15764 (PLBG)P.O. BOX 1504
Building 78-495 CALLE TAMPICO .
Address 51-630 Ave Ramirez LA OUINTA, CALIFORNIA 92253
Owner
Hicks
Mailing
Address 5T-630 Ave Ramirez
City Zip Tel.
La Qi Inta 922.53
Contractor Econo Sewer Service
Address
P.O. Hogs 192
City Zip Tel.:
.Palm�� 92261 346-2793
State Lic.City
fQ96a
& Classif. Lic. # 342
Arch., Engr.,
Designer
Address Tel.
City IZipI State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I a Vicensed,under provisions of Chapter 9 (commencing with Section
7000) of Division.3 of the essland Professions Code, and my license is in full force and
effect.
SIGNATURE
OW�ER BUILDER DECLARATION
I hereby affirm that,I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness arra Professions Code: Any city or county which requires a
- permit to construct, after, lmpr6vve, "demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed *statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or that. he 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).
❑ 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
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
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not Wild or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who Wilds or Improves thereon, and .who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certiflcaie,off co gent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified op thereof. (Sec. 3800, Labor Code.)
Policy No. Companyll
"`
O Copy is filed with the city. O Cieg;fv� y ishereby furnished.
CERTIFICATE OF EXEM ,TION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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: ff, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
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.
This is a building permit when properly filled out, signed and validated, and is subject to
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.
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.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST
Number
Legal Descri
No. 15754
OCC. GRP.
Description Sever Connection
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
- Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side :Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
SEP 11 1995
Sq. Ft.
Size -.
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$900.w
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
$30.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
X30. i43
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
- Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side :Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
SEP 11 1995
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES �
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER R
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH) METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (FINAL)
TEMP. POLE
WALL S0. FT.
DRINKING FOUNTAIN
SO. FT. ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3yac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER R
ROUGH WIRING
DUCT WORK
HEATING (FINAL)
ROCK STORAGE
OTHER APPJEQUIP.
FOUND. REINF.
GAS (ROUGH) METER LOOP
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
jf FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
f
. "}'
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COACHELLA VALLEY WATER DISTRICT
arm CASH RECEIPT DETAIL (►�
O84
f
v
Received From:
Date:
Account No. Lot( / . S%. , ' Tract
Service Address `J �� '�iL�•..•. G.A: Code
❑ Meter(s) t' a.r ,-1' `: 14t` U $
❑ Service(s) aye ?
"0 House Lateral (a)
❑ DetectorCheck(s)
❑ Meter Surcharge
❑t.Snitatlon•Capacity Charge
❑ W.S.B.F.C. f
❑ Temporary Construction Meter
is t �xs.; s _++ r: s • ^s s
�1. ❑ Turn on Charge -••
is°: ❑ Uncollected Account - Name
❑ Inspection Fee - Tract
Fee -''
❑ Plan Check Fees Water I Sewer a;
Tract - '. U
❑ Bond Payment - A.O. - Bond
Assmt.
❑ Customer Deposit
❑ Other
TOTAL $
Remarks:
❑Copy to: ti
Cash . , Water Service Y /
Check
Money r Cashier P
Order f; CVWD 438(11189)
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
Received From:
Address:
Account No.
Lot(s) Tract—
Service Address G.A. Code
• Meter(s)
• Service(s)
• Backflow(s)
• House Lateral(s)
• Detector Check(s)
• Meter Surcharge
• Sanitation Capacity Charge
• W.S.B.F.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
TOTAL
Remarks:
$ K.
D COPY to:
CAh Water Service
"'3
Check L
Money
Cashier
Oder CVWD-!438 (11189
P.02
—PAYMENT.-TEli MS-NET-,30.-DAYS..FROtu>-DATE-OF.SER.WCR _
1%% PER MONTH CHARGE AFTER 30 DAYS
---- - ---------
N^/
TOTAkm UPIALe
`.-_------•----_ V— TOT' L LA90R C /
---=�LEAS�-�'AY-•FRUM�HIS-iNVOiQ� — - —
NO STATEMENT YIff1 BE M�110E0 TAX
DATE GQldf`LC f/g l] Wt�r._K GrccRGD 6r`. - ,� '
TOTAIAMOUNT $ T
[] No one home (_j Total:.gr�ounI dU. ❑ To at billing Ip
5rynature —.� _ for abQv9 worx: or bo mailed after
PROOWS 7$$ i�lti:_�s , --completion
I rlcraby S,CV,AOwIaclgO the'asallaari0ry eompletlah
Crotan �a..1, 41171. of (he above da�rrlbe4 work. Of work
ECdN Di SEW�'7C SERVICES 7
o 0 D
O�G� DaD�G�
_
4`jr •�' �tY �4
--� P 0Box 192
�f
.
PALM DESERT, CALIFORNIA "•92261` y1'{ 3 r- �-1 :•
c 1
4 V 1.t_ 3:
PHONE •328=776:0: 345.2793
'-
> .. _.-
—PAYMENT.-TEli MS-NET-,30.-DAYS..FROtu>-DATE-OF.SER.WCR _
1%% PER MONTH CHARGE AFTER 30 DAYS
---- - ---------
N^/
TOTAkm UPIALe
`.-_------•----_ V— TOT' L LA90R C /
---=�LEAS�-�'AY-•FRUM�HIS-iNVOiQ� — - —
NO STATEMENT YIff1 BE M�110E0 TAX
DATE GQldf`LC f/g l] Wt�r._K GrccRGD 6r`. - ,� '
TOTAIAMOUNT $ T
[] No one home (_j Total:.gr�ounI dU. ❑ To at billing Ip
5rynature —.� _ for abQv9 worx: or bo mailed after
PROOWS 7$$ i�lti:_�s , --completion
I rlcraby S,CV,AOwIaclgO the'asallaari0ry eompletlah
Crotan �a..1, 41171. of (he above da�rrlbe4 work. Of work
�7A!TIE�R,
ESTABLISHED IN 1918 AS A PUBLIC AGENCY
DYSJT,131Gi��
COACHELLA VALLEY WATER DISTRICT
POST OFFICE BOX 1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (760) 398-2651 • FAX (760) 398-3711
DIRECTORS: OFFICERS:
JOHN W. McFADDEN, PRESIDENT
STEVEN B. ROBBINS,
PETER NELSON, VICE PRESIDENT
GENERAL MANAGER -CHIEF ENGINEER
TELLIS CODEKAS
JULIA FERNANDEZ, SECRETARY
RUSSELL KITAHARA
DAN PARKS, ASST. TO GENERAL MANAGER
PATRICIA A. LARSON
REDWINE AND SHERRILL, ATTORNEYS
November 7, 2003
File: 1112.
45
Doug Dietz
Post Office Box 10569
Palm Desert, California 92255
Dear Mr. Dietz:
Subject: Account No. 606014,178.0.1
51-630 Avenida Ramirez La Quinta
In response to your inquiry; -.:•this district does not have
available information.tegarding the completion of actual hook up
to our sanitation collection system for the above -referenced
property.
In researching our records, we found that the subject property
has met our sewer requirements. It is the homeowner's
responsibility to connect their pipeline to the sewer lateral.
If you have any questions please contact Rosie Anacleto,
Customer Service Representative, extension 2420.
Yours very truly,
Richard Shonerd
Customer Service Supervisor
RIA:ra
bc: City of La Quinta
Post Office Box 1504
La Quinta, California•92253
TRUE CONSERVATION
USE WATER WISELY