HomeMy WebLinkAboutHVRC18-0183City of Palm Desert
PERMIT NUMBER:
ISSUED DATE:
Building and Safety Department
73510 Fred Waring Drive
HVRC78-0183
4110I201812:00:00AM
Palm Desert, CA 92260
Permit Type: NVAC CHANGE OUT
Appl. Date: 4/10/2018
-
RESIDENTIAL
Appr. Date: 4/10/2018
Permit TIER 1-LESS 15 SEER
Subtype:
Exp. Date: 10R12018
Job Valuation: $3,000.00
Project Address: 14260 ASTER DR
Project Description:
APNITract/Lot No:
Owner:
Contractor:
Applicant:
624220008
GLENDORA LOPEZ
JOHN HARRISON
JOHN HARRISON
TR 2505
74260 ASTER DR
CONTRACTING INC
CONTRACTING INC
12
PALM DESERT, CA 92260
1143 W LINCOLN ST STE 2
1143 W LINCOLN ST STE 2
BANNING, CA 92220
BANNING, CA 92220
(760)322-2653
(760)322-2653
Licensed Contractor DeclaMlion
Fee Summary
hereby affirm under Denaity of oeoury that I am licensed under provisions of Chapter 9
ARCHIVE FEE - 8.5X11 UP TO 11 X1 7 GL-1100000-3411600 $0.28
(commencing with Section 7000) of Division 3 of the Business and Professions Cade,
end my license is In full force and effect.
GREEN 3LDG FEE S81473 GL-6100000-2281000 $1.00
Initial
RESIDENTIAf HVAC CHANGE OUT GL-110DOOO-3221100 $159.00
Total Fees Paid: $160.28
Owner -Builder Declaration
I hereby affirm under penalty of oeriury that I am exempt from the Contractors' State
License Law for the reason(s) indicated below by the checkmark(s) I have placed next
10 the applicable Rem(s) Section 7031.5 Business and Professions Code: Any City or
county which requires a permit to construct, alter, improve, demolish, or repair any
structure, prior to issuance, also requires the applicant for the permit to file a signed
slalemenllhat he or she is licensed pursuant to the provisions of the Contractors' State
License Law(Chapter S(commencing with Section 7000) of Division 3 of the Business
prim Name:
and Professions Code) or that he or she is exempt and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civi penalty of not more than five hundred dollars ($500).)
I, as owner of the properly, or my employees with wages as their sole compensation.
SignafureofApplfcant or Agent:
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 the property, 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 -guilder will have the
Date:
burden of proving that it was not built or improved for the purpose of sale.)
ElI,
as owner of the property, am exclusively contracting with licensed contractors 10
Construct the project (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a licensed contractor pursuant to the
Contractors' State License Law.)
I am exempt from Llcensure undertho Contractors' State License Law for the
following reason:
DalelSignaturo of property owner or agent
Workers' Compensation Declaration
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001, IN ADDITION TO THE COST OF COMPENSATION DAMAGES AS PROVIDED FOR IN
5ESTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
4'
I hereby affirm under the penalty of penury ONE of the following declarations:
I have and will maintain a cerlificate of consent to self -insure forworkers'
compensation, Issued by the Director of Industrial Relations as provided for by Section
Initial
3700 of the Labor Code, for the performance of the work for which this permit issued.
-
Policy No.
I have and will maintain workers' Compensation insurance, as required by Section
3700 of the Labor Code, for the performance of the work forwhich this permit Is
issued. My workers' compensation insurance carrier and policy number are:
r'
IR`itial
Carrier & Policy Number
L
EViration Dale
i
I certify that in the performance of the work for which this permit is issued, I shall not
I;
employ any person in any manner so as to become subject to the workers'
compensation laws of California and agre 1 if houid become subject to the
E
workers' compensation provisions of 5 Ion 370 f 1ha Labor code, I nhwith
""
comply with those rovisipns.
Initlatj@I
pplicant
�--� City Of Palm Desert (For Office Use only)
Department of Building and Safety `�, 2
JOB ID. AV,(a
[[�J
Building Permit Application PLANS FILED;
Project Address: ;� 1� 1- �-„ # S Suite #
Total Value of work: $ 1° � � ;Mote: Plan Review Fees maybe adjusted after Plan Review
Project Description (be specific)-
v it L,_
Contractor Business Narp67—
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Property Owner Name
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Address
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`� Address
City tt..l.. t-. �...L.� Zip
Phone � Y �
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city
Phone
Zip � 4
Fax
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Fax
E-mail Q < (1
E-mail
Contractor Licen e No.
