BPLB2018-002278-495 CALLE,TAMPICO C� 0. D 'i �KMIACl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: PLUMBING/
Application Number: BPLB2018-0022
Property Address: 52501 AVENIDA VELASCO
APN: 773294013
Application Description: CERLETTI / REMOVE TUB INSTALL SHOWER PAN
Property Zoning:
Application Valuation: $9,000.00
Applicant:
XQUIZIT HOME IMPROVEMENT
9700 HOYLAKE RD
DESERT HOT SPRINGS, CA 92240
A
FEB 1.2'2018
GITYOFLAGUINTA "
COMMUNITYDEVELOPMEWDEPARTMEW
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed un prov io of Chapter 9
(commencing with Section 7000) of.Division 3 of the Busin sand o scion 'Code, and
my License is in full force and effect. .
License Class: B License No.: 979831
Date: __
Contractor:
I hereby affirm under penalty of perjury that I ain 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).:
(_J 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 Na
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/12/2018
Owner:
ANDRE FREIHEIT
5. MARINE PARADE DR NO 912
TORONTO ON CANADA M8V, B4 92253
Contractor:
XQUIZIT HOME IMPROVEMENT
9700 HOYLAKE RD
DESERT HOT SPRINGS, CA 92240
(661)487-2072
Llc. No.: 979831
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'
comp cation, as provided for by Section 3700 of the Labor Code, for the performance
oft ork for whichthis permit is issued.
I have and will maintain workers' compensation insurance, as required by
V/e on 3700 of the Labor Code, for the performance of the work for which this permit is
sued. My workers' compensation insurance carrier and policy number are:
Carrier: NORGUARD INSURANCE COMPANY Policy Number: CAWC856071
_ I certify that in the performance of the work far which this rm' is issued, I
shall not employ any person in any manner so as to become sub' o workers'
compensation laws of California, and agree that, if I should a jest to the
workers' compensation provisions of Section 3 of th r C e, I shall forthwith
comply with those provisions.
Date: Applicant:
WARNI G: FAILURE TO SECURE WO ENS ION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRI INAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10 ,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 inform on i 7d.
I agree to comply with all city and county ordinances and state laws r sting ding
construction, and hereby authorize representatives of this ' y toe er u t above-
mentioned grope for inspection purposes.
Date: Signature (Applicant or Age ):
.
t +,
r
Date: 2/12/2018
. Application Number: BPLB2018-0022
Owner:
Property Address: 52501 AVENIDA VELASCO
ANDRE FREIHEIT
APN: ' 773294013
5 MARINE PARADE DR NO 912
Application Description: CERLETTI /REMOVE TUB INSTALL SHOWER PAN
TORONTO ON CANADA MBV, B4 92253
Property Zoning:
Application Valuation: $9,000.00
Applicant:
Contractor:
XQUIZIT HOME IMPROVEMENT
XQUIZIT HOME IMPROVEMENT
9700 HOYLAKE RD
9700 HOYLAKE RD
DESERT HOT SPRINGS, CA 92240
DESERT HOT SPRINGS, CA 92240
(661)487-2072
LIc. No.: 979831
Detail: REMOVE TUB SURROUND AND INSTALL NEW SHOWER VALVE BUILT UP PAN, V -BAR BACKER, TILE GROUT PER 2016 CALIFORNIA BUILDING CODE
AMOUNT
$1.00
$1.00
AMOUNT
$98.83
$98.83
AMOUNT
$13.00
AMOUNT
$13.00
AMOUNT
$13.00
AMOUNT
$13.00
$52.00
DESCRIPTION
ACCOUNT QTY
QTY '
BSAS SB1473 FEE 101-0000-20306 0
RECORDS MANAGEMENT FEE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
0
DESCRIPTION
ACCOUNT
QTY
PERMIT ISSUANCE
101-0000-42404
0
Total Paid for PERMIT ISSUANCE:
DESCRIPTION
ACCOUNT
QTY
FIXTU REITRAP
101-0000-42401
0
DESCRIPTION
ACCOUNT
QTY
FIXTURE/TRAP PC
101-0000-42600
0
DESCRIPTION
ACCOUNT
QTY
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
DESCRIPTION
ACCOUNT
QTY
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
Total Paid for PLUMBING FEES:
AMOUNT
$1.00
$1.00
AMOUNT
$98.83
$98.83
AMOUNT
$13.00
AMOUNT
$13.00
AMOUNT
$13.00
AMOUNT
$13.00
$52.00
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
1 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
i
$S.00
I
Contractor Name:
teva W�j�
-GEM JrGr I:F�IiK'I'
PERMIT # a�a�0�
— Q
PLAN LOCATION:
SF
Project Address:
Garage
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
Patio/Porch
SF
Email:
Fire Sprinklers
SF
State Lic: City Bus Lie:
s ,
Applicant Name:
.r/
y
Address:
LJ
City, ST, Zip:
Telephone:
a
Email:
Evaluation of Project $ 9k
I
Contractor Name:
New SFD Construction:
Address:
Address: L
Conditioned Space
SF
City, St, Zip
Garage
SF
Telephone:
Patio/Porch
SF
Email:
Fire Sprinklers
SF
State Lic: City Bus Lie:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
City, ST, Zip
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lie: City Bus Lie:
Property Owner's Name:
,
New Commercial / Tenant Improvements:
Address:.�;
Total Building SF
City, ST, Zip
Construction Type: - Occupancy:
Telephone:
Email: , ( ,
78495 CALLE TAMPICO
LA QUANTA, CA 92253
760-777-7000
M,oLati'
SLI
0% La 7 q t-.31
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE By