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PLBG (07-0539)52150 Avenida Madero 07-0539 `4 P.O. BOX. 1504 78-495 CALLE TAMPICO LA OUINTA. •CALIFORNIA 92253 Application Number - Property Address: APN: Application description: Property Zoning: Application valuation:. Applicant: 07-00000539 -"52150"AVENIDA-MADERO 773-203-008-8 _000000— PLUMBING COVE RESIDENTIAL 4500 Architect or Engineer: 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 Cl a s: C36 License . o.: 273088. r i Date: Contractor. OWNER -BUILDER DECLARATION ' hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason ISec. 7031 .5,'Business and Professions Code: Any city or county that requires a permit t6 construct, alter, improve, demolish, or repaii 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 ($500).: (_) 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.). ' (_) 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.). (_1 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: SNIFF STANLEY P O BOX 1414 LA QUINTA, CA 92253 Contractor: VALLEY PLUMBING 46780 CLINTON ST INDIO, CA 92201 (760)3.47-3629 Lic. No.: 273088 VOICE (760) 777-7012 FAX (760) 777-7011 • INSPECTIONS (760) 777-7153 Date: 2/21/07 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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 EMPLOYERS COMP Policy Number FN33090901 _ 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 /1co ly withtftgse provisions. Date: Applicant: WARNING:* FAILURE TO SECURE WORKERS C OMPENSATIONCOVERAGE 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 i ' IMPORTANT Application is hereby made io 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 h reby authorize representatives of this county to enter upon the above-mentioned property for inspection purpo5 s. . Date: Signature (Applicant or Agent): ....Application Number 07-00000539' .'Permit . . ..: PLUMBING SEWER . : Additional desc_. Permit Fee 30.00- Plan Check- Fee .00 Issue Date Valuation .4500 Expiration Date 8/20/07 ' Qty Unite Charge Per Extension BASE 'FEE : 30.00 . -------------------------- -------------- Special Notes and Comments' ------------------. SEWER CONNECTION/SEPTIC ABANDONEMENT 11 Vii' Fee summary Charged Paid Credited Due --------- Per-mit Fee Total. 30.00 .00 ---------- .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 s , LQPERMIT Bin # City of La Quinta Building u Safety Division Permi 1 iD P.O. Box 1.5041 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:' - / .Owner's Name: CW A. P. Number: 9.& Aress: POLegal Description:eq I City, ST, Zip: 24 a Contractor:/ 4' Telephone: s: D C j Description: T, Zip: / 0 V one: 6 kArch.,.En9r.1 ic. # : d 3 O City Lic. #: 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: S Ft: . 4• #Stories: '#Units: Telephone # of Contact Person: __J Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE 9 Submittal Req'd Reed TRACWNG PERMiT FEES _ Plan Sets. Plan Check submitted Item Amount . Structural Calcs Reviewed, ready for corrections Plan Check Deposit Truss Calq. Called Contact Person Plan Check Balance Energy Cala Plans btcked_np Construction Flood plain plan Plans resubmitted Mechanical Grading. pliin 2'' Review, ready for eorrectionemue Electrical Subeontactor List:. Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for.corrections/issue Developer Impact Fee Planning Approval Called Contact Persop A.I.P.P. Pub. Wks. Appr Date oC permit issue School Fees 'ANAP `PLJIV/P`1IVG. Inc. Lic #C42 855 851 - 760 328-7887 • 1-800-334-7255 CUSTOMER'S ORDER NO. DATE ORDERED AMOUNT 1 40 ap 7 FAX 760 328-6607 TAK BY DAT OMIS b ❑ A P.O. Ba 2318 • Cathedral City, CA 92235 ! M. BI PIJONE ADDRESS IC CITY E JO •N E AND L A, N ❑ DAY WORK Camera/Power Snake D SC IPTION OF WORK ❑ CONTRACT ❑ EXTRA QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT Gallons Pumping Fee per 1000 gal. Camera/Power Snake Out of Area Fee Locating / Opening Fee (per hour) $.75/HR Size System: Fuel Charge< A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. TOTAL MATERIALS TOTAL LABOR WAIVER: Not responsible for secondary damage such as water damage, chipped concrete, mJark on street or driveways or trees. SIGNATURE I DATE COMPLETED I / \ TAX TOTAL ! U ;7- f"f COACHELLA VALLEY WATER'DISTRICT CASH RECEIPT DETAIL Received'Fro NG W165 _ V —Date:"` i I is 7 Address. f 77 Account No r Lots) Tract .Service Address , G.A. Code 0 Meter(s) 0 Service(s) 0 Backflow(s) 0 House Lateral(s) 0 Detector Check(s) 0 Meter Surcharge XSanitation Capacity Charge 0 W.S.B.FC. 0 S.I.W.S.C. 0 Temporary Construction Meter .0 Turn on Charge 0 Uncollected Account Nam -0 Inspection Fee - Tract - Fee 0 Plan Check Fees Water Sewer - Tract - O Bond Payment -A.D. - —Bond_ Assam 0 Customer Deposit 0 Other Remarks: U 4.- C00Y to: Cash Check Money Order fr eT ------------- C, WaterServic. ts'F Cashier CVWD -438(1/05)