11-1181 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA.QUINTA, CALIFORNIA 92253
Application Number: <1 1 =0000 81:w
Property Address: __(54925 AVENIDA RAMIREZ
APN: 774-295-021-10 -000000-
Application description: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 8000
Applicant:
Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
• f����I11�11(/ f")
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty ofperjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Licens lass: A B C36 C4 License No.: 422155
at C ractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License law for the
following reason (Sec. 7031.5, Business and Professions Code: Any,cityor 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 sheds licensed pursuant to the provisions of the Contractor'sState
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 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.).
(_ 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 ISec. 3097, Civ. C.).
Lender's Name: t
Lender's Address:
LQPERMIT
Owner:
MORROW ROBERT F
P O BOX 660
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153 ;
Date: 10/27/11 '
DOCT 27 2011
Contractor: I -CITYA
ROTO ROOTER PLUMBERS FIhQ��E
2141 INDUSTRIAL COURT #D
VISTA, CA 92081
(760)598-4292
Lic. No.: 422155
WORKER'S COMPENSATION DECLARATION
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 GUARD INS Policy Number ROWCW234997
1 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 workers' compensation provisions of Section
3700 of the bor Code, I shall forthwith comply with those provisions.
ate:, plicant:
WARNING: FAILURE TO SECUR ORKERS' 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.
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
y 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
f 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 c my to e�upoeabove-mentioned property for inspect on purposes.
el� (Applicant or Agent):
,pplication Number 11-00001181
?ermit PLUMBING SEWER
,dditional desc .
?ermit Fee 30.00 Plan Check Fee .00
Issue Date . . . .'. Valuation 8000
:xpiration Date 4/24/12
Qty Unit Charge Per Extension
BASE"FEE 30.00
special Notes and Comments
;RPTTC ARAMON. ARWPR CnNNF.CT _ 9.0 10
- r Mi � EcZ 1VM
.�v. vv
vv
vv
Plan Check Total
.00
.00
.00
.00
OtherFeeTotal
•1.00
.00
.00
1.00.
Grand Total
31.00
.00
.00
31.00
LQPERMIT
t
Bin #...,
City of a QUinLQ..
Building 8'r Safety Division
P.Q. Box 1504, 78495 Calle Tampico
La Quinta, CA 92253 - (760) 777-70.12
Building Permit Application and Tracking Sheet
Permlt #
l .
Project Address:
Owner's Name: �J
A. P. Number:
A
Address: r
Legal Description:
City, ST, Zip: Ava V
Contractor: /'
Tele phone: r .>y::>c>v;Ym.;<
:;:. ? :<s•><;>;> :.;. A ..sti
Address:
Project Description: y
City, ST, Zip:
�I�J Z.
Tele hon -y +:a
XX
State Lie. # : Z.Z City Lie. #.:
Arch., Engr., Designer:
adz
Address:
City, ST, Zip:
Telephone:
State Lie.
.tSi{(vJZ/:�^.C;.v.• :Y `}�ryr .ti:,%F \WSJ:..
s:`••>'sNz z^>: <: :>:"` v::<?sn>`<:
Construction Type: Occupancy:
Project Pro a circle one): New Ad•3n
type '
J ) Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
—# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
Recd
TRACKING
PERMrr FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted'
Mechankal
Grading plan
2' Review, ready for corrections/issue
ElectricA
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd Review, ready for correctionsrssue
Develop --r Impact Fee'
Planning Approval '
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
ETotalmit
Fees
i ;� - . ' ,,
..• _.r _ :._ ILS ......
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..,
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❑ HEMET (951) 658-8541
/;OT
❑ LAKE ELSINORE (951) 674-2312 " • ❑ FALLBROOK & BONSALL (760) 728.7497 = ❑ WEST RANCHO BERNARDO &"
+
WORK ORDER NO.
❑ BANNING (951)922-M.1
❑ PERRIS (951) 657-9852
1100T
❑ RANCHO/fEMECULA (951) 6WO555 ❑ OCEANSIDE, CARLSBAD (760) 722-3155 WEST RANCHO PENASOUITOS (858) 4842138
❑ REDLANDS/YUCAIPA (909) 797-8697 ❑ VISTA & TRI -CITIES AREA (760) 726.6260 ❑ LAKE SAN MARCOS & LA COSTA (760) 726-6720
LABOR
. tt r
S C�95(951)
ALM SPRINGS/OHS 760) 22 C3 ENCINITAS & CARDIFF (760) 753-2674 ❑
38' C3 INDIO/PALM
RANCHO SANTA FE & IN (�756-3i96',
1-47-2390.
4
❑ SUNEI
) 679019
Plumbers r
❑ DESERT((760) 346-1736 ❑ DEL MAR 8 SO NA BEACH (858) 481-1633
DATE /
JOB # ...............
Division of RotoCo., Inc. { ..
D
REMIT TO: 2141 INUSTRIAL CT., STE D • VISTA, CA 92081
61TY:.:�
. ,PART NO. -_
,
_.__,.... ......................
. �i�
License Number 422155 • Federal ID Number: 33-0475032
Toll Free: (800) 491-7686 • Fax: (760) 598-1657 • 1-800 GET ROTO (438-7686)
TECH #1
TECH #2
..:...!...............
........... .ft.!S ...........-'
• - --
- MAIN LINE:
FIXTURE
FT � .BATH SINK - - - - - - -
- 0.
FLOOR DRAIN - - - - - 0
JOB NAME
�ll/j "
PURCHASE ORDER #
i
CLEANED:' TOILET - -
,
- - - - - - - -0 KITCHEN SINK - - - -
-0
FLOOR SINK- - - - - - -❑
��.QoG✓
:�y
-
OTHER
JOB ADDRESS. c.
•c BATHTUB
--------� LAUNDRY ---------0
.,
AREA DRAIN' --'-----0 *:
f.
SHOWER
------- 0 URINAL -----------
11
OTHER ❑
TAX
CITY
STATE, ZIP
CCESSED VIA
DRAIN ❑ CLEAN OUT
LED
CAUSE OF STOPPAGE
❑ ROOTS ❑ GREASE
TOTAL
PAYMENT RECEIVED
VENT
.❑OTHER ❑UNKNOWN
TIME IN
TIMEOUT
El YES'* GUARANTEE o NO
8A -M. - tJ P.M. MON. THRU FRI.•
,ESTIMATE: My estimare,for performing this work is: $
DRAIN CLEANING
$
WORK ORDER AUTHORIZATION / WAVIER: I authorize Roto -Rooter to perform the described services and I agree to pay the amounts
Indicated. I understand that Roto -Rooter is not responsible for broken, settled, rusted, deteriorated, or lead pipes, fixtures, or clean
outs and any damage resulting from cleaning or repairing such lines.
have
I have asked Roto -Rooter to provide services, Under Section 1689.13 of the?Callfomia Civil Code, In order to induce Roto -Rooter to
these services; 1) Initiated negotiation and contract; 2) executed this contract in connection with the making of emergency
or immediate necessary repairs or services necessary for the Immediate protection of per or personal property detailed on this
Invoice; and 3) 1 expressly acknowledge and waive the right to cancel this contract within three or seven business days, whichever
applies. ,
(PRINT NAM E) (SIGNATURE) -
COMPLETION I acknowledge completion of the above described work which has been done to my complete satisfaction.
-
(slcNAiuRE)
ADDT FOOTAGE
.
RESIDENTIAL GUARANTEE
ADDT FIXTURES
LABOR
Main/Branch Lines ..... :..:.. El months .
Toilet Au er ..:.:.
g • • .. .. ❑ 7 days •
Plumbing Repair ............. ❑ 6 months
Plumbing Replacement ....... ❑ l year
Extended Guarantee ..:...:.." ❑ 1 year
PLUMBING LABOR
PARTS
PRODUCTS/TREATMENT'
-COMMERCIAL GUARANTEE
LABOR
VIDEO INSPECTION
Main/Branch Lines ... ❑ 30 days
-•'
Toilet Auger ~, .❑ 24 hours
:^.............'... r '
Plumbing Repair .............. ❑ 90 days
Plumbing Replacement .... ❑ 90 days
61TY:.:�
. ,PART NO. -_
,
DESCRIPTION / REMARKS / REPAIRS'NEEDED
' ''PRICE'
HYDRO-JETTER -
v
MINI JETTER
REASON FOR NO GUARANTEE- • _
-
-
�
LINE/ LEAK LOCATION
PUMP SEPTIC/GREASE,
-
OTHER
ADDITIONAL WORK RE9UIREMENT
TAX
TOTAL
PAYMENT RECEIVED
e`PLEASE INITIAL FOLLOWING: '
A.- - .,The serviceman discussed Roto -Rooter products with me. .
B. `' I have been advised additional lines cleaned at this time are half prices.
'C I have been advised that running my main line from' o 3- roof vent is
Improper access and can only be given a 10 day guarantee, a 2" main line has a
�,pro guarantee. In order to get a 120 day guarantee a cleanout must be installed.
CC
the
am
_ CLEAN UP
LEI_!XCELLENTEl SATISFACTORY ❑ POOR SEE. REVERSE FOR TERMS'&
CUSTOMER COPY ,
EXRDATE APPROV. #
y authorize Rotoco, Inc. to charge my Credit Card foi the above charges. I understand that by signing below I. -
reeing to all charges incurred on this invoice and that the work was completed to my satisfaction:
ildei Signature X
CONDITIONS
❑ CASH ❑ BILL ❑ CK # ❑ CREDIT CARD/TYPE
tttt3Nl
'Y•
kAy .
