BMCH2017-034978-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Twit 44aw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BMCH2O17-0349
Property Address:
53785 AVENIDA RAMIREZ
APN:
774161016
Application Description:
PACELLI, MICHELLE HVAC CHANGE -OUT
Property Zoning:
Application Valuation:
$7,600.00
Applicant:
CARRERA AIR
P 0 BOX 6193
LA QUINTA, CA 92248
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:, C20 License No.: 959853
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 followingreason (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, 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.). . '
(_) 1 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/1/2017
Owner:
MICHELE PACELL
53785 AVENIDA RAMIREZ
LA QUINTA, CA 0
Contractor:
CARRERA AIR
P 0 BOX 6193
LA QUINTA, CA 9248.
(760)343-6675
Llc. No.: 959853
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, fdr 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9155895
I certify that in the performance of !he 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, 1 shall forthwith
comply with those provisions.
Date:
Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIML 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 perform+d under or pursuant to any permit
issued as a result of this application the ownek and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the p=ity 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 applicz tion 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 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: Signature (Applicant or Agent):
s
Date: 9/1/2017
Application Number:
BMCH2017-0349
Owner:
Property Address:
53785 AVENIDA RAMIREZ
MICHELE PACELLI
APN:
774161016
53785 AVENIDA;RAMIREZ
Application Description:
PACELLI, MICHELLE HVAC CHANGE -OUT
LA QUINTA, CA C,
Property Zoning:
Application Valuation:
$7,600.00
Applicant:
Contractor:
CARRERA AIR
CARRERA AIR
P 0 BOX 6193
P 0 BOX 6193
LA QUINTA, CA 92248
LA QUINTA, CA 52248
(760)343-6675
------------------------------------------------------------------------------------------
Llc. No.: 959853
Detail: HVAC CHANGE OUT - 14SEER/81AFUE (1) 4 TON SPLIT SYSTEM. CARBON MONOXIDE ALARM(S) TO BE INSTALLEC PRIOR TO FINAL INSPECTION. 2016
CALIFORNIA BUILDING CODES.
s
DESCRIPTION ACCOUNT' CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HVAC CHANGEOUT - SPLIT -SYSTEM PC
101-0000-42600
0
$38.00
Total Paid for CHANGEOUT: $114.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
Credit Card Fee
101-0000-43505
0
$3.89
Total Paid for Credit Card Fee: $3.89
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMEMT FEE: $5.00