BMCH2015-035578-495 CALLE TAMPICO r 0 D
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BMCH2O15-0355
Owner:
Property Address:
49496 VIA CONQUISTADOR
ROBERT PENSKI
APN:
602260028
4318 FOREST AVE
Application Description:
PLUMMER / CHANGE -OUT (1)16SEER/80AFUE SPLIT SYSTEM
MERCER, WA 9253
Property Zoning:
Application Valuation:
$17,800.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
0
z
�n
Applicant: Contractor: 'm C-
IE INC HARRISON ENTEFPRISES INC D `PU'�'I
31225 LA BAYA 31-170 RESERVE :DRIVE STE A m �
WESTLAKE VILLAGE, CA 91362 SCANNED THOUSAND PALMS, CA 9227 m a
(760)343-7488 m
Llc. No.: 686310
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.: 686310
015 9-471 11S Contracte ��---
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 subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(1 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 I 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
Lender's Address:
9/14/2015
I'r1
ti
O
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one o 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.
v,�-W 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: _ Policy Number: _
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.
D -atlw I4 -i t! Applica`mwll kS
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 FOF. IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNO!VLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on thi_ 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 applimtion becomes null and void if work is
not commenced within 180 days from date of ssuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and st ate 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 representacives of this city to enter upon the above-
mentioned property for inspection purposes.
Da,t�el 4 1 t1 Signature (Applicant orAgent
)"L'�.
INFORMATION
DESCRIPTION'`'S .° s f;;"`ACCOUNT N ' QTY *.. :AMOUNT tg PAID _ PAID DATE
s
BSAS SB1473 FEE 101-0000-20306
0
$1.00 $0.00
�yr a.
. < PAID BY != ti.' METHOD"'pa
W
, `; RECEIPT # C HECK # CLTD BY '.
Total Paid forBUILDING STANDARDS.ADMINISTRATION 6SA: .$1.00 $0.00
� 'DESCRIPTION;;, `°
°ACCOUNT�QTY
':, AMOUNT, �`
.PAID,
PAI DATE
HVAC CHANGEOUT - SPLIT-SYSTEM
101-0000-42402
0
$72.52
$0.00
PAID. BY
i ,METHOD,
RECEIPT #
CHECK #
CLTD BY,,
•, ' 'NSDESCRIPTIO,
- ` .'ACCOUNT '.�- ` u ,.
QTY:
AMOUNT,
'.' PAID
PAID DATE
HVAC CHANGEOUT - SPLIT-SYSTEM PC
101-0000-42600
0
$36.26
$0.00
b * PAID BY
s
f"z METHOD
-RECEIPT, #
CHECK #;rt
CLTD BY
Total Paid forCHANGEOUT: $108.78 $0.00
€q•• : " DESCRIPTION'.,-_ `'
ACCOUNT
QTY
:,AMOUNT,,
` PAIDt,
'PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
,`4PAIBY
D>g
'.,METHOD
>RECE
,.
x "...CHECK
"CLTDBY=
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
Description: PLUMMER / CHANGE -OUT (1)16SEER/80AFUE SPLIT SYSTEM
Type: MECHANICAL Subtype: Status: UNDER REVIEW
Applied: 9/14/2015 SKH
Approved:
Parcel No: 602260028 Site Address: 49496 VIA CONQUISTADOR LA QUINTA,CA 92253
Subdivision: Block: Lot: 31
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $17,800.00 Occupancy Type: Construction Type:
Expired: i
No. Buildings: 0 No. Stories: 0 No. Unites: 0
i
q, p,CITY
Details: HVAC CHANGE OUT - (1)16SEER/80AFUE SPLIT SYSTEM [2013 ENERGY] CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
Printed: Monday, September 14, 2015 3:46:24 PM 1 of 2
.., SYSTEMS*
A ZIP
' a PHONE
w FAX �
EMAIL f
NAME TYPE NAME:, -
;' _ A ` ADbRESSi y
i
q, p,CITY
STATE
APPLICANT IE INC
31225 LA BAYA
WESTLAKE
VILLAGE
CA
91362
CONTRACTOR HARRISON ENTERPRISES INC DBA
GENERAL AIR
31-170 RESERVE DRIVE
STE A
THOUSAND
PALMS
CA
92276
OWNER ROBERT PENSKI
4318 FOREST AVE
r MERCER
WA
92253
FINANCIAL INFORMATION
Printed: Monday, September 14, 2015 3:46:24 PM 1 of 2
.., SYSTEMS*
Permit Details PERMIT NUMBER,
�wf:= Citof LarQuinta BMCH2O1�5=0355
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LTD
., DESCRIPTION
ACCOUNT.,.
QTY
' .AMOUNT . _
PAID �`,
PAID DATE
.RECEIPT.#
CHECK#'"
METHOD
PAID BY
BY"
_
-`.
s
E
BSA$ SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT: $108.78 $0.00
PERMIT ISSUANCE
101-0000-42404
1 0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:00
PARENT PROJECTS
.
' BOND INFORMATION ""
Printed: Monday, September 14, 2015 3:46:24 PM 2 of 2
sysTe,ins
Stephanie Khatami
From: Steven Schnierer <sschnierer@road runner.com>
Sent: Tuesday, May 17, 2016 12:03 PM
To: Stephanie Khatami
Subject: RE: Permit Request - HVAC Replacement At 53650 Avenida 2amirez
I do have another one. We pulled a permit back on 9/14/15, permit #BMCH2O15-0355. The address on the
permit is wrong. The address should have been 55114 Firestone. . .
--------Original message --------
From: Stephanie Khatami <Skhatami@l`quinta.org>
Date: 5/17/16 11:20 AM (GMT -08:00)
To: Steven Schnierer.<sschnierer@roadrunner.com>
Subject: RE: Permit Request - HVAC. Replacement At 53650 Avenida Ramirez
MAKE US LAST PLEASE
Stephanie Khatami I Permit Technician
City of La Quinta
78495 Calle Tampico c La Quinta, CA 92253
Ph. 760.777.7019
skhatami@la-guinta.org :,
From: Steven Schnierer[ma iIto: sschnierer0broadrun ner.com]
Sent: Tuesday, May 17, 2016 11:19 AM
To: Stephanie Khatami
Subject: RE: Permit Request - HVAC Replacement At 53650 Avenida Ramirez
I'm in Cathedral City right now. I'm going to Rancho Mirage and Palm Desert then I'll be over in your area. I do
have to go to the county, Indio, and Coachella too. So whenever you have them ready I can come by.
-------- Original message --------
From: Stephanie Khatami <Skhatami@la-quinta.org>
1
Date: 5/17/16 10:41 AM (GMT -08:00)
To: "Steven W. Schnierer" <sschnierer aQroadrunner.com>
Subject: RE: Permit Request - HVAC Replacement At 53650 Avenida Ramirez
Hi Steven,
When are you coming for these?
Stephanie Khatami I Permit Technician
City of La Quinta
78495 Calle Tampico o La Quinta, CA 92253
Ph. 760.777.7019
skhatami@la-guinta.org
From: Steven W. Schnierer[ma iIto: sschnierer@roadrunner. com]
Sent: Monday, May 16, 2016 9:17 PM
To: Mary Fasano; Stephanie Khatami
Subject: Permit Request - HVAC Replacement At 53650 Avenida Ramirez
r