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07-0689 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T,iht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: i . 07-00000689 3 Property Address: 53620 AVENIDA RUBIO APN: 774-113-005-20 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 3000 Applicant: _ ' t J Architect or Engineer: a1Jor ------------------------------ - ------------------- 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 Busines and Professionals Code, and my License is in full force and effect. License Class: C36 Lice 803145 Contractor: jr WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 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: dq Lender's Address: tx I,QPERDIIT Owner: ELIDIA MENDOZA 53620 AVENIDA MENDOZA LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/06/07 Contractor: DESERT EMPIRE PLUMBINrDRAINP.O. BOX 1836cCATHEDRAL CITY, CA 92O 6 n2007 (760)328-6417 Lic. No.: 803145 CITY OF LA QUINTA --------------------------------------------- -- 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' 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 ENDURANCE WC Policy Number WEN0004170-01 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 orkers' compensation provisions of Section 3700 of the Labor Code shall fo with com 'th those provisions. an WARNING: FAILUEE TURE WORK S' COMPEN ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL E LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO HE 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 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 const r ction, and hereby authorize representatives of this/co///unnn222y to enter upon the above-mentioned prope for insp tion purpo .0, D nature (Applicant or Agent): LQPERMIT - ' Application Number 07-00000689 Permit PLUMBING SEWER Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 3000 Expiration Date 9/02/07 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 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT - ' 1 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL ` , N2* 118451 .7 Received From:+ V A `-') A rt 7 t Date: �� D Address: J" �' �"C%1 �� `ter G �_ l l i i; L. Account No. Lots) Tract Service Address ' f' •'�"-� G `� ``^ �� G.A. Code ❑ Meter(s) $ ❑ Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ Detector Cheek(s) ❑ Meter Surcharge . _ anitation Capacity'Charge 5 S ❑ 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 j ❑ Customer Deposit ❑ Other TOTAL Remarks: 0 1 Water Service Cashier CVWD-438 (IM) Bin # City Of La Quinta" Building U, Safety Division Permit #„(a P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:' _ Owner's Name: r A. P. Number. Legal Description: Address:6 i Contractor. !K City, ST, Zip: ' nfU�I� 11 "3 (�lvzl(j Telephone: Address: Project Description: City, ST, Zip: Telephone:7 State Lie. #,: ko,/ City Lic. if Arch., Engr., Designer. ' Address: City, ST, Zip: Telephone: . State Lic. #: Construction Type: Occupancy: Name of Contact Person: type(circle one): New ' Ads! n Alter Repair �O Telephone # of Contact Person: Sq. Ft.:.' # Stories: :# Units: 30'00 Estimated Value of Project 3 0 Q Q APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACIMG Plan Sets PERMIT FEES Plan Check submitted Structural Cala. Item Reviewed, rcridy for corrections Amonnt . Truss Cala. Pon Chyek Deposit Called Contact Person Energy Cala. Plan Check Balance Plans Picked up Flood plain plan Construction Plans resubmitted ' Grading. plan' Mechanical 2-' Review, ready for eorreetions/issae Subcootactor List . Electrical Called Contact Person Grant Deed Plumbing . Plans picked up ILO.A. Approval S.M.L Plans resubmitted IN HOUSE:.:''' Grading Review, ready for.correctioWlssae Planning Approval Developer Impact Fee Called .Contact Person Pub. Wks. Appr A.LP.P.- .Date of permit issue School Fees Total Permit Fees