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BPLB2018-003378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: LEAK SPECIALTIES 1268 8TH ST COACHELLA, CA 92236 C&yr°"�u''au�fw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT PLUMBING/ BPLB2018-0033 54995 SHOAL CREEK 775141040 TOWNSEND /26LF OF GAS LINE $800.00 MAR 0 5 2018 WYONQ IWTA 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.: 807812 Dater _,Contractor �I OWNER -BUILDER DECLARATION 1 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 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.). (_) I am exempt under Sec. B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY rI 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: 3/5/2018 Owner: GARY TOWNSEND Contractor: LEAK SPECIALTIES 1268 8TH ST COACHELLA, CA 92236 (760)564-9440 Llc. No.: 8078,2 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury oneof the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3A00 of the Labor Code, for the performance of the work for which this permit is issued. PDI have and will maintain workers'=ompensation insurance, as required by 25 I n 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: EXEMPT Policy Number: _ _ I certify that in the performance rf the work for which this permit is issued, I shall not employ any person in any manner eo as to become subject to the workers' compensation laws of California, and agree :hat, 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: 3 ✓ - tf Applican WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,D00). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES -AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKOO W UDGEMENT IMPORTANT: Application is hereby made tothe 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 perfo: mea 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 appfication becomes null and void if work isnot commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will. subject permit to cancellat on. I certify that I have read this application andistate that the above information is correct. I agree to comply, with all city and county or•3inances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned property for inspection. purposes Date: -3 s' d Signature (Applicant or Age ) Date: 3/5/2018 Application Number: BPLB2018-0033 Owner: Property Address: 54995 SHOAL CREEK GARY TOWNSEND APN: 775141040 Application Description: TOWNSEND /26LF OF GAS LINE Property Zoning: Application Valuation: $800.00 Applicant: Contractor: LEAK SPECIALTIES LEAK SPECIALIIES 1268 8TH ST 1268 8TH ST COACHELLA, CA 92236 COACHELLA, CA 92236 (760)564-9440 ------------------------- ---------------------------------------------------------- Llc. No.: 80781-2 Detail: INSTALL 26 LF OF 3/4 GAS LINE TO WALLS TO SUPPLY FURNACE PER 2016 CALIFORNIA BUILDING CODES 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 r Sbra l'a a[ CITY OF IA QUINTA a i7iS�on��cc/ �=1— h� ate oZ` BUILDING & SAFETY DEPT. ��a �� Rr �c �t ►�� APPROVED�d Re-Pou�i' N FOR CONSTRUCTION �Z x i s�S S o DATE 3 �f �� D'�i_'°i' I0 Fi^o►��oGrsc, a 1 ohy F x t s'! ,1-bLoq^ �y ............ c: .;j.rr or ax:rir---�...i..t- PERMIT # PLAN LOCATION: Project Address: S 1-1 _ 9'(S s�oq Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: L ? J Patio/Porch SF Email: Applicant Name:ze,9 L c7� ll l eS State Lic: City Bus Lic: Address: State Lic: City Bus Lic: City, ST, Zip; Telephon . '760 's-6 q C{ 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: .G. ar New Commercial / Tenant Improvements:. Address: Total Building SF City, ST, Zip Construction Type: Occupancy: Telephone: 71/ "CS OO Email: 78495 CALLE TAMPICO LA.QUINTA, CA 92253 760=777-7000 t - \s to •!. • OFFICE USE ONLY, a 1 Submittal Req'd -Rec'd Plan Sets Structural Calcs ' 1 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 1 . r 5