-
❑Architect Name
❑Designer Name
Engineer Name
Address
Address
City
Zip
city
zip
Phone
Phone
Fax
W
E-mail
E-mail
License No.
License No.
--
iN
Applica Name
Signature
Date
co�,U�, (11'c_� L&A)
j
ntact el phone Number
14-1-1
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PLEASE COMPLETE THE REVERSE SIDE
73-510 Fred Waring Drive, Palm Desert, Cif 92260 • (760) 776-6420 • (760) 776-6392 fax • www.cityofPaImdesert, org
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Signature of Tenant
F CITE OF PALM DESERT
- Builaing Safety De_ PERMIT -�
pt �m=rii.
7-3-5 i 0 Fred lrrlari rg_ GL
Pafm Dose: � , (760j 776-64-20
SMOKE & CARBON MONOXIDE ALARM RETROFIT
2016 C2fffornia R" sidsr:tia' Cody sec=_ion: R314.8 and R315.2
VVrtere c ps rr;r is required for arteraPons repairs or additions exce=dif�{g Si.GOG. including extErior war
HVAC change -outs, electrical panel upgrades, windows, etc. �x_isfing dwelling or sIi ping units that , Le goofing,
garages orfref burning appliances inCli.rdino fireplaces sluff have a carbon monoxide alarm.
acn d
Smoke and Carbon monoxide alarms shall be installed in the following manner:
• 10 each Sleeping. r
-p" oom (only require Smok& Alarms unless bedrooms cant -in a gas appfr nee then a carbo:;
monoxide a!arm is required as=Jelij
• Outside each separate sleepinga ea
FJfonoxrI= r In the f,,ir{iediI Vicin:ty of the bedrooms. (require Smoke- andCarborl
• fn each sto ylevel Oftne dwe[Iir:a. fnclu-:HnQ
f:4onoxidz- AIarms) bajemCnLS and hap fai3!- attic rooms (require Smoke and' Carbon
� Smoke alar{ri, and sma ;e de i`oi r^ f
omits s shad not be located where ambi_nt conditions. including humidi yF a ,d
tempsratcrrC are outside the limits speCf`red by the manufaCtilr
• Instal!atio i near bathrooms. Smoke ers published instructions
or opening of a bathroo rr thatcontains Ufa, msFshaff be ihs,all d no. less than a 3 fit_ horizontal distance from the door
odea bathtub or sha'rrer unless this would prevent plaCement o`asrnok= alarm
required by Other sections of the cods
.. a,a.m
t Smoke alarms and smoke d_fectars shall not be installed within 36 in. horizontal Path f t
forced air i]easing or cooling system and shall be installed autsfda of the direct ai o'��r from 1hQse�mQ_c,=em�yF�r� of a
Smoke ala rrns and s a=
smoke d tec�ars shall not be installed within a 36 in_ horizontal path from the tip ofthe blade of
a ceiling -suspended (paddfej fan
Smoke Detectors shall }
fl be vri�hirl 1G years of manufacture mar, to r
Ca lVeniid,' Eli IQniZai{a i 5 t t key daE and,0; re{7f�C if SL{Cl1 dal~ d�?� nrJi exist
more e,arms must be installed with a ten year battery
InterGpnneCtian:
Where more: tnan one carbon monc)y:de alarm is required to be installed
tf;e alarm shall be interconnected in manner that activation of one alarmtshalf activahin the f Ienall unit ofFt�evvithin G slce in unit
Interconnection is not required in existing dwelling units where repairs do not result a the removal of s, and g
alarms, exception:
finishes, or there is no access by means of attic. basement or crawl no ceiling
4J1..pac�.
The Building Inspector will verify the installation of the smoke and carbon monoxide alarms durin the
inspection process or the owner can complete and sign under the penalty of perjury the following: g
! understand th a above requirements and certify that we now have smoke alarms and carbon monoxide alarms
installed that comp�l . _I agree to comply with the CRC in regards to smoke alarms and carbon monoxide alarms.
iF �0 - rr �J 1"" III I
(Property Owner's name) and f, who own and/or live in the
(Ten 0
DwVlli)g located at:
Signature of Ovvne
Date
`This is a voluntary smoke and carbon monoxide alarm verification procedure. if you prefer a building inspector to
perform the verification. you must arrange to have an adult present at the time of inspection.
`Nat:. this veri icatian is only used when normal access to the interior of the dwelling is not achieved during tilt course
of protect carts±ruction. fit is normally used for projects such as re -roofing. re -siding. patio covers or swimming pools.
4i1112017
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