB AT 111E RATE OF 1tQ% PER TJIT)TJTH ON PRODUGMTREATtr'EfIT UWpAnBALANCES AT -TER 30DAYS OFRJPOICEDATEAWJUALPEROOMOE VIDEO INSPECTION ..TOTAL LABOR RAlEiN.RE MEDCHECKFfEf2ML • • I find Ile firm and material charged above safsfadey and! agree is pay HYOROJE ITER ❑ WARRAPlTY 6x same an presentation of invofoe, and furlhra agree to pay reasonable MAINE JETIER ❑ 5 Day ❑ I Year chaxjd far odleclSon incILdrg atlomeys fees In 1W evW of my defecdL LtHE1LfAK LOCATION ,._ C] s hfantn Cl ?TO 0 Shimm"NOTICE.TO ... OWNER(Sectlom.7or9Conlrnctare,Llcenea._larJ urtra s� YtAorhJ Lln troy an/mflrffiv,S]tRrNafhq►Ouv.mLLaA7l rtoovafia'prisai rtnh9re ..PUTAPSEPTfCIUREASE ... ... .. ... .:�"` WARRANTY CALLS btl�7Nl jOJr(.fePa1[riM6flH �f Wbitblq �EnMA6p nmtsrlst. h16811�R10 nf(dm h6 dsYn egirdt tmr ps/eb/. u+ez to ur rou v.sv l+vwrl swnot a3eirsl men cema ex nom. OTHER ARE SCHEDULED befaemrm""exhrat.u"prwwwLwo30Wo+.anmfis AainProeventera mr�i'®risntlracbHfseNisealtEeo�rQ'tema�sdlte MOO NiMthtP1"Nls duoWaW TAX FROM fA-F BAN -Md. �a " a® "^I '�s"B00f°@=ms�'t"tQ�°or4��II " Imaw eat 113.9 tun w1 par" I." on tltaetfwd psm as9 slat, rn nmr'm to siv ctMtWs kw Ire ' Uroam'mV,bs ma3{:r"l br f a PL)Tnwl to U sl fie dain►d an P?ttmsTOTAL PAY.t1ENTREC✓=TVETYX PKCFE)EM Inhieds Sr PAYMENT DUE ❑ CASH ❑ C.C. ILL ❑CHECK# ❑X -7-7 06/06/2013 THU l5t09 PAX La Quint:a Bldg s Safety clay Of La 8010 190 Safety iDJvbW ' Petr►rR. p.0, BOX 1304, 78-49S Carle Tampko 4 Qt 94iCA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ProjectAddtt3as:.Owner's Name: .6 A P. NumEja: Address: j City. ST, Zip: LQ a vwi-� Contractor. `� mfYl L 11(� (, Tei hone' - Ld.0 ,� f n Address: �j q S V C� Projccc Description: City, ST, Zip:• C ao d— Tetephotte . y q state J,ia #.:C11 a).o Lia il; Arch., Eugr�, DeM per: Addrem- Tolep(toae:' . Coastrtttction Type" Oaupa y,+ Stato Lia #: PM, jtd 4+Pe (circle one): Now Add'a Alta Repair Demo Name ofCi?affictParson. GO`Jl Sy. IL: # Siodes; 3�•Llnfta; i • Telephone aP Gantsct Persute: (p C"� y L4VA1.. 8stitaeted Value of Pr wet App1-1CANT: DO NOT wRrrE SELOW TMS LINE # 5nlrmltlal: ►d Fbec'� TBACMG a PiEI?;A'�1' FEPS i?iRrt Seta ` Man Gyieck subaittbod ifew Araooat i Strnct stCatcs Reviewed, ready for eorrecdome Pla CpeckDepoait 71uss:Calea. C-20EdContact Persya Plan Check Baranaa .Tltte 24 Com F9ma ticked up Case�oaiion F10ad;pl2ln plaII Plana resubmitted lYtec6anlcal GrAdftto plan Z'!Ftevtew, ready for aor►oationeri sue Electrical Subcontacfor List Called Contact Perama Plnmbina Graat:Detd Maps &W up i>t.OA Approval Plato "submittedGrading Roew, ready for core domrii fte . Devdopar Impact Ba MnA.Ing ptoroal Cs11cd Coataci Person A.1 Y P. rob Niu Appy pate orpermlt !scut • $t360I FCtB . Total Permit Fees a