13-1691 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
13-00001691
51863 AVENIDA OBREGON
773-163-017-5 -000000-
PLUMBING
COVE RESIDENTIAL
5784
Architect or Eng neer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect.
License jClass: A B C36 C4 License No.: 422155'
DDaaterw / - i' '/y Contractor-,
V
OW R -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 sheds 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).:
1; ;as owner -of the property,.or my employees with wages as their sole compensation, will do the work, and
e.structure isnot intended or offered for sale (Sec. 7044, Business andProfessions Code: The
, ntr"actors"State licen5eiaw' does not apply to an owner of property who builds or improves thereon,
and"wno 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.).
(_ 1 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
1 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: lk
�.
LQPERMIT
Owner:
FERMIN F. DIAZ
51863 AVENIDA
LA QUINTA, CA
(760)777-7628
OBREGON
92253
Contractor:
ROTO ROOTER PLUMBERS
2141 INDUSTRIAL COUR
VISTA, CA 92081
(760)598-4292
Lic. No.: 422155
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/21/14
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
r'� 7h
A issued.
!7ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
IL Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier AMERICAN ZURICH Policy Number WC900098701
_.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. '
Oate:,y21 It Lf Applicant:-* 7
WARNING: FAILURE TO SECURE WORKERS' COMPEN TION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED. THOUSAND
DOLLARS 1$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 Director of Building and Safety 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 thiscountyto enter upon the above-mentioned property for inspection purpose
Date;'/ —t'1 `� tiignature (Applicant or Agent): /1
LQPERMIT
Application Number
Permit . .
Additional desc .
Permit Fee . . .
Issue Date . . .
Expiration Date .
13-00001691
PLUMBING 2013
11.92 Plan Check Fee
Valuation . .
7/20/14
Qty Unit Charge Per Extension
1.00 11.9200 EA PLBG BUILDING SEWER 11.92
----------------------------------------------------------------------------
Special Notes and Comments
SEWER CONNECTION - SEPTIC ABANDONMENT,
CONNECT TO SEWER. 2013 CALIFORNIA
BUILDING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
PERMIT ISSUANCE M/P/E 90.57
PLAN CHECK, PLUMBING 11.92
Fee summary Charged
Permit Fee Total 11.92
Plan Check Total .00
Other Fee Total 103.49
Grand Total 115.41
Paid Credited Due
.00 .00 11.92
.00 .00 .00
.00 .00 103.49
.00 .00 115.41
Bin #
City of La Quinta
Building-8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
....Building,Permit Application and Tracking Sheet
Permit #
A'Yoject Address: SrI b p V6M b4 O 2E(,o v Owner's Name: FC&M I tJ F, J) I A
A. P. Number: Address: S'] &�13. AU6A)'bq 0f2�Go�
Legal Description: City, ST, Zip: (—A Qvi nfng G4 9 2 z5 j
ontractor: Telephone:
Address:Rt-11
1 /-1 % S t00roject Description:
ity, ST, Zip: Ute--- C A O r C
-Telephone:
<# '
eo-'l nc C To
,eateLic.#:
Lic. #; f
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
r,.sss:as:+.•s:•:,;:;asss::;ass:;;ssr.;:::5% it:;;;
;<::::::.:.:::: l;w:.:::;::::;<: >:<.:::>:• Construction Type: Occupancy.
:>::<rj;?:..;.-;<:.<.<:?i,»::«<:s:'<:»::»;:<. Project type (circle one): New Add, n Alter Repair Demo
State Lic. #:
Fame of Contact Person: 5:'�A -rs— oGohE� Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person: 7&0 — 76(0 _ (0 9103 imated Value of Project: S' �/; O O
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets ,
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person-
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Q
V-1
0 `Meter(s)
'0 SbrvI co(s),
0 8ackfIoW(s)___
0 House Lateral (a)
Q Dolector CheCk(a)
U Mbteir Surcharge - -- — ------- .... . ....
VIO'Sonlialldn Cap'a6lty Charge A_o k_ll
0 W.S.S.F.C.
0 Temporary Construction Meter
0 turn an Charge
.0 Uncollected Account.—Name
U
cbount -.Name* Inspection Fe6 Tract -
Fee -
* Pion Check Fees Water I Sewer -
Tract -
G� Bond
Payment - A.M. --Bond,
Aseml.
0 Customer Deposli,
Other
4
TOTAL $
Z! -q
..........
Remarks- .. ....... .
®r-
. . . . . . . ........
V&PY to:
Cish WaterS6rvice
Check'
MoKey 96574
Cashier
Order , 1! 00,
CVVVD-438(11169)
.. ................... ... ...
��� A 4-
COACHELLA VALLEY WATER DlSfRtCT
CASH RECEIPTDETAIL
:Received Froffu
Address;
1--,
Account No. 3A/
y.YLot(
Tr
Service Address _Z
act
G.A. Code
V-1
0 `Meter(s)
'0 SbrvI co(s),
0 8ackfIoW(s)___
0 House Lateral (a)
Q Dolector CheCk(a)
U Mbteir Surcharge - -- — ------- .... . ....
VIO'Sonlialldn Cap'a6lty Charge A_o k_ll
0 W.S.S.F.C.
0 Temporary Construction Meter
0 turn an Charge
.0 Uncollected Account.—Name
U
cbount -.Name* Inspection Fe6 Tract -
Fee -
* Pion Check Fees Water I Sewer -
Tract -
G� Bond
Payment - A.M. --Bond,
Aseml.
0 Customer Deposli,
Other
4
TOTAL $
Z! -q
..........
Remarks- .. ....... .
®r-
. . . . . . . ........
V&PY to:
Cish WaterS6rvice
Check'
MoKey 96574
Cashier
Order , 1! 00,
CVVVD-438(11169)
.. ................... ... ...
Y
78 .1:05 CALLE'�ESTADO7 eL.A QUINTA, ::.•CALIFORNIA 92253 = (6191 564-2246
FAX (619) 564-.5617
June. 11, 19 9:1
To Whom-
It'. May Concern
The structure located at;'51 X86.:3' Avenida:Obrego'n .will be
located-in a "a. f_1•oo'd zone.. perrevi=sed F.I.R.M. (panels
06070:9; 0.0'5• A and ;0010 'A► f,or Lai- Qunta.. This 'change will be
effective August.,13, 199-1.',- The property.' is'currently
designated° as .zone A0.'(depth:-`two
If you h-ave any questions, -feel free to contact mei
Sincerely, "
BUILDING AND SAFETY
Tom Hartung
Director of Building and:Safetys
TH/lc
b
MAILING ADD.RESS'_.- P.O.= BOX '1504 LA iQUINTA, CALIFORNIA 92253
Y
F5
THE VINTAGE CLUB MASTER ASSOCIATION
tj
�: �v-(o&a
i
w- ?36-313-o
�C,e,� .Wcee,
,Z4po I p�
ctf �tv" tjorlk
75-001 VINTAGE DRIVE WEST - INDIAN WELLS I CALIFORNIA 92210 - 1'760) 862-2198 - FAX: (7 . 60) 862-2199