PLBG (06-1015)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
1 �v Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
06-00001015
51551 AVENIDA MENDOZA
773-142-016-4 -000000-
PLUMBING
COVE RESIDENTIAL
2000
Tu!t44Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
------------------- ------------------------------
u SED CONTRACTOR'S DE RATION
I hereby of rm under penalty of perjury the am license under provisis of Chapter 9 commencing with
Section 70 01 Division 3 of the Bus' an Profes e, an y Lic s in full force and effect.
License CI ss36 ice e N 94
Date: '311-A& Contractor:
I I 1 4 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 ($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.).
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 dues nut 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:
PROCKNOW CLETUS
51551 AVENID)
LA QUINTA, C1
Contractor:
SCOTT COMPAN7
P.O. BOX 214E
INDIO, CA 92<
(760)779-593E
Lic. No.: 585
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/13/06
-----------------------------------------------
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' c mpensation insurance, as required by Section 3700 of the Labor
Code, for the performance of t e work for which this permit is issued. My workers' compensation
insurance carrier and policy n bar are:
Carrier EXEMPT Policy miser EXEMPT
_ I certify that, in the performa of the w k for whi fiis per t s issued, I shall ploy any
laerson in any manner s become ub' o the work s' c aws of California,
nd agree that, if I s I b come to t orker compensation provisions of Section
(D
W7!F of the Labor ith cc y ose provisions.
U
Date: Applicant:
WARNING: F LURE TO SECURE WO '
RKE 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.
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 t any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and II defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees fo ny act or omission related to the work being
performed under or following issuance of this per i .
2. Any permit issued as a result of this application comes null and void if work is not commenced
within 180 days from date of issuance of such crmit, or ce sation of work for 180 days will subject
permit to cancellation.
I certif that have read this application and state the a ve inform ion is correct. gree comply with all
city an cou y ordinances and state laws relating nstru d by thorize representatives
of this ount touter upon the above-mentioned property r i n purp
Date: 1; ;. Signature (Applicant or Agent):
Application Number . . . . . 06-00001015
Permit . . . PLUMBING SEWER
Additional desc .
Permit Fee . . . . 30.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2000
-"` Expiration Date 9/09/06
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
CO
.00
Grand Total 30.00
.00
.00
30.00
LQPERMIT
Bin #
City of La Quinta
Building & Safety Division
Permit # P.O. B,
ox. 78-495 Calle Tampico
La Quinta, CA 922.53 -.(760) 777-.7012
Building Permit Application and Tracking ShPPt
Project Address: 5-1 —d-
A. P. Number:
Legal Description:
Contractor:S' o
oo
Address:
City, ST, Zip:
Telephone:
State Lit. #
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone #. of Contact Person:
# Submittal Re,
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading.plan'
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
I
77— C-0
APPLICANT: DO I
Recd
Plan Check subs
Reviewed, ready
Called Contact I
Plans, picked up
Plans resubmitte
2nd Review, read
Called Contact I
Plans picked up
Plans resubmitte
hd Review, ready
Called Contact P
Date of permit is,
>
Owner's Name: &enrs-
Address: � / j- �i' 7VI /%%/t/ 117,—
ST,Zip:Lphone:
f%7 `' ' ?3 i O
Project Description: ✓'/iV',—,-,—
mConstruction Type: Occupancy:
6 i� Project type (circle one): New Add'n Alter 'Repair Demo
Sq. Ft.: # Stories: 1. #Units:
Estimated Value of Project: 00 coo
JOT WRITE BELOW THIS UNE
TRACiQNG . PERMIT FEES
fitted Item Amount
for corrections Plan Check Deposit
erson . Plan Check Balance
Construction
I
Mechanical
for correctioWissae
Electrical
erson
Plumbing
S.M.I.
I
Grading
for corrections/issue
Developer Impact Fee
arson
A.I.P.P.
ue
Total Permit Fees
i,
VALLEY WATER DISTRICT CASH RECEIPT DETAIL N2. 112185
Received Fro X
Address: ►
Account No. Lots)
Service Address
❑ Meter(s)
❑ Service(s)
i racy
G.A. Code
❑ Backflow(s)
❑ House Lateral(s)
❑ Detector Check(s)
❑ Meter Surcharge
ASanitation Capacity Charge SS
3s�!• Oy
❑ 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
''11
TOTAL 3S1 �• D o
$
Remarks:
00,
Copy to:
Cash
Water Servi
Check u/^
Money O v lV
J
��
Order
J
Cashier
CvwDa3e f1105>
CLETUS PROCKNOW 10-84 MC,
MARCIA PROCKNOW
Pb BOX 1363, 1 Z_1 •....
is L 2 2000 24?1: 0 2 &905558911' L0486
10486
EC Sewer Service, Inc.
clba ECONO SEWER•SERVICE.
P.O. Bog 581029, North Palm Springs, CA. 92258
(760) 346-2793 (760)'328-7760
Tax (760) 251-3405
JOB TICKET
IWAIMi i
SERVICE -O -PUMP SEPTIC TANK HAS SEPTIC TANK BEEN DUG UP9 ❑ Yes ❑ No _;WpMT. ON SrIE
REQUESTED ❑ PUMP SEEPAGE PTI AT ITS RISER ❑ OFFICE BILLING
❑ PUMP GREASE TRAP Yellow Oust:
❑ OTHER 8 Yellow Office
Pumping Fee per 1000 Gallons (or fraction)
Waste Discharge Fee per 1000 Gallons
Locating and Opening Fee (lhr. Min.)
1O,ut o�,4rt a Fee C P
r
GREASE TRAPS
RECOMMEND INLETIOUTLETBAFFLE REPADL
EXCESSIVE'GREASEIFOODIDEB S.
EXCESSIVEODOR. A - �4 t - �
RECOMMEND MOREJFREQUENT P ING.
RECOMMEND LINE CLEANING.
SEPTIC SYSTEMS � \ �\
❑ THE LEACEIIIIO S1fSTEM E[AS FAILED. 0
❑ THERE IS AN OBSTRUCTION "UPSTREAM" OFITIM S \TA�1K
It witl be neasiwy to co n I'i cl�e\ening �'mpany. (+ \\
❑ WE RECOMMEND MAMTEF ANCE FUI kP.ING OF THE SEPTI TANK EVERY tea``
❑ YEAR ❑ OTTER YEAR\ ❑\ 2-3 YEARS �,
To remove built uP solids. This will int\ se the life of yo`ur leuhing system.
❑ THIS PUMPING WILL PROVIDE ONLY TEMPORARY�`1�E S 'NOT
SOLVE CUSTOMERS SEPTIC PROBLEM BECAUSE OF THE ABOVE.
❑ CUSTOMER HAS BEEN GIVEN AN "EXPLAINATION' PACKET.
A SERVICE CHARGE OF: $22 WILL BE DUE
ON ALL RETRUNED CHECKS.
A FINANCE CHARGE OF 1112% PER MONTH, 18 % PER YEAR, WILL BE
CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS.
IN PAYMENT IS BY CHECK
DRIVERS LIG N STATE
I hereby aeknowiedge the satisfactory, eompletlon of the above described work:
SIGNATURE s Toter n
�')nw />A Al' .. l/ n.l4r�t-x�- . ` -10-0E' Due 6 U