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HomeMy WebLinkAboutAVENIDA SOLANA 40808 HVRC19-02811 City of Palm Desert PERMIT NUMBER: ISSUE DATE: Building and Safety Department 73510 Fred Waring Drive HVRC19-0281 5/1512019 Palm Palm Desert, CA 92260 Permit Type: HVAC CHANGE OUT Appl. Date: 511512019 RESIDENTIAL Permit TIER 3-18 OR MORE Subtype: SEER Job Valuation: $6,791.00 Appr. Date: Exp. Date: 1111112019 Project Address: 40808 AVENIDA SOLANA Project Description: REPLACE 2 TON DUCTLESS MINI SPLIT SYSTEM APNITract/Lot No: Owner: Contractor: Applicant: 622300022 MARY CHRISTINE REGAN HARRISON ENTERPRISES INC HARRISON ENTERPRISES INC TR 29045 40808 AVENIDA SOLANA 31170 RESERVE DRIVE 31170 RESERVE DRIVE 3 PALM DESERT, CA 92260 THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276 (760)343-7488 (760)343-7488 Licensed Contractor Declaration Fee Summary I hereby affirm under penalty of perjury that t am licensed under provisions of Chapter 9 ARCHIVE FEE - 8,5X11 UP TO 11 X1 7 GL-1100000-3411600 $0.35 (commencing with Section 7000) of Division 3 Of the Business and Professions Code, and my license is in full force and affect. GREEN BLDG FEE SB1473 GL-6100000.2281000 $1.00 Initial RESIDENTIAL HVAC CHANGE OUT GL-1100000-3221100 $111.30 Total Fees Paid: $112.65 Owner -Builder Declaration 1 hereby affirm under penalty of peoer'ury that I am exempt from the Contractors' State f herebyalffrm under the ponattyof pedurythat there is a construction fending agency for the License Law for the reason(s) indicated below by the checkmark(s) I have placed next performance of the work for which this permit is issued (Sec 3097, Civil Code) to the applicable item(s) Section 7031.5 Business and Professions Cade: Any city or Lenders Name andaddress county which requires a permit to construct, alter, improve, demolish, or repair any structure, prier to issuance, also requires the applicant for the permit to fife a signed Asbestos Declaration statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business Written asbestos notification pursuant to Part 61 of Title 40 of the Code of Federal Regulations is required and Professions Code) or that he Or she is exempt and the basis for the alleged when asbestos exists In buildings, or portions thereof, undergoing demolition. I hereby declare that exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the demolition authorized by this penult is from construction that does or does not contain applicant to a civil penalty of not more than five hundred dollars ($500).) asbestos, or that no demolition is authorized by this permit. I, as owner of the property, or my employees with wages as their sole compensation, NOTICE: You may protest any of the fees for this permit in accordance with CA Gov Code Sec. 66020 will do the work, and the structure is not intended or offered for sale (Sec. 70", Business and Professions Code: The Contractors' State License Law does not apply to (a). The protest must satisfy the requirements of Gov. Code Sea66020(a) and must be filed within 90 days of the dale of this notice. In addition, an owner of property who builds or improves the property, provided that the you must lender payment of the protested fees at the time of the payment or provide evidence of arrangements to pay the protested fees or exactions at the time they Improvements are not intended or offered for sale. If, however, the building or are due if they are not already due. improvement is sold within one year of completion, the Owner -Builder will have the burden of prov,ng that it was not built or improved 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 Contractofs 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 Licensure under the Contractors' State License Law for the following reason: Date/Signature of property owner or agent W rk r ' C nnensation Declaration 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 J$100,000), 1N ADDITION TO THE COST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under the penalty of perjury ONE of the followina declarations: I have and wilt maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit issued. Initial Policy No, I have and will maintain workers' compensation Insurance, as required by Section 700 of the Labor Code, for the performance of the work forwhich this permit is issued. My workers' compensation insurance carter and policy number are: Cartier & Policy Number CYPRESS INSURANCE COMPANY RAWC012965 _ Initial Expiration Date 5/112020 1 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 became 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 wl h tho a provisions. 7S 1 _ Initial Date Applicant —�— City of Palm Desert Department of Building and Safety Building_ Permit Application (For Office Use Only) JOB ID: PLANS FILED: Project Address: 40808 Avenida Solana Suite # Total Value of work: $ 6,791.04 Note: Plan Review Fees may be adjusted after Plan Review Project Description (be specific): Replace 2 ton ductless mini split system Contractor Business Name General Air Conditioning Property Owner Name David and Mary Regan Address 31170 Reserve Drive Address 40808 Avenida Solana city Zip Thousand Palms, CA 92276 city Zip Palm Desert, CA 92260 Phone 760-343-7488 Phone 760-674-3131 Fax Fax E-mail E-mail Contractor License No. 686310 ❑Architect Name ❑Designer Name Engineer Name Address Address city Zip city Zip Phone Phone Fax Fax E-mail E-mail License No. License No. Applicant Name Signature Date Steven Schnierer May 15, 2019 Contact Telephone Number E-mail 818-735-7876 swschnierer@roadrunner.com PLEASE COMPLETE THE REVERSE SIDE 73-510 Fred Waring Drive, Palm Desert, CA 92260 • (760) 776-6420 • (760) 776-6392 fax • www.cityofpalmdesert.org N O 0 In J t" I O Qt cu 0 ei N LL .d.. u -a G! 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