BPLB2017-004378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2017-0043
Property Address: 79320 DESERT STREAM DR
APN: 604321006
Application Description: SMITH RESIDENCE / 50 GALLON WATER HEATER
Property Zoning:
Application Valuation: $1,410.00
Applicant:
TOMMY ROOTER PLUMBING INC
80975 INDIO BLVD #09
INDIO, CA 92201
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: 4 —ab —n Contrac%or
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/14/2017
Owner: cn
KEITH SMITH
79320 DESERT ST3EAM
LA QUINTA, CA 9253 C7
n
mT �
Contractor: t D at�
TOMMY ROOTER PLUMBING I a
80975 INDIO BLVD #B9 rn a v
INDIO, CA 92201 a Cz
(760)574-4444 m
Llc. No.: 930133 Z
WORKER'S COMPENSAT)ON DECLARATION
I hereby affirm under penalty of perjury one oEthe following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 370C of the Labor Code, for the performance
of the work for which this permit is issued. .
I have and will maintain workers' campensation insurance, as required by
Section 3700 of the Labor Code, for the perfornance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: NORGUARD INSURANCE COMPANY . Policy Number: TOWC851139
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of Ahe work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree than, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
� n
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
Date: Applicant:' �V \
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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(_) I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FORIN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale: If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on thisapplication.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this appliotion is made, each person at whose
(_) I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owneC and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(_) I am exempt under Sec. B.&P.C. for this reason
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.
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:
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 representat ves of this city to enter upon the
above-mentioned property for inspection purposes.
Date' ,2 n— 1___�Signature (Applicant or Age
v4
Date: 3/14/2017
Application Number:
BPLB2017-0043
Owner:
Property Address:
79320 DESERT STREAM DR
KEITH SMITH
APN:
604321006
79320 DESERT ST TEAM
Application Description:
SMITH RESIDENCE / 50 GALLON WATER HEATER
LA QUINTA, CA 9253
Property. Zoning:
Application Valuation:
$1,410.00
Applicant: Contractor:
TOMMY ROOTER PLUMBING INC TOMMY ROOTER 3LUMBING INC
80975 INDIO BLVD #69 80975 INDIO BLVD #B9
INDIO, CA 92201 INDIO, CA 92201
(760)574-4444
Llc. No.: 930133
---------------------------------------------------------------------------------------------
Detail: 50 GALLON WATER HEATER CHANGE OUT [GAS] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO FINAL INSPECTION. 2016 CALIFORNIA
BUILDING CODES.
IM
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT IQTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION' BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
OTY
AMOUNT
WATER HEATER/VENT
101-0000-42401.
0
$12.67
DESCRIPTION
ACCOUNT
:TY
AMOUNT
WATER HEATER/VENT PC
101-0000-42600
0
$7.60
Total Paid for PLUMBING FEES: $20.27
DESCRIPTION
ACCOUNT
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
R-AL's`=D
pQ��{ .0 C•om—' . Reside t�Al
e�:••...:.:�::' ;'�':..• .,i.,.S � Fa�F t Oft
' �Residen "a�.A�terntt te-Zottt:: ,l'.etut�t.#: ,
:..:.:-
'
�.,,...... ton
� _:.... , Date"
tte .,.. : , • 'a 3 '�� ' .,:: :- Out f 1�+'�tei �
c
'x -Chap
ent
apt .....
�•
g'}�tw ttJ�ldtd
A ic,hot..w0t l iiilen `fY3wfl): alai- hyd, �„eic_spacd hearirt h�"��rs .
hlatrrs'
and
. =60
�laa� or. .
. � i�.WFi`hrbi�und:t�Nlelsinas�be- - <gEietgy4��.!'-o�':`� it�l'i�od
vsa q��yy��
t
fie_ �13fXi+:`3�'t..`Type
Ariitcrlptive
- . -�• 'tiNg``tueits --shall
�� ',.V"� Wet TiK7YCt11QftaR' •:,. "n
� = rte; - �* .�-.
