13-0146 (PLBG)P.O`.' BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:33,QO.0
16 02 A 6
Property Address:
51660 AVENIDA OBREGON
APN: a
773-124-0.08-4 -000000-,
'Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3000.
Applicant: Architect:or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Owner:
ROBYN DOOLEY
57383 PUEBLO TRAIL
YUCCA VALLEY, CA 92284
---------------------------------
Contractor:
• Owner e
---------------.-----
O •
Date: 2/11/13
----------------------- --------------------------------- — — — — — — — — — — — — — - — --- — — ------ -----------
LICENSED CONTRACTORS DECLARATION �� "WORKER'S COMPENSATION DECLARATION
.1 hereby affirm under penalty perjury that.) ain licensed under provisions of Chapter 9 (commencing with I hereby affirm under enalt of perjury oneof the fofowin declarations: -
Y I P 9 penalty P 1 Y, 9
Section 7000) of Division 3 of,th_ a Susiness and Professionals Codei•and my License is in full force and effect. -f have and will maintain a certificate of consent to self -insure for workers' compensation, as provided �•n
License Class: - •/� ansa ..for by Section 3700 of the Labor,Code, for the -performance of the work'for,'which this permit is
i m r .;i.. // - .", - •issued.
'Date// 17015% W 15 Contractor., _,`'•'
OWNER -BUILDER D'kFECLARATION '
' I herebyatfirmunder 'penalty License I am exempt from the Contractor's'StateLicense Law for the
following reason (Sec.J031.5, 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
perinii,to file a signed'statement that he-or—She' is licensed pursuant,to the provisions of the Contractor's State
License Law.(Chapter9:(cornimencing'with Section 7000) of Division 3 of the eusinessand Professions Code) or
that he or shit is exemptjtherefrorim and the'6sis for the alleged exemvi
exemption. Any olation 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 6o6niended or. offered for saleASec.•7044 Business and Professions Code: The
Contractors' State ;License Law does not apply to`an ownerof property who builds or improves thereon,
' and who does the work.himself or herselfthroughhis 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 f.completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.)..
(_ 1 I, as owner.of the,prpg9rty,Am exclusively, pontracting.with licensed contractors to construct the.project'(Sec.
7044, Business and Professions Code: The Contractors' StateLicense Law does not apply to an'owner of
property who builds'or improves thereon, and,who contracts for the projects with a contractor(s)`Iicensed
pursuant to the Contractors' State License Law.).
( I I am exempt under:Sec. , BAP.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:
LQPERMIT
I haveand will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for th'e.performance of the work for which this permit is issued. My workers' compensation
p.ur��f�l1ce carrier and policy number are:. •, tl/t
Carrier r,r Policy_Number Z Z 7 b - '
-:M 1 certify that, in the performance of the work for which this permit•is issued,a shall not employ any. .
person in any manner so as to becomesubject to the workers' compensation laws of California,
Ail . and agree that; if I uld'become subject to the workers' c pensatiori pro3isions of Section
- . 3700.of.he Labor I'shall`forth hiom •wi toe iovisions. • '
X!�=Applipqnl: TO SECURE -WORKERS C MPENSATION COVERAGES UNLAWFUL,' -AND SHALL.
SUBJECT AN,.EMPLOYERTOCRIMINAL PEN IES AND CIVIL FINESUPTO: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. I
- APPLICANT ACKNOWLEDGEMENT -
IMPORTANT .Application is heieby.made to the Director of Building and Safety.for a.permifsubject 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 p rformeduntler or pursuant to any permit issued as a result of this application;
the owner; and'fhe 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 andvoidif 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 b ing construction, and hereby authorizer esentatives
of this county to enter upon the above-mentioned prop r inspection pose
Dat- eJ l3 Signature (App)" " ,cant or Agent): O /
f0; �Y
Application Number . . . . . 13-00000146
Permit . . .
PLUMBING SEWER
Additional desc . .
Permit Fee . . . .
