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PLBG (10-0694)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4ht 4 4 Quum Application Number: _ 10-00000694., Property Address: _- 53661 AVENIDA MENDOZA APN: 774-132-019-8 -000000- Application description: PLUMBING Property Zoning: I COVE RESIDENTIAL, Application valuation: 280.0 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: ---------- JBusine's ------------------------- S CONTRACTOR'S DECLARATIONhereby affirm {rider penaly of icensed un er provisions of Chapter 9 (commencing with Section 7p00) of Division'3 of tProfession 7 e, and my License is in full force and effect. License Blass: 142 f Licen No.: 661018 Dater ntr OWNER -BUILDER DECLARATION I hereby affirm under pe 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.). - ( 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 contractors) licensed pursuant to the Contractors' State License Law.). ' I 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: - I % '-- LQPERMIT VOICE (760) 777770.12 FAX (760).777-7011 INSPECTIONS (760) 777-7153 Owner: REYES DONALD J 53-661 AVENIDA MENDOZA LA QUINTA, CA 92253 Contractor: HAMMER PUMPI D C ll �f110 P O BOX 2448 CATHEDRAL CIT 92235' (760) 360-7448 0F1AQU*'TA Lic. IJo.: 6610 8 LS� %IAXCEOFTT� WORKER'S COMPENSATION DECLARATION - Date: 7/28/10 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. Y 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 SELF - INSURED Policy Number 2246 I certify th the performa�nof thewirk for which this 'sued, I shall not employ any- perso in any manner so beco�9 subject to th oikers' compensation laws of California, /andfa�gree that, if I shoulme sLbjea to the wor 'compensation provisions of Section 37p0 of the Labor Cqde, I all fdrthwith comply with thos 'sio0; WARNING: 61A 1.1 TO SECURE 0 KR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO MINAL 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 EES: 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 'it 2. Any permit issued as a result of thisokation become null and void;if ark is not co enced within 180 days from date of issu5nce of such permi2/ulcl, cessation if wo for 180 day will subject permit to cancellation. I certify that I have read this application and state that the above iatio s correct. Iith all city and c'unty rdinances and state lawsrelating to building conio , and hereby authorize resentatives of this my t enter upon -the above-mentioned property�f s act*.. purposes. ate 2U to Si ure (Applicant or Agent) LQPERMIT Application Number 10-00000694 Permit . ... PLUMBING SEWER Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00' Issue Date . . . Valuation 2800 Expiration Date 1/24/11 Qty Unit Charge Per Extension BASE FEE 30.00 ----------------------------------------------------------------------------- Special Notes and Comments SEPTIC ABANDON, SEWER CONNECT. 2007 CODES -.----------------_-_----------------------- Other Fees . . ... - . . . BLDG STDS ADMIN (SB1473) 1.00 Fee_ summary Charged Paid Credited Due Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 00 1.00 . Grand Total 31.00 .00 .00 31.00 LQPERMIT JdATlrS, COACHELLA VALLEY -WATER DISTRICT X01 Tilt P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398=2651 -• INVOICE Date: 6123/2010 SUBJECT: 53601 AVENIDA MENDOZA, LA QUINTA CYNTHIA REYES Project: 10-2381 4217 CONTE DR' Project Date: 6/23/2010 CARSON CITY, NV 89701 Amount Due: $3,995.00GEO• 06 -06 -12 - Planner: REBECCA MILWARD , TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 1.00 SCC -COLLECTION $1,658.00 $1,658.00 1.00 SCC -TREATMENT $2,337.00 $2,337.00 $3,995.00 PAID JUN 2 9 2010 COACHELLA VALLEY WATER DISTRICT SUBJECT: 53661 AVENIDA MENDOZA. LA OUINTA COACHELLA VALLEY WATER DISTRICT P.O. Box 1058, COACHELLA. CALIFORNIA 9223$ (760) 398-2651 Page 1 K; www.hammerpumping.com 760/360-7448 760/321-7448 FAX 760/324-6434 Customer Name Address ` City Additional Service-Required❑Recommended ❑ Description/ Remarks/ Drawings P.O. 60X,2448 - Cathedral City, CA 92235-2448 - LIC# 661018 JOB INVOICE JOB DATE: t I IN: I TIME OUT. - TECHNICIAN fit! TECHNICIAN 02 HELPERISI 2- BY: " JOB LOCATION SERVICE BACK UP ❑ CONTRACT MAINTENANCE REPAIR MAINTENANCE ESTIMATE �T CONSTRUCTION y,. OTHER a PAID BY: :redit Card -- MC t VESA # EXP.DATE I hereby authorize Hammer Pumping, Inc. to charge my credit card for the above charges. I understand that by signing below I am agreeing to all charges incurred on this ticket and that the work was completed to my satisfaction. P.O. N START DATE: COMME ❑ Leach System Failing ❑ Roots ❑ Excessive sludge/grease SERVICES COMPLETED Bin # Permit # a 10 t Project Address: 3 4o(o City of La Quinta Building &' Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet ME Owner's Name: �^ �S A. P. Number: Address: Legal Descriptiop: i Contractor: 4 Lu /`.Sc Address: ?0b� 2 A- Q– 'r City, ST, Zip: rx$` ?,: •.•': Telephone: 17A-ASZZ 3633— Project Description:(— City, ST, Zip: Telephone: RSO �� I U :^>•vc.iy;� ; ,'%::; City Lic. #, State Lic. # : Arch., Engr., Designer: Address: City., ST, Zip: Telephone:k.::` Construction Type: Occupancy: State Lic. #:; Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: i Sq. Ft.: # S es: #Units: Telephone # of Contact Pei -son: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amoant Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Tide 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2° Review, ready for corrections/issue Electrical Subcontactor List i Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans,resubmitted Grading IN HOUSE:- '.'� Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. A r PP Date of permit issue School Fees i J Total Permit Fees