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PLBG (05-3608)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 05 00003600 51617 AVENIDA ME 773-142-019-7 PLUMBING COVE RESIDENTIAL 2500 ,,,--9rchitect or Engineer: A� 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. LicenseClass: C36 -C42 -B LicenseNo.: 793482 ,,,-Caw l5nra 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, as owner of the property, or my employees withwages as their sale 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, 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 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 40" Y DEPARTMENT PERMIT Owner: CHRISTE MAGANA 51617 AVENIDA MENDOZA LA QUINTA, CA 92253 Contractor:* SO CAL PLUMBING & REPIPE CO P.O. BOX 955 YUCCA VALLEY, CA 92286 (760)369-4104 Lic. No.: 793482 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/12/05 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' compens�tion 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 EKEMPT 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 subiect to th&workers' compensation grovisions of Section 3700 of the La�q� C ose p��v�ons. ��ro—rfFwsth 1 -ale— id WARNING: FAILURE TO SECURE WORKERS'COM NSATION 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 unde r 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 su biect permit to cancellation I certify that I have read this application and state that the above information is correct. I ag�ee to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this_county to enter =up above-mentioned property .1 for ins Applicant or Application Number . .. . . . 05-00003608 Permit . . . . . . PLUMBING SEWER Additional desc . . Permit Fee . . . . 30.00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 2500 Expiration Date 2/08/06 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and.Comments SEPTIC ABANDON; SEWER CONNECT Fee summary. Charged Paid Credited Due ----------------- Permit Fee Total ---------- ---------- 30.00 ---- 7 ----- .00 ----------- .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT Bin # Permit # Project Address: 15 A. P. Number: X Submittal Rtq'd Plan Sets Structural Caics. Truss Caics. Energy CalM Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. A School Fees CRY of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet D 0%%-ncr*sName: VN ns,4-e TAiddrff,s,s: C n. S Cin'. ST. Zip: keicphonc� 031 - 'q --7) 9 __T_ T Project Description: 1_9A City Lic. #: Construction Type: Occupancy: 'FSProject type (circle one): Ne- 'Add'n Altcr Repair Demo ories: Sq. Ft.: # St - T CA -Y -5f Y Contractor: Address: City, ST,.Zip': TRACKING Telephone:. A State Lic. $1 _3 -V8 Arch., Engr., Designer: Address: City. ST. Zip: Telephone: State Lic. #: Name of Contact Person X Telephone # of Contact Person. - X Submittal Rtq'd Plan Sets Structural Caics. Truss Caics. Energy CalM Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. A School Fees CRY of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet D 0%%-ncr*sName: VN ns,4-e TAiddrff,s,s: C n. S Cin'. ST. Zip: keicphonc� 031 - 'q --7) 9 __T_ T Project Description: 1_9A City Lic. #: Construction Type: Occupancy: 'FSProject type (circle one): Ne- 'Add'n Altcr Repair Demo ories: Sq. Ft.: # St - T CA -Y -5f Y r -Estimated Val ue of.Proiect: APPLICANT: DO NOT WRITE BELOW THIS LIN Rec'd TRACKING PERMIT FEES Plan Check submitted Item Amount Reviewed. ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans Oicked up Construction Plans resubmitted Mechanical 2" Review. ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up SAI.I. Plans resubmitted Grading ' Review. ready for correctionslissue Developer Impact Fee Called Contact Person A.I.P.P. Date of permit issue Total Permit Fees Aw"Sm A w Pw I __1 PLIMPING Lic #C42 855 851 I W -goof FAX 760 328-6607 P.O. Box Cathedral City, CA 92235 8) ER'S ORDER NO. DAI�VD E -;� 19KI, N BY DATE PROMISED 0 A.M. 0 P.M.. BILLTO PHONE ADDRESS MECAP 7 CITY L ?7��r HELPER JOB NAME AND LOdATION .00- ��e 0 DAY WORK DESCRIPTION OF WORK gs of 0 CONTRACT 0 EXTRA //,T QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT Gallons Pumping Fee per 1000 gal. Dumping Fee per 1000 gal. Out of Area Fee Locating / Opening Fee (per ho _,� �510_� Size System: ,00 IAVI_�IdOf �61� A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. TOTAL 18% PER YEAR WILL BE CHARGED ON PAST DUE MATERIALS ACCOUNTS OVER 30 DAYS. TOTAL AIVER.Notre onsible for secondary damage such as water LABOR s ,c 1P co c , m et or driveway ped n reti, ys or trees. TAX SI 'DATE COMPLETED TOTAL COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL N2 Received From: —C� S �j *4 Address: five 10836.1 Account No. V Q./. Loys) Tract V_le,. nj %0 L4 40 G.A. Code 0 Meter(s) $ 0 Service(s) 0 Backflow(s) 0 House Lateral(s) 0 Detector Check(s) 0 Meter Surcharge Cleanitation Capacity Charge L5:5— • W.S.B.FC. • S.I.W.S.C. • Temporary Construction Meter 0 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 0 Customer Deposit 0 Other TOTAL Remarks: 0 Copy to: Cash Check Money Order Water Service 00 Cashier CVWD-438 (1/05) FZ 7i 0''Fl6i R O -F,- -�'R zkg Al Va -i figtoit M liftiW 6 "hingt. —4 1; —Fr.. A— e, f, I'll. Oe 9.c -.