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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 Aw' wAwPw,i 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