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BPLB2019-003378-495 CALLE TAMPICO Tity/ D " Quiotz LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2019-0033 Property Address: 54925 AVENIDA ALVARADO APN: 774292022 Application Description: SEARS / NEW PROPANE TANK AND 54LF GAS LINE Property Zoning: Application Valuation: $400.00 ILA I Applicant: SCOTT RAYBORNE MAR 2 0 MORAQUINTi. . �LrI�fY7l��i�...+.•r..-;h1��»"��JR.,'7f��{,� LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. tense Class: Li nse No.: Cant actor- 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 111 the applicant to a civil penalty of not more than five hundred dollars ($500).: as owner of the property, or my.emptoyees 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 herselfthrough 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 Wadid not build or improve for the purpose of sale.). s 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 ntractors' State License Law.)- .. exempt under ec. B.&P.C. for this reason Dotty OwntfY: t✓ �� CONSTRUCTION LENDING ASJCY 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/20/2019 Owner: Sears Joyce A / Arnold G & Joyce A Sears Family Trust 54925 AVE ALVARADO LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: 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 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 workers' compensation insurance carrier and policy number are: Carri 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 or Section 3700of the Labor Code, I shall forthwith complywitht seer :sions. Date: r Applit WARNING: FAILUR TO SECURE WORKERS' COMPENSATION COV RAGE 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 actor 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 her y authorize representatives of this city to enter upon the above - mentioned pro arty f 1r inspection purposes. DB ` gA W(Applicant or Agent)4446, Application Number: Property Address: APN: Application Description? Property Zoning: Application Valuation: Applicant: SCOTT RAYBORNE BPLB2019-0033 54925 AVENIDA ALVARADO 774292022 SEARS / NEW PROPANE TANK AND 54LF GAS LINE $400.00 Date: 3/20/2019 Owner: Sears Joyce A / Arnold G & Joyce A Sears Family Trust 54925 AVE ALVARADO LA QUINTA, CA 92253 Contractor: OWNER BUILDER Llc. No.: Detail: 54LF OF 3/4" GAS LINE TO ADD A PROPANE TANK FOR STOVE SOUTH' EAST FRONT CORNER. PER 2016 CALIFORNIA BUILDING CODES. DESCRIPTION ACCOUNT CITY AMOUNT HOURLY CHARGE - CITY BUILDING STAFF 101-0000-42600 0.5 $80.00 Total Paid for BLDG CITY STAFF - PER HOUR: $80.00 DESCRIPTION ACCOUNT CITY 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 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $26.68 Total Paid for PLUMBING FEES: $40.02 DESCRIPTION ACCOUNT CITY 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 za0"iffra PERMIT # 8p PLAN LOCATION: Project Address: Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech Alb Applicant Name:MIA ��pj Address: City, ST, Zip: n�Q Telephone: (.r Email: Contractor Name: Address: City, St, Zip Telephone: Email: State Lic: City Bus Lic: Property Owner's Name: 11W4 � Address: UIV City, ST, Zip ,J 0 Telephone: -z:2- 7-2�6`7 Email: ✓' Valuation of Project $ New SFD Construction: Conditioned Space Garage Patio/Porch Fire Sprinklers LW SF SF SF SF /yV New Commercial / Tenant Improvements: Gfr'f�j� Total Building SF Construction Type: Occupancy: 78495 CALLE TAMPICO LA QU I NTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Req'd Reed Plan Sets Structural Calcs Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License -mAkl<- ��y v 4RA'u[A L.4 A16 I 2 Aru ! C:7 �Ror�-TA N'K- Rau cR� 31q OmAlcw Li NE A L VA, " 115 0 cur2-:& . CITY OF LA QUINTA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE DATE3ltr 24BY lj� ti� CITY OF LA O.UINTA SUB -CONTRACTOR, LIST JOB ADDRESS Syc? 15AVf—&Wkk(P- PERMIT NUMBER � � 7 OWNER L a BUILDER This form shalt be posted on the job with the Building tn_spection Card at all times isem n_a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be compieted by applicant. "On File" is not an acceptable response. 3rade 1 Glass..ification ,.. Contractor State :ContractoCs LicetlAe: ,. Workers .Compensa.ti.on In.su.ra.n..ee Company Name Classification (e.g. A, B, C-8) License Number (xxxxxx) Exp. Date (xx/xx/xx) Carrier Name (e.g. State Fund, CalComp) Policy Number (Format Varies) Exp. Date (xx/xx/xx) EARTHWORK (C.12): CONCRETE (C-8) FRAMING (C-5) STRUCT. STEEL (C-51). PLUMBING (C46.) Y I LATH, PLASTER (:C-35) J :013YWALL (G=9) H:VAC (C:-20) ELECTRICAL (C-10) ROOFING (C-39) SHEET METAL (G-43) FLO.O:RING (:C-15) GLAZING (C-171 INSULATION (C-Zj SEWAGE DISP. (C-h2) PAINTING (C-33) CERAMIC TILE (C-54:) CABINETS (C-8) FENCING (C-13) LANDSCAPING (C-27) POOL (C-53)