30.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 3000
Expiration Date
8/10/13
Qty Unit Charge
Per
Extension
BASE FEE
30.00
.00 15.0000
EA PLB BUILDING SEWER
.00
7 -------------------------------------------------------------------
Special Notes and Comments
SEPTIC ABANDON. SEWER
CONNECT. 2010
CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
--------------------
Credited
--------------------
Due
-----------------
Permit Fee Total
30.00
.00 .00
30.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
31.00
.00 .00
31.00
LQPERMIT
Bin. #
.
oty of la..:Quinta
`Bupoi a Safety Division
P.O. Box 1504,78-495 Calle Tampico
1A.Qulnta,.CA 92253 -„(760) 777-7012
BuRding;Permit Application and Tracking Sheet
Pe It #
Project Address: ve • .Ob re t) K
'Owner sNar6e:.
' L7oale
A- P. Number.
Address:
Legal Description:
City, ST, Zip: �!l/0-1le C0. , 9Z7-8 Y
Contractor.
r5
'Telephone: 76�0�,rS
Address: 3876`3 f"ot; J�.�
Project Description: Sewer .GONv�e� o,^
�V)5
City, ST, Zip:. 7y r v -i �c.l� C. 9.223 q
Telephone: '
State Lie. # : a1 S Z / $O City Lia #;
Arch, Engr., Designer:,
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: Z Qu 'l.r^ .V1
'Construction Type:,.. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: , # Stories: #Units:
Telephone # of Contact Person: 7 $' / �/ U
Estimated Value of Project: 3 000.
APPLICANT: DO NOT WRITE BELOWJHIS UNE
#
Submittal
' Req'd
Recd
TRA ILING
PERMIT FEES
Plan Sets
Plan Check submitted-
Item Amount
Structural Gales.
Reviewed, ready for. corrections
PLin Chcck Deposit. .
Truss Calcs.
Called Contaef PersonPlan
Check Balance
Mile 24 Cates.
Pians•pieked up
Construction
Flood plain plan.
Plans resubmitted
Mechatilcal
Grading plan
2f°, Review, ready for corrections!issue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plnns.plcked up
ML
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1rd Revlew,'ready for correetlons/issae
Developer Impact Fee
Planning Approval
'Called, Contact Person
A.LP.P.
Pub. Wks. Appr
Date of.permltissue -
School Fees
Total Permit Fees
zATCOACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058; COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 2/4/2013
SUBJECT: SANTA CARMELITA, 51660 AVENIDA OBREGON, LA QUINTA, LID 681418, "SCC FEE ONLY"
ROBYN DOOLEY Project: 13-4378
57383 PUEBLO TRAIL
Project Date: 2/4/2013
YUCCA VALLEY, CA 92284 Amount Due: $4,231.00GEO:
06-06-01-3
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK .
f
JUtSJtt. 1: OAN IA UAKMELI TA, 51660 AVENIDA OBREGON, LA QUINTA, LID 681418. "SCC FEE ONLY"
OACHELLA VALLEY WATER
P.O. BOX1058COCOACHELLA, CALIFORNIA D92236C(760) 398-2651
Page 1
MMMSM
www.hammerpumping.com
760/360-7448 7601321-7448 FAX 760/324-6434
Customer Name
i
Address
City
Ph#
Additional Service -El Required ❑Recommended
P.O. BOX 2448 -Cathedral Cit ;'CA 92235-2448 - LIC# 661018 JOB INVOICE
LO.�DERED
TIMEIN: TIME OUT: TECHNICIAN a1 TECHNICIAN 82 HELPER(S)
BV: P.O. k START DAT£: END DATE:
TION
l.)N)l
Description/ Remarks/ Drawings
REASON FOR
SERVICE
BACK UP
CONTRACT
MAINTENANCE
❑ REPAIR
❑ MAINTENANCE
F -!,,ESTIMATE
CONSTRUCTION
OTHER
PAID BY:
Credit Card — MC ! VISA # EXP.DATE
I hereby authorize Hammer Pumping, Inc. to charge my credit card for the above charges.
I understand that by signing below I am agreeing to all charges incurred on this ticket and
that the work was completed to my satisfaction.
Ft ? r'°? -17 -17
Signatureforjob completion OATEf
COMMENTS
❑ Leach System Failing ❑ Roots ❑ Excessive sludge/grease
SERVICES COMPLETED
f M 3 M
Problem Solved!