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BPLB2018-000478-495 CALLE TAMPICO DVOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/16/2018 Permit'Type/Subtype: PLUMBING/ Owner: Application Number: BPLB2018-0004 ERNIE PETERSON Property Address: 54973 RIVIERA 54973 RIVIERA APN: 775153022 LA QUINTA, CA 92253 Application Description: PETERSON RESIDENCE / GAS LINE. Property Zoning: Application Valuation: $5,000.00 Applicant: �� Pp D Contractor: VALLEY PLUMBING CO FERRAUD INDUSTRIES INC DBA VALLEY PLUMBI OUTSIDE CITY LIMITS "AIV � � \` 78886 AVENUE 41 BERMUDA DUNES, CA 92203 CITY 06F COMMUNfTYDEUELOPM6V ° pAti wjEvfi (760)347-3629 Llc.• No.: 273088 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 Profess' s Code, and my License is in full force and effect. License Class: C36 License No.: 273088 actor: OWNER -BUILDER DEISLARAT I hereby affirm under penalty of perjury that I am exempOom 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 all 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, 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 Name: Lender's Address: 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 t ork 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: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC64403023 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 su 'ect to the workers' compensation provisions of Section 37 of the Labor Cod , (shall forthwith comply with those provisions. Date: Applic WARNING: FAILURE TO SECURE WORKERS' COMPE SATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). I 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. 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 buil ing construction, and hereby authorize representatives of this cienter'upon t above-mentioned property for inspection purposes. — �/ Qate:! 'ME— ggnat�(Applicant or Agent) ' Date: 1/16/2018 Application Number: BPLB2018-0004 Owner: Property Address: 54973 RIVIERA ERNIE PETERSON APN: 775153022 54973 RIVIERA Application Description: • PETERSON RESIDENCE / GAS LINE LA QUINTA, CA 92253 Property Zoning: Application Valuation: $5,000.00 ' Applicant: Contractor: VALLEY PLUMBING CO FERRAUD INDUSTRIES INC DBA VALLEY PLUMBI OUTSIDE CITY LIMITS 78886 AVENUE 41 BERMUDA DUNES, CA 92203 (760)347-3629 Llc. No.: 273088 ---------------------------------------------------------------------------------------------- Detail: REPAIR AND REPLACE GAS LINE FOR POOL HEATER. 70 LF PER 2016 CALIFORNIA BUILDING CODE FINANCIAL •• • DESCRIPTION ACCOUNTCITY 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 $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 CITY 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 CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 �+• W ---.._..-- G:EM gftf c 0E.SERA - .— ------ _....-- PERMIT# �'I �� l U'� V PLAN LOCATION: / c Project Address:?^'' roject Description:' Pool, Remodel, Add't, Elect; Plumb, Mech APN #: LCI. % (,t�✓� �' . Garage SF Applicant Name: LU Iv �— Address:42 Email: City, ST, Zip: SF Telephone: .7 & a Email:L , n �� _ j /41�G (Valuation of Project Contractor Name: U New SFD Construction: Address: Address: ?68s 8cS (D t 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: �� CHS' a New Commercial /Tenant Improvements: Address: �`-f 3 Total Building SF . City, ST, Zip Construction Type: Occupancy: Telephone: ©6 2��% '73 7 Email. 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 # Submittal 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 F r i •