BPLB2018-003278-495 CALLE TAMPICO . D ��
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: PLUMBING/
Application Number: BPLB2018-0032
Property Address: 53660 AVENIDA MONTEZUMA
APN: 774101007
Application Description: MANQUERO / PROPANE TANK AND PLUMBING FOR STOVE
Property Zoning:
Application Valuation: $800.00 n —
Applicant: D �'
ANTHONY MANQUERO
53660 MONTEZUMA.
LA QUINTA, CA 92253
CITYOFLAQUINTA
COMMUNMEVEIOPMENT05ARTMENT
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: License No.:
Date:
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
the applicant to a civil penalty of not more than five hundred dollars ($500).:
I, s owner of the property, or my employees with wages as their sole
/Oje
pe, sation, 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
Wd not build or improve for the purpose of sale.).
s owner of the property, am exclusively contracting with licensed contractors to
t 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
ntractors' State License Law.).'.
/,�,�a exempt under Sec. ' B.&P.C. for this reason
Dater sk f Owner:
CONSTRUCTION LENDING AGEN
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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 77.7-7153-
Date:
77-7153
Date: 3/1/2018
Owner:
ANTHONY MANQUERO
53660 MONTEZUMA
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
WORKER'S COMPENSATION DECLARATION
Thereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificFte of consent to self -insure for workers'
compensation, as provided for by Section 3770 of the Labor Code, for the performance
of the work for which this permit is issued.
_ I have'and will maintain workers' •_ompensation 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 insuranca carrier and policy number are:
Carrie Policy Number: _
I Certify that in the performance or the work for which this permit is issued, I
shall" of employ any person in any manner sD 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 37QQ of the Labor Code, l shall forthwith
comply with those provisions. f / ! /f
Date: Applica
WARNING: FAILURE TO SECURE WORKERS' CO ENSATION COERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRINgNAL 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�:he Building Official for a permit subject to
the conditions and restrictions set forth on tLis application.
1. Each person upon whose behalf this app ication 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 appLcation becomes null and void if work is not,
commenced within 180 days from date of issjance of such permit, or cessation of work
for 180 days will subject permit to cancellation.
1 certify that I have read this application and Aate 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 represen-atives of this city to enter upon the above-
mentioned property for inspection purposes- /n /f n .
Dat t ` / g Signature (Applicant or Age
Date: 3/1/2018
Application Number:
BPLB2018-0032
Owner:
Proper* Address:
53660 AVENIDA MONTEZUMA
ANTHONY MANQUERO
APN:
774101007.
53660 MONTE?UMA
Application Description:
MANQUERO / PROPANE TANK AND PLUMBING FOR STOVE
LA QUINTA, C,4_ 92253,
Property Zoning:
Application Valuation:
$800.00
Applicant:
Contractor:
ANTHONY MANQUERO
OWNER BUILDER
53660 MONTEZUMA
LA QUINTA, CA 92253
---------------------------.-----------------------------------------------------------------
Llc. No.:
Detail: ADD PROPANE AND GAS LINE FOR STONE CINLY.THIS PERMIT DOES NOT INCLUDE ANY OTHER PLUMBING. PER 2016 CALIFORNIA PLUMBING
CODE.
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
$98.83
Total Paid for PERMIT ISSUANCE: $98.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$13.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$26.01
Total Paid for PLUMBING FEES: $39.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611 •
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
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PERMIT#
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PLAN .LOCATION:
City, St, Zip
Project Address: ��
`
Project Description:
Pool, Remodel, Add't, Elect, Plumb Mech
-A)N #:
rd Ca �� 1� `FV e. 46
State Lic: City Bus Lic:
State Lic: City Bus Lic:
Applicant Name:
Address:
City, ST, Zip: /
Telephone:
Email:
Valuation of Project
Contractor Name:
-New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name-
New Commercial / Tenant Improvements:
Address:
Total Building' SF
City, ST, Zip
Construction Type: Occupancy:
Telephone.
Email:
78495 CALLE TAMPICO
LA QUI 'NTA, CA 92253
760-777-7000
OFFICE USE ONLY
N
#
.-S u.bmittal
Req'd
'Rec'd
'Plan Sets
Structural Calcs
,
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
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BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
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