13-1135 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4'yl 4 4 0, g-mraj
Application Number: 13-00001135
Property Address: 51930 AVENIDA RAMIREZ -
APN: 773-171-009-16 -000000-
Application description: PLUMBING
Property Zo ' ning; COVE RESIDENTIAL
Application valuation: 2000
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SI.NGH.KAREN
25 ROCKY MOUNTAIN
COTO DE CAZA, CA 92679
Contractor:
EGGAN, RICK E*DWARD*
-73680 HIGHWAY �'STE
PALM DESERT, CA 92260
(.760.)404-6325
Li6. No.-: 9.50244
VOICE (760) 777-7012
F AX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/09/13
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h"NANClf DEOT.
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- 7
LICENSED CONT.RACTOR:S DECLARATION
WORKER'S CoiiPENSATION DECLARATION
I hereby ayirm.under penalty of perjury. that.l.am licensed under provisi6hs of Chapter 9 fcommencing with
. .
I hereby affirm under pena!ty of perjury one of the following declarations:
Section -7000) of Divi sion 3 of the Business a�d.Pr6fcTssiorals Code, and my License is in full force and effect.
I have and , will maintain a c6rtificatd-of consent to self -insure for.w6rkers' compen�ation, as provided
Lipe�se Class:' C42 LicenseNo.: 950244
for by Section 3700 of the Labor Code, for the performance of the work for�whicfi this permit,is
t
Da e� Co or:
niract
.issued.
I hive -and will maintain workers? com0insation insurance,.as' , re'quired by Section 3700 of the Labor
tode, for the perfornf6rice, of the work.for which this" p6rmit is iss6ed. my workers' compensation
. .
OWNEW-0691'60�1� DECLARATION
i6suranc arrier.an d p ollcy,number a . re:
e c
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's,State License Law for the
Carrier APPLIED:UNDERWR� k .. Policy Number 46-862298-01-01�-
following reason (Sec. 7031.5;_Busihess and Professions Code: Any city or cou , nty that requires a permit to
I certify*that, in the perforrharice of the work for which this permit is issued, I shall"hot employ any
construct, alter, impro - ve, demolish, or repair.a;y str ' 6cture, prior to its issu6nce, also requires the applicant ior the
persionin any'rpa�ne_r so as to become.subjeqt t . o the workers' compensation- law' s of - California,
'ensation
permit to,file a signed stpLternent that he oi.she is licensed pur"suant to the provisions of the Contractor's State
and agree th6t,,if I should become subject to the workiiiirs'.com P, provi'sion's of'Section
License LawliChapter, 9 (commencing with Section 7000) of Division 3'of the Businessand.Plr.ofessions Code) or
3700 of the Labor -C nhwith comply with those provisions.
that he or she is exempt 0
the(efr in and thii basis- fiirffielali�ged �xeniptiori. Any violation of;Section 7031,.5 by
any applicant f6r a permit subjects the applicant'to a'civil pe nalty of not more than five hundred dollars ($500).:
Date: Applicant:
1, 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 iSec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKER§�, COMPENS 10 IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner oi properiy who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANDCIVIL FINES UP TO ONE HUNDRED THOUSAND
and who* , does , the work himself or herself through his or her own employees, provided that the
DOLLARS($100,000). IN ADDITION TO.THE COST bF'COMiPENSATION, DAMA:GES AS PROvIDED FOR IN
improvempnis are not intended or offered for' sale. If, however, the-bulilding,6r improvement is sold.within
SECTION 3706 OF THE �ABOR CODE, INTEREST� AND ATTORNIEY'S FEES.
one year of completion, the'owner-builder will have the burden of proving the . t he or she did not build'or
improve Jor'the purp ose of sale.j.
APPLICANT ACKNOWLEDGEMENT
1, as. ownir of the . p!ope,�Y; arri exclusively contracting with lic ensed cont . ractors to construct the project ISec.'
IMPORTANT Appllciati6n is hereby made to the' biriector bf Building and, Safety for a permit . subject to the
7044','B usiness and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions.and restrictions. set forth.on this application.
prope�ty who builds or improves thereon, and who contracts projects with a contractor(s) licensed
I.. Each person upo6 whose behalf this application is made, each person at whose request, and for
.1for.the
pwsuant.t6ffie Contractors; State License Law.).
whose benefit work,.is performed under or.pursuant to any permit issued as�a result of this application,
I am exempt under Sec. B.&P.C. for,this reason
the owner, and the applicant, each agrees to, and shbil..defend, indemnify -and hold harm.leis the City
of La Quinta, its officers, agents and employees for any act -dr omission related to the work being
performed under or following issuance of this permic,
Date: Owner.
