05-4337 (PLBG)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.-00004337,
52150 AVENIDA RAMIREZ
773-222-008-15 -000000-
PLUMBING
COVE RESIDENTIAL
.32.001
c&ht 4 4 a"
Architect or Engineer:
0 ( AA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
�i 7- 1
_,_ .
SEP 2 2005
CITY UP,cc SEP!• -
'LICENSED CONTRACTOR'S DECLARATION' hereby: affirm, under. penalty of- perjury the.t I am licensed -under provisions.of'Chapter 9`Icommencing with
Section 7000) of Division 3 of_ the Business and Professionals Code,' "antl my License is in full force and effect.
License Class:., C21 C42 License No.: 482180
1 hn CwY� t
ate (^�` Contractor��:
OWNER-BUILDERDECLARATION
I; hereby affirm under penalty of. perjury that {am exempt from the Contractor's State License Law for the
following reason. (sec. 7031.5, Business,iand Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish; orrepair-any structure, prior to its issuance;.also requires the applicant for the
_permit to file a.signed statement that he or sheds licensed pursuant to the provisions of the Contractor's.State -
License'Law (Chapter 9 (commencing with Section 7000) of Division 3 o 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).:
-
I_), 1, as.ownerbf the property,. or my employees with wages as their sole compensation, will do the work, and
. the structure is_ hot'imended 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'herowW.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.): -. a'F'
(_) 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 dos 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.).
( 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: J�
LQP6RMfT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/27/05
Owner:
LA QUINTA PALMS REAL ESTATE CO
.51-001 EISENHOWER DRIVE
LA QUINTA, CA 92253
Contractor:
ALMS UNDERGROUND'CONST, INC:
38703�,VISTA DRIVE
CATHEDRAL CITY, CA 92234
(760)324.-1911.-
t
iC. No.: 48180
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjurypne of the following declarations:.
I have and will maintain'dcertificate of consent to self -insure for•workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance aCthe work for which, this permit is
issued.- :- --„
:ll� 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
An;
surance carrier;andpolicy numberare:
Carrier CALIFORNIA INS Policy Number 460093580101
_ I certify that, in the performance of the work forwhichthis permit is issued, I shall,not employ any
person in any manner so as to become subject to the :workersScoinpensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of,the Labor Code, I shall forthwith comply with those provisions.
ate: — —
0. pplicam::ZY]
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGE IS UNLAWFUL, AND SHALL
SUBJECTAN 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 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 LaQuinta, 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 construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
/e: nature (Applicant or Agent):__T=k1- /' e d W y/,
Application Number . . . . . 05-00004337
Permit . . . PLUMBING SEWER
Additional desc . .
Permit Fee . . . . 30.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 3200
Expiration Date 3/26/06
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
----------
.00
----------
.00
30.00
Plan Check Total .00
.00
.00
.00
Grand Total 30.00
.00
.00
30.00
LQPERMIT
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"Your Waste Is Our Problem" -
Waste
JOB INVOICE' �:
0992.0 NVOICE-
0992-0
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CUSTOMER'S OFIDER!40.
DATE ORDERED
PALM SPRINGS, CA 92262-
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(760)- 322-2400 (760) 347-3545
ORDER TAKEN BY
DATE PROMISED 0 A.M:.
0 P.M.
BILL
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ADDRIESS L/
MEC!�
CITY 1)
ALPER
0.11XffE AND LOCATION
Dumping Fee -per 1000 gal.
0 DAY WORK
[I CONTRACT CONTRACT
DESCRIPTION OF
12
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QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT,
Ww
Gallons
Pumping Fee per 1000 gal.
Dumping Fee -per 1000 gal.
Out of Area Fee
Locating Opening Fee (per hour)
Size System:
A SERVICE CHARGE OF $20 WILL BE DUE
I' ON ALL RETURNED CHECKS.
A`fINANCE, CHARGE OF 1%% PER MONTH, 18% PER YEAR
WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 36 DAYS.
HOURS
LABOR
AMOUNT
TOTAL
MATERIALS
MECHANICS Qa
TOTAL
LABOR
HELPERSj- @
I hereby a c know' redgd'ttre s'tis lac'
completion of the above describedvork, TOTAL LABOR
TAX
SIGNATURE
DATE. COMPLETED
.':TOTAL
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To Reorder Ceti NEBS CUSTCIVI'printing service TOLL FREE 1-800-888-6327 NEBS, InG., Peterborough, NH 03458.
Ref. No: G 710703566
Under the California Mechanics Lien Law any contractor, subcontractor, laborer, supplier
or other person who helps to improve yobr property, but Is not paid for histher Mork or
supplies, has a right to enforce a claim against your property. This means that after a court
hearing, your property could be sold by a court officer and the proceed§ of the sale used to
satisfy the Indebtedness. This can happen even if you have paid your contractor in full if the
subcontractors, laborers or suppliers remain unpaid.
To preserve their right to file a claim or lien against your property, certain claimants such
as subcontractors or material suppliers are required to provide you with a document entitled
"Preliminary Notice." Original (or prime) contractors and laborers for wages do not have to
provide this notice. A Preliminary Notice is not a lien against your property. its purpose is to
notify you of persons who may have a right to file a lien against your property if they are not
paid. Generally, the maximum time allowed for filing a claim or lien against your property Is
ninety (90) Days after completion of your project.
TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY,
YOU MAY WISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS:
]) Require that payments be made directly to subcontractors and material suppliers through
a joint control. Any joint control agreement should Include the addendum approved by the
Registrar of Contractors.
2) Issue joint checks for payment, made out to both your contractor and subcontractors or
material suppliers involved in the project. This will help to insure that all persons due payment
are actually paid.
3) After UPON making payment on any .completed phase of the project, and before making
any further payments, require your contractor to provide you with unconditional lien releases
signed by each material supplier, subcontractor and laborer Involved In that portion of the
work for which payment was made. On projects involving Improvements to a single family
residence or a duplex owned by individuals, the persons signing these releases lose the right
to file a claim against your property. In other types of construction this protection may still be
Important, but may not be as complete. TO PROTECT YOURSELF UNDER THIS OPTION YOU
MUST BE CERTAIN THAT ALL MATERIAL SUPPLIERS, SUBCONTRACTORS OR LABORERS
HAVE SIGNED. ,