Ey �.
CONDITIONS AND EXCLUSIONS
Roto -Rooter Service & Plumbing Co. guarantees the services performed as set forth in this invoice to be free from defect in materials or
workmanship for the applicable time period stated above. If within the Guarantee Period a drain stoppage or other defect in the repair of plumbing
fixtures or plumbing parts installed by Roto -Router Service & Plumbing Co. occurs, Roto -Rooter Service & Plumbing Co. will clear the drain stoppage
or, repair or replace (at Roto -Rooter Service & :Plumbing Co.'s option) the plumbing fixture or plumbing part previously installed at no cost to customer,
subject to the following exclusions and limitations:
1. This Guarantee applies only to the specific sewer lines cleaned, or plumbing fixtures or plumbing parts supplied and installed by Roto -Rooter
Service & Plumbing Co.
2. Roto -Rooter Service & Plumbing Co. must receive notice of the defect within the Guarantee Period.
3. This Guarantee does not apply to:
a. Multi Unit Dwellings sewer and drain lines, plumbing fixtures or plumbing parts.
b. Materials furnished or work performed by other than Roto -Rooter Service & Plumbing Co.
c. Drains, sewer lines, plumbing fixtures and plumbing parts which have been misused, abused, damaged or modified by others;
d. Drain or sewer line stoppages caused by foreign objects, including but not limited to sanitary articles, paper towels, toys, etc.; or
e. Sewer lines which are settled, broken, offset deteriorated, damaged or improperly or illegally installed.
f. Drains, sewer lines, plumbing fixtures on septic systems.
g. Commercial accounts.
4. The Guarantee Period commences on the date or original service and shall not be extended by subsequent services or repairs made pursuant to
the terms of the Guarantee. The Guarantee hereunder extends to the customer invoiced for the services and is not transferable. .
5. Roio-Rooter Service & Plumbing Co.'s liability hereunder shall be limited to recleaning of drain or sewer stoppage (Max. two repeat visits) or
the repair or replacement of defective plumbing fixtures or plumbing parts: Roto -Rooter Service & Plumbing Co. shall not be liable for (1) Incidental or
consequential damages; (2) Water or other damage; (3) Loss of ise; or (4). Loss of anticipated benefits or profits, any of which result from the furnishing
of services or products, or from the breach of the Guarantee, even if Roto -Rooter Service & Plumbing Co. knew of the likelihood of such damages.
6. Any implied warranty of merchantability, or fitness for a particular purpose of use, shall be limited to the duration of the foregoing written
guarantee. The foregoing written guarantee is..the.customer's sole and exclusive remedy and in lieu of all other_guaraitties and_watrantie ,_exRress or
implied, written or oral. This guarantee may only be modified in writing, signed by an officer of—Roto-Rooter Service & Plumbing Co:
7. This guarantee does not apply in the event customer breaches any of the Terms and Conditions of service, including but not limited to timely
payment of all charges,
8. Collection. Owner agrees to pay all collection fees and charges including but not limited to all legal.and attorney fees that result should Owner
default in payment of this contract. Overdue accounts are subject to interest charged at the rate of 18% per annum.
9. Legal Fees. In the event litigation arises out of this contract, prevailing party(ies) are entitled to all legal, arbitration, and attorney fees. The
court shall not be bound to award fees based on any set, court fee schedule but shall if it so chooses, award the true amount of all costs, expenses and
attorney fees paid or incurred.
TERN -IS: NET 10 DAYS. A FINANCE CHARGE will be computed on the unpaid balance by a single period rate of 1-i.L)% per month, which is an
ANNUAL PFiRCENi'AGE RATE OF 18%. A $35.00 FEE WILL. BE CHARGED FOR ALL RETURNED CIIECKS.
"State laxv requires any one who contracts to do construction work to be licensed by the Contractors State license Board in the license category in which
the contractor is going to be working - if the total price of the Job is $750.00 or more (including labor and materials).
Licensed contractors are regulated by laws designed to protect the public., If you contract with someone who does not have a license. The Contractors
State License Board may be unable to assist you with a complaint. Your only remedy against an unlicensed contractor may be in civil court, and you may
be liable for damages arising out of any injuries to the contractor or his or her employees.
You may contract the Contractors State License Board to find out if this contractor has a valid license. The board has complete information on the history
of licensed contractors including any possible suspensions, revocations, judgements and citations. The board has offices throughout California. Please
check the government pages of the white pages for the office nearest you or call (800) 321-CSLB for more information."
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