2: �earrnlalj syslXnrr'Jsrvbca' Ingle
r'rrrisdirt; do not 6ltoiyrtht trutallatian of a:/�ci!+ru ying;wrr rystep#
o ttr.heatkx for.,Y . c�veltlitg'tat
-tarrk.and s shall b6 insulule d tomtet the re uiilrntnl� a 1 S
3r•7�t�tl(t r t
.► ,......__ it r�.;. .... .._. .... - ,
den Aatlwr's/ResPottslbk Bu1MIt>�
iv» is 8txoraft aei�
tkat'this Cert�atc of Cotnpiianca4d inen mt res naityitiry for the buiJdleig c�esi8n
o t Ca►ifotria• Busistcas attd' Professions Coda to accept Pa : <., : .
..y.: a �iaii let =der. DbA91,Qp.
on this Cartitkste�o omPliarec�� ;.. ,..: 9 Totts tor_ Wildiog'�ign itkntifled oti `cus �CeiCificate o Com�+}ience
- •s.,l: iaitd CrtttBtice ptri
;.. _ ...•,._. •_:�;s «.... _e�! - p oCtiYSCaTiVbt0iaC.ode of R lationa. "this
et 1 and 6
cpnfQrety fD the tequtcp�rtxn of Title. cu ' ' iK with t ie'. I fd ptoviti; odoty'
.. - — the
-. Tlie. aiding doslgneTedgms idemtified on N`ii C'tctif►casmo C ns,
and
Prirens.
:.; ..._.�. LTi _
cntcalatio pl=-ApccifictitiC3t:! su€iiistttl to
`'liuFldn�-�pi dti` the ddte�: gpPticattic 1
cnfoi m� xt>;!a cnc' qos . Uaf with this rildi i Icution:
1".tic--... ... _ . _ � _ � • • _ .....
Address: is CA
city/stat ; ' r 1. —C;.�
1
1
"
®001/001
06✓�b1R013. Tit' 'It, 09 VAX L6
Quiriibe 331do & t3aP84�
i {
pity of L Quin a t"
BI►ildhw x Safety MOM
P.O.'&lx 1504, 76ti495 Ca3le ramNcD
Permit'#
La QWn4,. CA 92251- (760) 777.7012
Buiidfng. Permit App(ica On and Tracking Sheet
-19 3a o
fiS qWl Owuor's Nerae: �' � i
Add=: S
a
A P. Ntunlyer
0�
�,ST, ZJp: C a
s'
AM= j
l IDl �� � prgjactDasnrlgtioA
-� C
' MY, SI, Zip:E
=
rat hj=:
Co Otoation Type • �pam9:
$tabu L� t '
Pnojoa (oircie anc): Now Addrn Alva Repeh
D=O-
.14M of d Pm=.
LsZ Sq. FG:
b'torles:
rthdks
j T Qf Cadet Pett+oa:
5 BRimed `Value of Aoje i Q -)APPLICANT:
DD 1110T WRITE BUDW TM LINE '
' d ' rd
. Reo+yi TRACONG
Pion C lga eabmitud Item
Amount
3l[nCtAiai Gllca.
Revkwed, Wady for wrrtc:iom Plan Check Mpodt
;
ito� C�1ea.
eared Zonae: Person Plan Cbeolc Babtnca,
Tl y4 CAM
?lawpiekid up Coaetreefioa '
! . • 19fodd jHplll p�
Pias eanbroltted - MecbwdW
GradtaQ pb'°
3d Reeiew, ready fat corrocaoU&U=e
SdDcotitorbor Mist
Caped Coiu0# Pe mn piamhtug
i •"• '•
� GraQt �ssA
Plwne lrt'=°I ap SAS.I.
I1JQsAlM
Pi tarewbmM4 GM029
-
'i
� gip,
'� Iievler►, ieady tat eortectiopsMne •D�weioper ItOctBaC
� PiR APFi'ova!
Caucd Contra rs"On �•
'6
PaqWlot Aper
ermlt or
DAOe sraue
P
.
. - ScApd�Bta
i
Total Path i.1