PLBG (06-3313) + RR (04644)77451 Calle Madrid
06-3313
04644
P. -O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r 06-00003313
Property Address: '
77451 CALLE MADRID
APN:
774-242-001-3 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2900
lIr:::i 4Q
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT.
Applicant: Architect or Engineer:
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 Class: C,3366 -C42 -B 793482
Date:9— I[4 tractor:
OWNER -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 she is 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 1$500)::
(_ 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
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who 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—) I am exempt under Sec. B.&P.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
Owner:
WOLFE ANN ASHLEY
77451 CALLE MADRID
LA QUINTA, CA 92253
Contractor:
SO CAL PLUMBING
P.O. BOX 955
YUCCA VALLEY, CA
(760)369-4104
Lic. No.: 793482
VOICE (760) 777-7012
FAX .(760) 777-7011
INSPECTIONS (760) 777-7153—
P81
Q
I ' PE CO
SEP 13 2000
CITY OF LA QUINTA
FINANCE DEPT.
Date: 9/13/06
-----------------------------------------------
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
issued.
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
insurance carrier and policy number are: -
Carrier EXEMPT Policy Number EXEMPT
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 tr,nn...,•ti-1„ ..arti rhnca orovisions.
Date: 0 pplio WARNING: FAILURE 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 (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION3706 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. 1. agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property f urposes.
Date: /r Signature (Applicant or entl:
- Application Number . . . . . 06-00003313
Permit . . . PLUMBING SEWER
Additional desc .
Permit Fee 30.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
2900
Expiration Date 3/12/07
Qty Unit Charge Per•
'Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special•Notes and Comments
SEWER CONNECT/SEPTIC ABANDONEMENT
_
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
LQPERMIT
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PLIMP11116
www www w w.
Lic #C42 855 851
V V JLO- 100 I --1-OYY-.7'ago. / L.03
FAX 760 328-6607
P.O. Box 2318 • Cathedral City, CA 92235
CUSTOMER'S ORDER N0.
ORDER TAKEN BY
D ORDERED
DATE PROM SED ❑ A.M.
❑ P.M.
BILL TO
PHONE
ADDRESS
MEE ANIC
CITY
HELPER
JOB NAME AND LOCATION
❑ DAY WORK
❑ CONTRACT
❑ EXTRA
DESCRIPTION OF WORK
r.
V
QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
Gallons .400e> r„_
wvl
Pumping Fee per 1000 gal.
Dumping Fee per Md gal. v 1
Out of Area Fee
Locating / Opening Fee er hour)
nklv
Size System:
1
i
A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS.
18% PER YEAR WILL BE CHARGED ON PAST .0
ACCOUNTS OVER 30 DAYS
TOTAL
MATERIALS
TOTAL
LABOR
WARIER: Not responsible for secondary a a 9,suc r
damage, chipped concfe ark o set•o rv aainr ye or trees.
SIGNATURE r DATE COMPLETED
TAX
TOTAL
L �;; C7COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL
"
O
-7, 6:
Received From:5
Nda M599
, ate.
Address:
Account No .3-3
Lot(s) Tract
Service Address uz G.A. Code
0 Meter(s)
• Service(s)
• Backflow(s)
0 House Lateral(s)
0 Detector Check(s)
0 Meter Surcharge
2-1Sanitation Capacity Charge
• W.S.B.F.C.
• S.I.W.S.C.
• Temporary Construction Meter
• Turn on Charge
0 Uncollected Account - Name
0 Inspection Fee - Tract -
Fee -
0 Plan Check Fees Water / Sewer -
Tract -
0 Bond Payment - A.D. - — Bond— Assmt
• Customer Deposit
• Other
-j i
emar s:
0/ Copy to:
Cash
Check
Money
Order
O
TOTAL $
Water Service
Cashier—
Bin #
City of La Quinta
Building 81 Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
p1
Project Address: ' I f '" I rj OMtr (Lt
Owner's Name:
A. P. Number:
Address: . 4
Legal Description:
Contractor:PL
City, ST, Zip: `>-
Telephone:
Address:
Pro' --scription:
City, ST, Zip: l
Telephone: 2> (O C! — 4C 0
State Lic. # : R
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: I
State Lic. #:
Name of Contact Person: Y [ tdA4A/ 'L—
Construction Type: Occupancy:
Project type (circle one): New Add'n ?.iter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Lq&q — 3 (
Estimated Value of Project:
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
Zed 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:-
''d 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
414 Qli` 04644
P.O. BOX 1504 .
Building 7,.451, "" LA QUINTA CALIFORNIA 92253
'Address - - - -
_
Owner
Anja Wolf
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address same A.P. Number 774-242"-001
City Zip Tel.
La, Quinta 1 92253 Legal Description
Contractor Project Description Re—roof
Apex Roofing Company »
Address429Harbison Circle
City Zip
Pancho rMirac[o 92270 4 Tel. 324t9172
,
State Lic. City
& Classif. 491381 Lic. # 1249
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am-li en'sed under provisions of -Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Prooffe ssions,Code, and my license is in full force and
effect.: _ „- iA.'r</f .,E",:. - ! . ','- "^ d>' %f I # +•i
SIGNATURE - -^' DATE
OWNER -BUILDER DECLARATION
I' hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 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 its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basts
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).
O 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified.copy"thereof. (Sec. 3800, Labor Code.)
Policy NO. -Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuafion
Or less.)
• 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
. comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. No.
Size Stories
No. Dw.
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
$6,710
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
ti6 2 .50
Mech.
Electrical
Plumbing
S.M.I.
.O
Grading
Driveway Enc.
Infrastructure
TOTAL.
REMARKS
t 1\ 'I;'1'.„ p J"i ' •Y 'Y . l%
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE lN S .E TO ,R -
Issued by: Date Permit
Validated by:
Validation:
I
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO F1 rp i
UNITS
SLAB GRADE
2ND FL SO FT. C
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
DUCT WORK
ROCK STORAGE
GAR50. FT. flt
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEOUIP.
DRAINAGE PIPING
CAR P. I SO FT. 0
TEMP. POLE
WALL I SO. FT. @
GROUT
DRINKING FOUNTAIN
SO FT 0
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION S
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
GAR. FIREWALL
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID a t V. c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/,c
HOUSE SEWER
INSULATIONISOUND
GAS PIPING
PERMIT FEE
FINISH GRADING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE IPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
'A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xE
=$
LUMBER GR.
FINAL INSP.
. -FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL