BPLB2017-0113LICENSED 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: C55 License No.: 925031
Date: g 16 17 Contractor c tas
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Low 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).:
(� 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. . BAP.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 cf 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 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: SENTINEL INSURANCE COMPANY LTD Polity Number: 76WEGRTSSSI
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:+'drl Applicant: V-AT2--;1�_
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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 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 building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Dater fb 17 Signature (Applicant or Agent): ��—
VOICE (760) 777-7125
•78-495 CALLE TAMPICO
• D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
DESIGN &DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/16/2017
Application -Number: BPLB2017-0113
Owner:
Property Address: 44790 SEELEY DR
JIMMY CHEUNG
C
APN: .604224009
44790 SEELEY DR
--'J
I � --- z
Application Description: CHEUNG /INSTALL NEW WATER SOFTENER
LA QUINTA, CA 92253
F
Property Zoning:
o
Application Valuation: $3,781.00
S
Applicant:
Contractor:
; o
IE INC
YANCHEWSKI & WARDELL ENTERPRISES; INC -DB
31225 LA BAYA
1351 DISTRIBUTION WAY STE 9 ¢ (J
WESTLAKE VILLAGE, CA 91362
VISTA, CA 92081
(�
L
(760)754-1960
-A
Llc. No.: 925031
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: C55 License No.: 925031
Date: g 16 17 Contractor c tas
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Low 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).:
(� 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. . BAP.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 cf 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 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: SENTINEL INSURANCE COMPANY LTD Polity Number: 76WEGRTSSSI
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:+'drl Applicant: V-AT2--;1�_
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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 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 building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Dater fb 17 Signature (Applicant or Agent): ��—
Date: 8/16/2017
Application Number: BPLB2017-0113
Owner:
Property Address: 44790 SEELEY DR
JIMMY CHEUNG
APN: 604224009
44790 SEELEY DF
Application Description: CHEUNG / INSTALL NEW WATER SOFTENER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $3,781.00
Applicant:
Contractor:
IE INC
YANCHEWSKI & WARDELL ENTERPRISES, INC DB
31225 LA BAYA
1351 DISTRIBUTION.WAY STE 9
WESTLAKE VILLAGE, CA 91362
VISTA, CA 92081
(760)754-1960
Llc. No.: 925031
Detail: INSTALL ECOWATER EVOLUTION REFINER BOOST WATER SOFTNER LOCATED IN BACKYARD. NO CVWD RESPONSE REGARDING GUIDELINES FOR
INSTALLATION. WE WILL APPROVE WATER SOFTNER ON CASE FOR CASE BASIS UNTIL PROPER RESPONSE IS GIVEN. 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
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$12.67
Total Paid for PLUMBING FEES: $25:34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-6000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TD-TALS: $127.61
i
Bin.# .
City Of QC11I1�
BuMing &r Safety Dtvcston
P.O. Box 1504,78-495 Calle Tampico
ta.Quinta, CA 92253 - (760) 777-7012
Zj Building Permit Application' and Tracking-Sheet
Permit #
Project Address: 44790 Seeley Drive
Owner'sName:.Jimmy Cheung
A. P. Number.
Address: 44790 Seeley Drive
Legal Description:
City, ST, Zip: La Quinta, CA 92253
Contractor. Ecowater Systems of San Diego
Telephone: 951-294-7197 s;,x
Address: 1351 Distribution Way, Suite 9
Project Description: Install Ecowater'Evolution Refiner Boost
City, ST, Zip: Vista, CA 92091
Water Softener in back yard
Telephone: 760=754-1960 ?
State Lic. # : 925031 City Lie. M.
Arch., Engr., Designer.
Address:
City., ST,' Zip:
Telephone: - ::�
State Lica#: `' •••w�j:� •
Construction Type: . Occupancy
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Steven Schnierer
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person: 818-735-7876
Estimated Value of Project: $3,781.00
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACICTIHG
- PERMIP FEES
Plan Stu
Plan Cheek submitted
Item Amount
Structural CaIes.
Reviewed, ready for corrections
Plan Chca Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechuiic:d
Grading plan
Z'! Review, ready for correctionshssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
W HOUSE:-
'"' Review; ready for correctionsliissae
Developer Impact Fee
Planning Approval.
Called Contact Person
AXP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees