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BPLB2019-008478-495 CALLE TAMPICO C` t yl U eep a9bit LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2019-0084 Property Address: 78010 CORONADOS CIR CIR APN: 646210001 Application Description: COLBURN / NEW GAS LINE INSTALLATION Property Zoning: Application Valuation: $2,000.00 Applicant: �. QUALITY MECHANICAL PLUMBING P 0 DD 80533 VIRGINIA AVE �p p, INDIO, CA 92201 MAY 2 `T 2019 CITY OF LAQUINTA DESIGN & DEVELOPMENT DEPARTMENT 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. License Class: C36 License No.: 923620 Date: %�� Contras 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).: (_) 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/24/2019 Owner: DAVID COLBURN 78010 CORONADOS CIRCLE LA QUINTA, CA 92253 Contractor: QUALITY MECHANICAL PLUMBING 80533 VIRGINIA AVE INDIO, CA 92201 (760)610-3211 LIc. No.: 923620 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. ,&.Lt I have and will maintain workers' compensation insurance, as required by 3ettfsF3700 4f 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: !`V£RESTPREMIERINSURANCEC_QMPANY Policy Number: 7600014774191 _ 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 La bo Shall forthwith comply with those provisions. Date: Applica 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 Fallowing 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. � Date: Signature (Applicant or Agent): 'Date: - 1'5/24/2019 Application Number: BPLB2019-0084 Property Address: 78010 CORONADOS CIR CIR APN: 646210001 Application Description: COLBURN / NEW GAS LINE INSTALLATION Property Zoning: Application Valuation: $2,000.00 Applicant: QUALITY MECHANICAL PLUMBING 80533 VIRGINIA AVE INDIO, CA 92201 Owner: DAVID COLBURN 78010 CORONADOS CIRCLE LA QUINTA, CA 92253 Contractor: QUALITY MECHANICAL PLUMBING 80533 VIRGINIA AVE INDIO, CA 92201 (760)610-3211 Llc. No.: 923620 Detail: NEW 3/4" GAS LINE INSTALLATION FOR KITCHEN RANGE AND 1" GAS LINE INSTALLATION FOR FUTURE OUTDOOR BARBEQUE PER 2016 CALIFORNIA BUILDING CODES. 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 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $13.34 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $26.68 Total Paid for PLUMBING FEES: $40.02 DESCRIPTION ACCOUNT QTY 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 - CAI 1FO <IA _ Project Address: --7 5Q ( OCCUOA00S APN #: r 1.0 r i i�:: Applicant Name: pE7,q V1 ,,• rx� Address: City, ST, Zip: Telephone: -U�O IAv S2-k—L / Email: Architect/Engineer Name: Address: City, St, Zip Telephone: Email: State Lic: City Bus Lic: PERMIT # ZINC NLHIW LUUA f IUN: Project Description: Valuation of Project $. �Oc7 Construction Grading: Bedrooms: I Stories: /t3495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 Occupancy: # Units: OFFICE USE ONLY # Submittal Required Received Plan Sets I 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 4 7-------------------.-------------- THIN CUT PAVERS. $0 CONCRETE WD CONSISTENT V BRICK EXISTING FIG t 1C PROPOSED PRAM WK5201i `0018q PROJECT: David Colburn Residence 78101 Coronados Circle, La Quinta, CA 92253 Date of Drawing: 2.27.19 REVISION 5 7 go i o co"mkool CiTY OF LA QUINTA BUILDING & SAFETY DEFT. APPROVED U29 RUCTION DATE557Y_ PAGE 4 C 1TY PATIO NSH NICHOLAS LAWRENCE DESIGN, LLC 41-801 Corporate Way, #13 Palm Desert, CA 92260 310 274 8090 Drawn by: Virginia Brierlev YLUVV,6;,Nc) - 757 (.A I 51 `� +ui Grp wlor UorcAC, 1-� Ui*a �IS g2253 c1'ZY WKE 2a9 • 0064 78010 COCONAWS cIL