06-2789 (PLBG) Alft IIIIIIIIIIIIIIIIIIIIIIIII 05
P.O. BOX 1504 IE T,&t 4 � VOICE(760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING&SAFETY DEPARTMENT INSPECTIONS(760) 777-7153
BUILDING PERMIT
Date: 7/25/06
Application Number: 06-00002789 Owner:
Property Address: 49688 AVILA DR HOLLAND JAY PUTNAM
APN: 646-270-008- - - P O BOX 946
Application description: PLUMBING LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL D 4
Application valuation: 3950
Contractor: JULJ
Applicant: Architect or Engineer: ALMS UNDERGROUND CONST, INC. U 2 5 2006 1
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234 CINDFQUIN7A
(760)324-1911 FINANCE DEPT
fLic. No. : 482180
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LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)of Division 3 of the Business and Professionals Code,and my License is in full force and effect. _ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License Class: C21 C42 License No.: 482180 for by Section 3700 of the Labor Code,for the performance of the work for which this permit is
** � issued.
Datev��JUN�t ontractor: �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
OWNER-BUILUR DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier CALIFORNIA INS Policy Number 460093580102
following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ 1 certify that,in the performance of the work for which this permit is issued,I shall not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any manner so as to become subject to the workers'compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I should become subject to the workers'comp ation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the Labor C e,I shall fort 'th compI ith the ov' ions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by nt–�
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).: ategS! plicant:
(_1 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 WARNING: FA URE TO SECURE WORKE OMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL P LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000) IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractors)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I—) I am exempt under Sec. ,B.&P.C.for this reason 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued ISec.3097,Civ.C.). city and ounty ordinances and st laws relating to bu' ing construction,and hereby authorize esentatives
of Y aF ounty totenter upon th ove-mentioned grope or inspection pose
Lender's Name: '
ate i ture(Applicant or Agent):
Lender's Address: 1 JA
LQPERMIT
Application Number . . . . . 06-00002789
Permit PLUMBING SEWER
Additional desc .
Permit Fee . . . . 30.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 3950
Expiration Date 1/21/07
Qty Unit Charge Per Extension
BASE FEE 30.00
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Special Notes and Comments
SEPTIC ABANDON; SEWER CONNECT
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 30.00 .00 .00 30.00
Plan Check Total .00 .00 .00 .00
Grand Total 30.00 .00 .00 30.00
LQPERmrr
Bin # City of La Quinta
Building 81 Safety.Division .
Permit# p P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: �j /q j 1 Owner's Name:
A.P.Number: Address:
Legal Description: City,ST,Zip: L,
Contractor: /q1,, S Unclerl roV Cv�s+- Telephone: �
Address: 3 Q,70 3 V y S-�" r Project Description:
City, ST,Zip: 223y c7 i&y\_
Telephone: 3 Z q / I
State Lic.# : y $2 20 City Lic.#: 6 9
Arch.,Engr.,Designer- `
Address:
City,ST,Zip:
Telephone: Construction Type: Occupancy:
State Lic.#: Project type(circle one): New Add'n Alter Repair Demo
Name of Contact Person: p u 1}n S Sq.Ft.: #Stories: #Units:
Telephone#of Contact Person: �5 7 S ' /,5j/0 Estimated Value of Project: 3 9s O
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd 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
Energy Calcs. Plans picked up Construction
Flood plain plan Plans 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
TLA A LEY WATE DISTRICT CASH RECEIPT DETAIL 1,Q 115 4 3 0 /_
Received Fro V"OAr'
Date: t(J
Address: C9
Account No. _ LIM- TractService Address A, G.A.Code
❑ Meter(s) $
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ Detector Check(s)
❑ Meter Surcharge r y 1
.Sanitation Capacity Charge `Lc' 1� •vv
❑ W.S.B.F.C.
❑ S.I.W.S.C.
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account-Name
❑ Inspection Fee-Tract-
Fee-
❑ Plan Check Fees Water/Sewer-
Tract-
❑ Bond Payment-A.D.- Bond Assmt
❑ Customer Deposit
❑ Other r�j
TOTAL $ t(/
Remarks:
DCCopy to: '¢
✓Cash Water Servi
Check
Money Cash
i
Ordert) fA—
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MS.JAY P.+HOL'LA�ND' '; fJ.
P.O.BOX 946 760-564-4166 , j (�
q; LA OUINTA,C_A 92247-0946 + ` * jr L 16 21/12204881
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1 I 2502 Morongo Trail IE
PUMPINGSERVICE Palm Springs, CA 92264 No. 012781
(760) 327-8859
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CITY STATE ZIP CITY STATE ZIP
CUSTOMER ORDER TSALESMAN TERMS F.O.B. DATE
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PAYMENT DUE UPON RECEIPT ��