BPLB2020-000678-495 CALLE TAMPICO D" VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/24/2020
Permit Type/Subtype: PLUMBING/ Owner:
Application Number: BPLB2020-0006 JEANNE PEDRINI
Property Address: 78067 COBALT DR 78067 COBALT DRIVE
APN: 604023025 LA QUINTA, CA 92253
Application Description: PEDRINI / REPLACEMENT OF SHOWER PAN IN PRIMARY BATHROOM
Property Zoning:
Application Valuation: $500.00
Applicant: Contractor:
ZACHARY CHRISTENSEN - DAVE CHRISTENSEN TILE P
DAVE CHRISTENSEN TILE
44131 FENNER AVE D44131 FENNER AVE
LANCASTER, CA 93536 JAN 2 4 2020 LANCASTER, CA 93536
CITYOF LAQUINTA 0 (661)886-6894
DESIGN& DEVELOPMENT DEPARTMENT Llc. No.:447154
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: Cl 4 License No.: 447154
Date: 7 zc/ Contractor:
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
Lender's Address:
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. My workers' compensation insurance carrier and policy number are:
Carrier: EXEMPT 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.
2�
Date: _lb(, Applicant: _
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
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 hereby authorize representatives of this city to enter upon the above -
mentioned property for inspection purposes.
Date: " L `�—�� Signature (Applicant or Agent):
Date: 1/24/2020
Application Number:
BPLB2020-0006
Owner:
Property Address:
78067 COBALT DR
JEANNE PEDRINI
APN:
604023025
78067 COBALT DRIVE
Application Description:
PEDRINI / REPLACEMENT OF SHOWER PAN IN PRIMARY BATHROOM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$500.00
Applicant:
Contractor:
ZACHARY CHRISTENSEN
- DAVE CHRISTENSEN TILE
DAVE CHRISTENSEN TILE
44131 FENNER AVE
44131 FENNER AVE
LANCASTER, CA 93536
LANCASTER, CA 93536
(661)886-6894
Llc. No.: 447154
Detail: INSTALLATION / REPLACEMENT OF TILE SHOWER PAN IN PRIMARY BATHROOM LOCATION. ALL WORK SHALL COMPLY WITH 2O19 CALIFORNIA
BUILDING CODES.
DESCRIPTION
FINANCIAL INFORMATION
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
$101.97
Total Paid for PERMIT ISSUANCE: $101.97
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP
101-0000-42401
0
$13.42
DESCRIPTION
ACCOUNT
CITY
AMOUNT
FIXTURE/TRAP PC
101-0000-42600
0
$13.42
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$13.42
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$13.42
Total Paid for PLUMBING 2019: $53.68
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
GE1111 ofo,rwI,etarL—
PERMIT#
PLAN LOCATION:
Project Address: 7 rc) ? (0414 C7
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
Applicant Name:
Address: 1-0 / inn v
City, ST, Zip: C4 S,�
Telephone: G61 6-1 - , Y2
Email: G l 7 I � �.)
l 7 I
Valuation of Project $ 00
Contractor Name: /1vL- j)� S to 1
New SFD Construction:
Address: G,12 W-2S �
Conditioned Space SF
City, St, Zip ZLC � , /
(7
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
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lie: City Bus Lie:
Property Owner's Name: // n
u n n
New Commercial / Tenant Improvements:
Address: - Ya67 c k
Total Building SF
City, ST, ZipLo 2 2 S 3
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
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First Floor
[776.5 Sq ft]
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BUILDING DIVISION
REVIEWED FOR
CODE
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?L:D2020 — 000 r.
79047-7 CO-SACT 'bP- .
46'
Building Sketch
Bedroom
23.
r
71
Cv. Patti 5'
35Sgft
7'
Kitchen Dining
24'
Living Room
20'
i
18' Unc�, Balcony 811
1 [160 Sq ft]
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