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 woik for 180 days will subject
CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to,comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state'laws relating to building .. construction, and hereby authorize representatives
f this county to enter upon the above-mentioned property for inspe I . n purposes.
Lender's Name:
X�o
Date: Signature (Applicii�t or Agent): v�
Lender's Address:
LQPER.MIT
LQPERMIT
Application Number . . . . . 13-00001135
Permit . . . . . . PLUMBING 2013
Additional desc
Permit'Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuatk6n
0
Expiration Date �3/08/14
Qty Unit Charge Per
Extension
1.00 11.9200 -EA PLBG BUILDING SEWER
m
11.92
---------------------------- --------------- 7 -------- 7 ----------------
Special Notes and'Comments
SEWER HOOK -:UP SEPTIC ABANDONMENT 2010
CODES.
- -------------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG'STDS ADMIN (SB1473)
1.00
PERM ISSUANC]t�
IT 4" W.P/
Fe�e summary,.. 'Charged Paid Credited..
Due
7 - --- - - - - - - --- - - - - - - - - - - - - - - -
Fee'Total�- 1 1,.-�9 2- 00
fl. 92
Plan Che�c`k Tot" al"i OJD �0 . 0
.00
9.1
,q,�H6 i"w'Fee: Total .001, .!0 0
91,57,
-,.Gtand Total-":' 103.�49.:. .00, A 0
-103.49
LQPERMIT
Bin #
C! of ..Qui,nta
40ding &r.,Sifety, Pivisio'n
P.O. BOX4504, �-8-495-,611eTjmpico-�'
b Oui�ta;i 'CA 92253 �7�40 12
7.
'liq an? �rackjn
3' f1d" - A 'r` M - �d T i g Sheet
ut mg., e it A�p tion
Permit #
Project Address:
A. P. Number,
Add�ei�,- 1,Lr,(pU10J—,4-71x3
Legal Description:
j
Contractor: 9�-
46i,400fie:
Address:
41 esciiption:
rojectlD
City, ST, Zip:
TeIepbQne:jK;0 96LI &g
State Lic. # : ?5-v Zq Lf 'CityLic.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
..... .. . . . . .... . . ... ..
-:,construction Type:. Occupancy:
. .
State Lic. #:
roj6ct: type (circl one):. New 'Add'n Alter Repair Demo
Name of Contact Person:
Sq.,Ft.:
# Stories:
#Units:
Telephone 4 of Contact Pe6n:
E stim�ted, value of �rqjpct:
"AFTL A14T: DO NOT WRITE�,BELOW THIS LINE ol 7-49rrp
S*ubmittal
'Req?d
Rei'
c'd.-
TRACMG
PERMIT FEES
Plan Sets
Plan Check submittid
Item..
Amount
Structural Cales.
Reviewcd'�cady for corrections
Plan Check Deposit
Truss Cales.
Called.Contact Person
Plan Check Balance.
Title 24 Cates.
Planspicked up
Construction
Flood plain plan
Plans'resubr;)itted
Mechanical
Grading plan
2"Rcvie*,iciay.fo�'correctionsrissue
Electrical
Subcontact6r List
Called Cok�ct Persoh
Plumbing
Grant Deed
Plan41ckco up.
S.M.1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
R�yicv�, , -ready for corrictions/issue
*Developer Impact Fee
Planning Approval
Called Contact Perso n
A.I.P.P.
Pub. Wks. Appr
'Date of permiiissue
School Fees
Total Permit Fees
4.
L
COACHELLA.VALLEY WATER. -DISTRICT
P.m. ;Box 1,058, COACHELLA, CAL-IFORNIA.'e.92236 (7.60 398-2651
-INVO-IdE' "Date: 915/2013
SUBJECT: SANTA CARMELITA.'51930 AVENIDA kAMIREZ,lLAQUINTA, LID 1. 682368,."SCC.FEE ONLY"
KARAN SINGH Pimect 13-4835
25 ROCKY -MOUNTAIN .0i . io&-lome.
9/5/2013
'Aifiount.Dtie: - $4,851.0.0
TRABUCO CANYON.' CA 92679 QE0::f. 06-06-01-4
Pipmer. SANDRA VILLALOBOS
SUBJECT: SANTA CARMELITA, 6i9A0'AVENIDA RAMIF�EZ,; LA QU'NITA, YD 682368, -SCC FEE ONLY-
COACHELLA VALLEYVATER DISTRICT
P.O. Box 1058, COACHELLA, CALIOdkkrA'02216'.(760),398�26Sl
$2,415.00
$2,436.00
$4,851.00
Page I