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PLBG (04-6377)51680 Avenida Martinez 04-6377 BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . 0004006-377 Date 9/21/04 Property Address . . . . . . 51680 AVENIDA MARTINEZ APN: 773-142-009-16 -00.0-0-070- Application description . . . PLUMBING Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . . . 2500 Owner Contractor. ------------------------ CLARK LAURENCE R w i ' ALMS UNDERGROUND CONST, .INC. *NOT ON FILE 38703 VISTA DRIVE UNKNOWN CA 99999 CATHEDRAL CITY CA 92234 WCC: VIRGINIA INC WC: 00500016007 01/01/05 CSLB: 482180 11/30/05 CCC: C42 -C21 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING SEWER Additional desc Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2500 Qty Unit Charge Per Extension. BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments % SEPTIC ABANDON; SEWER CONNECT Fee summary Charged' Paid Credited Due ----------------- ---------= -- - -- --------------- Permit --------Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 P.O. BOC 1504 • VOICE (760) 777-7012 7A QU CALLS T CALIFORNIAMPICOFAX (760) 777-7011 LA QUINTA, IFORNI92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: o4-(63-77 Date: q' a I- p 4J Applicant: I Architect or Engineer: Applicanrs Mailing Address: tf . Architect or Engineer's Address: Lic. No.: t3UILUINU PERMIT DECLARATIONS 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) n full force and effect. ,r / License Class C cense No. Iif 7 Date / !bntractor--Sf % % lOD1 &A(%ojaD G OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perl'ury 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 is ed. My w rkers' ompensation ins ce carrier and olicy number e: Carrier olicy Number -69 n AP, 2 _ I certif that, m t e performance of the work for which this permits issued, s–hall not em oy 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. Date 1-4 Ppkant ! WARNING: 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 ($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. 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 APPLICANT IMPORTANT Application is hereby made to the Director of Buildingand Safety fo aACKNOWLEDGEMENT the ur 1. Each person upon whose behalf this application is made. each person at permit e fe o request and for whose benefit work isperformedunder 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 employeesfor 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 this county to enter upon the above-mentioned property for inspection purposes. _ ., • Signature (Applicant or Agent): /` n e [ Fu / 1 O / ELI CROSS SECTION - SEWER LATERAL NOTES, 1.- THE CLEANOUT SHALL BE THE SAME SIZE AS THE EXISTING SEWER LATERAL. 2.- IF REQUIRED BY THE CITY OF DESERT HOT SPRINGS, A BACKWATER VALVE SHALL BE PROVIDED BY THE OWNER AS SPECIFIED IN THE UNIFORM PLUMBING CODE WHERE THE DRAINAGE PIPING SERVING THE FIXTURES IS LOCATED BELOW THE ELEVATION OF THE TOP OF THE CLEANOUT AT THE PROPERTY LINE. THE BACKWATER VALVE SHALL BE A 'JOSAM - 1100' OR A ' ZURN 1090', OR APPROVED EQUAL. 3.- THE BACKWATER VALVE, IF REQUIRED, SHALL BE ENCLOSED IN A BROOKS 24' x 36' - 100 SERIES VALVE BOX WITH COVER ', OR APPROVED EQUALi OR IN AN 18' CONCRETE PIPE; WITH COVER. 4, SEWER LATERAL SHALL BE AT A 2% MINIMUN SLOPE UNLESS OTHERWISE APPROVED. SEWER LATERAL ON neral Manager - Drawn, MKWZ Date,09-01-03 PRIVATE PROPERTY DRAWING No. MISSION SPRINGS S-9 WATER DISTRICT SEP -21-2„004 09:56 AM LARRY-1-KAREN—CLARK COACHEL.L.A VALLEY WATER DISTRICT ' :'ert:urcharpe y_;r. • ea,-atr x;CapacltyCha►ae - . -11Y Construction Meter :ed Account - Name_ ,n Fee - Tract - Fee - — .c Fees Water ! Sewer - Tract - ent -A.D. -_ Bortd_ A Asemt. :r roposlt "do flll"drsvlw 760 564 2713 N° 95744 Trac G.A. Code ----- a 10 -RL a. . _ / —30l P. 02 Waterservice LI( J Cash)er CVW(r-436 (11 fall) I'.. ' R; N 1. CLARK ' `Z L T t1 4786: _ -.i 1 1—NCE R. CLARK 2713 AVENIDA MARTINEZ r -72)o,_ _. :A, C1 92253 ---------------------------- S FARGO BANK, N.A. VALUED CUSTOMER SINCE 1986 Iivw -SFARGO.COIA +. _ A- ' _,.tpo. ' ► ' "300 2474034-449 2 780o, 4786 w.,. Wwwpm. kHYVf1rF1)YfApC1I6W SEP -21-2004 TUE O9:a0AM ID: PAGE:2 HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 earn '29Zn _ 7dda (760) 321- 7448 CUSTOMER'S ORDER NO. DATE ORDERED ot - Z;L - t ORDER TAKEN BY DATE PROMISED 0 A.M. ❑ P.M. BILL TO r PHONE ADDRESS ME@t1ANIC ty CITY HELPER JOB NAME AND LOCATION r / / } LI UAY WORK DESCRIPTION OF WORK 1 7 '-L ❑ CONTRACT [I EXTRA C / _ I QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT 1006) Gallons Pumping Fee per 1000 gal.Com' c,r s GO Dumping Fee per 1000 gal. C, Out of Area Fee Locating / Opening Fee (per hour) Size System: 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. HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS Q HELPERS Q TOTAL LABOR I hereby ackn wledBe the s `tisfactory TOTAL LABOR completion f f e'atiove d Scribed work: TAX SIGNfCTU RE \v" IF A y DATE COMPLETED C, Z U `_, TOTAL