�4 A Lake Worth. FL Ousw=r SerAm 77 - MEMO bA� NP -A: 3 2 2 2 ? LE� 2 ?i".L.'40 ?008 3 2,? Ile: 100 -Al- 4 945 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 51-617 Mendoza LA QUINTA, CALIFORNIA 92253 Owner Mailing Charles areidin BUILDING: T I YPE CONST.—OCC. GR ' P. Address Same A.P. Number, 773-142-0"J1 City Zip ITO. La Quinta 9,22-53 Legal Description Contractor Project Description Room addition John Harrison Construction Address 2bb R. El Cielo* Suite 676 City Zip Tel. Palm Springal 92263 320-4412 State Lic. City & Classif. 475070 Lic. # 1076 Sq. Ft. 264 No. No. Dw. Arch., Engr., Size Stories Unit s Designer New 0 Add 0 Alter 0 Repair 0 Demolition 0 Address Tel. City Zip State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes�ions COC19, and my license is in full force and effect. 7�- �11_ SIGNATURE .1 DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation $12081.60 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 PERMIT AMOUNT 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 basis Plan Chk. Dep. for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civilpenally ofnotmore than five hundreddollars ($500). 0 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 0 UZ 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 Const. 0 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 Mech. luouu or improvement is sold within one year of completion, the owner -builder will have the burden Electrical of proVing that he did not build or improve for the purpose of sale.) 0 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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 S. M. 1. such proje - cts with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 0 1 am exempt under Sec.—B. & P.C. for this reason Driveway Eric. Date Owner Inf rastructure 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 0 Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) Valuation 64.'� A rk-A, -Ub� _,A or less.) I certify that in the performance of thp 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: N, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center Line —Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Nam Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE /---iN—,,PFr.Tn-R expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: Permit 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. Validated by: Signature of applicant Date Mailing Addres Validation: City, State, Zip WHITE m FINANCE, PINK -.A PLICANT, GREEN 0.7,A6596SCIR'S OFFICE, HARID,COPY'- FILE CONS TRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT (a UNITS L-A ok�13GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. Qt UFORMS 2 SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. a GAS(ROUGH) METER LOOP GAR SO. FT. Cl POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. 6 GROUT WATER HEATER WALL So. FT. rd FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. a $ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH E R(AUTOY DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 SO. FT. @ c I WATER HEATER MAX. HEATER OUTPUT, B.7.U. SO. FT. RESID a 1 'A c SEWAGE DISPOSAL SO.FT.GAR (& JVc HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL I TOTAL FEES MICRO FEE . —7�EE PL.CK.FEE T NST.,FEE —1 ELECT.FEE SMIFEE T LUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK To//"GROUND PLUMBING 5;� JI-- UN DERGROUND A.C. UNIT COLL. AREA L-A ok�13GRADE ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK UFORMS 2 SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS(ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu.yd. $ _plus_x$ $ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING if / V/ MENTILATION 7 REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR" GAR. FIREWALL F LATHING MESH INSULATIONISOUND FINISH GRADING JVFINAL INSPECTION� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATUREWINITIALS GARDEN WALL FINAL DESERT SANDS UNIFIED SCHOOL DISTRICT 82-879 Highway 111 Indio, CA .92201 CERTIFICATE OF SCHOOL FACILITY FEE WAIVER V 'NT CANNOT NOTI.M. THUS o0C ME BE DUPLICA D. TO: DATE: V This -is to certify that developer of w h i c h i s L I ocated at /:z within this school dis trict', is not requirc4 to'pay school facility fees pursuant to the authority generated by Government Code Section"53080. Building permits for the - p - roject indicated above may now be issued by your j y Q�dj �­F ___ _� �___ -ct-i,on,.--fjF VALU,�TION INDICATED ON BUILDING PERMIT EXCEEDS $20,000 THIS WAIVER IS VOID AND A SCHOOL FACILIT ST—BE—PAID PRIOR TO ISSUANCE OF BUILDING PERMIT.__r__ IES_FEE—ML for DESERT SANDS UNIFIED SCHOOL DISTRICT White -Building Department Yellow-Facili6es Planning Pink -Developer (10)-38