14-0167 (PLBG)P.O. BOX.1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000167
Property Address: 78610 BOTTLE BRUSH DR
APN: 646-311-040-40 -000000-
Application description: PLUMBING
Property Zoning: MEDIUM DENSITY RES
Application valuation: 3200
Applicant: U
1.�
T4ht 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
NVN
--------------------------------------------------
NSED CON ACTO S DECLARATION
I hereby affirm under penalty of jury that I a i, ense un r (isions of Chapter 9 (commencing with
Section,? 00 of Division 3 o he Business an rofe ionals Co , d'my License is in full force and effect.
License ass C42 C36 Lice a No.: 661018
Dates Con ractor:
OWNER -BUILDER DECLARATION
hereby affir 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 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 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 (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(sl licensed
pursuant to the Contractors' State License Law.).
(_ I 1 am exempt under Sec. , BAP.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:
Lender's Address: n
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/18/14
Owner:
KELLY FRANCOIS _ FFEIBI
78610 BOTTLE BRUSH DRIV DLA QUINTA, CA 92253
(
la ia1�a
Contractor:C1TMO
HAMMER PUMPING INC MANCE
P.O. BOX 2448
CATHEDRAL CITY, CA 92235
(760)321-7448
L'Ic. No.: 661018
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
9for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
^�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- mber are: -
Carrier NATIONAL UNION Policy mber 910606
_ I certify that, in the performance f the ork for which this permit is issued, I shall not employ any
arson in any manner so as beco a su j t two—th(—Workers' compensation laws of California,
nd agree that; if I should com subject the workers' compensation provisions of Section
(// 700 of the Labor Code shal orthwith com with hose provisions.
Date: \ D �' APpli �y/nt�`` 1
WARNING: F (LURE TO SECUR 0 KERS' COMPENSATION COV AGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO IMINAL 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
performed under or following issuance of this permit.
2. Any permit issued as a result of this applibecomes nuI n void if work is not commenced
within 180 days from date of issua of such erma, or c tion of w k for 180 days will subject
permit to cancellation.
I certify that I have read this application and tate that the a ove info r ation is c I agree to comply with all
city and county rdinances and state laws 4lating to bui g ons ction, and here a rize representatives
of this sou yft en eerr upon the above-mentioned pro pe I' f r ' pect,on purpos
Date 2 I U (Signature (Applicant Ir Agent),
! 1.
Application Number . . . . . 14-00000167
Permit . . . .
. PLUMBING 2013
Additional desc .
.
Permit Fee . . .
. 11.92
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date .
. 8/17/14
Qty Unit Charge
Per
Extension
1.00 11.9200
EA PLBG BUILDING
SEWER
11.92
=---------------------------------------------------------------------------
Special Notes and
Comments
PLUMBING - CONNECT
TO SEWER, SEPTIC
ABANDONMENT. 2013
CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . PERMIT
ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
4.77
Fee summary
-----------------
Charged Paid
--------------------
Credited
--------------------
Due
Permit Fee Total
11.92
.00 .00
11.92
Plan Check Total
.00
.00 .00
.00
Other Fee Total
95.34
.00 .00
95.34
Grand Total
107.26
.00 .00
107.26
LQPERMIT
L0
Din #
City of La Q uin to
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
i , I LPI
Project Address: U�� i rte— J�
Owner's Name:
E p` %S
A. P. Number:
Address:
Legal Description:
City, ST, Zip: p_ J 92
Contractor: V rn < `J
Telephone'
Address:e-P n--?) d� "Z L L,
Project Description:
City, ST, Zip: CIS i �—i--o 2 A ` c
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Tele h o e:
P
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d I-� t
State Lic. # : °p
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone
<' >': :::>: • : <::::::::.;.::::::::::::.
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Construction Type: Occupancy
State L
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact.Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
00
Estimated Value of Project:0� 2 0 —
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Recd
TRACKING
PERMIT 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
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�`�''Th'� COACHELLA VALLEY WATER DISTRICT
O� `� P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
�sr�t�>
INVOICE Date: 2/12/2014
SUBJECT: DESERT CLUB MANNER, 78610 BOTTLEBRUSH DR, LA QUINTA, LID 462360
JORGE MEZA Project:
78610 BOTTLEBRUSH DR Project Date:
Amount Due:
LA QUINTA, CA 92253 GEO:
Planner:
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
14-5240
2/12/2014
$4,851.00
05-07-31-4
SANDRA VILLALOBOS
SUBJECT: DESERT CLUB MANNER, 78610 BOTTLEBRUSH DR, LA QUINTA, LID 462360
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Pagel
1.00 FF SCC -COLLECTION
$2,415.00 $2,415.00
1.00 FJ SCC -TREATMENT
$2,436.00 $2,436.00
$4,851.00
PID - oo
✓# �a 8
FEB 12 201+
COACHELLA VALLEY
WATER DISTRICT
SUBJECT: DESERT CLUB MANNER, 78610 BOTTLEBRUSH DR, LA QUINTA, LID 462360
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Pagel