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09-1134 (PLBG)r. P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00001134 Property Address: 77500 CALLE POTRERO APN: 774-274-023-12 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 3000 Applicant: "`&t!t44Q" Architect or Engineer: �/` BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury 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. License Class: C42 . 00, Li=seAo.: 661018 Bate/.�-? 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 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 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 ISec. 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, 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.). (_) 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: LQPERMIT Owner: LOIS HEWITSON 77500 CALLE PORTRERO LA QUINTA, CA 92253 Contractor: HAMMER PUMPING INC P O BOX 2448 CATHEDRAL CITY, CA 92235 (760)360-7448 LiC. No.: 661018 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/28/09 WORKER'S COMPENSATION DECLARATION 1 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 provid_.. _ 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 CCLD/ST FUND Policy Number 1828655-2009 I 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 sub'ect to the workers' compensation laws of California, and agree that, if I should become u o the -w -W, -W, compensation provisions of Section ,, 3700 of the Labor Cod a Moifhwith hose provisions. ///1__�r,_o9 / I --- 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. 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 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 informatio scouec I agree to comply with all city and countpordinan�cesd ate laws relating to buildg•oos ron,.and• - y_%uthorize presentatives of ' /c'o�lunty bove-mentioned pro r mspecti poses. Datea v _applicant or Application Number . . . . . 09-00001134 Permit . . . PLUMBING SEWER Additional desc . Permit Fee . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 3000 Expiration Date 4/26/10 Qty Unit Charge Per Extension BASE FEE 30.00 -------------------------------------------------•--------------------------- Special Notes and Comments SEPTIC ABANDON, SEWER CONNECT. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 - Fee summary Charged Paid ----------------- ---------- -7 -------- Credited ---------- ---------- Due Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 Bin # City Of !La Quinta Building &r Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #P.O. �,�� 0 Project Address: -% 7 (� ,L Pro Wo Owner's Name: 4j�s •�� . A. P. Number: pw,'�p�, Address: -7-750c,-) Legal Description: City, ST, Zip: C-,(,_ Contractor: � Telephone:i Tele hone: U G l S >` MEMO Address: �. Project Description: w� /Lpojof4 City, ST, Zip:w;� TeleP hone. (90) — 3 6 � 7 `'t State Lic. # :76—( City Lic. #; Arch., Engr., Designer: � l-�7 V Address: City., ST, Zip: Telephone: ele h P 0 State Lic. # Name of Contact Person: Con n T structi o e: Occupancy: Type: P Y: Project tYPa (circle one):: New Add'n Alter Repairair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 3,9,90. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. 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 corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees L a lAT r?. COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 10/14/2009 SUBJECT: 77500 CALLE POTRERO, LA QUINTA 606131,075.0.8 LOIS HEWITSON Project: 77500 CALLE POTRERO 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 9-1945 10/14/2009 $3,995.00 606131 REBECCA MILWARD SUBJECT: 77500 CALLE POTRERO, LA QUINTA 606131,075.0.8 COACHELLA VALLEY MATER DISTRICT Jl P.O. 60X 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 9 Pa e1 a www.hammerpumping.com 760/360-7448 760/321-7448 FAX 760/324-6434 Customer Name Address -~-5 C rC10 <. c` v r V O ITy�,..C;��Ifi Phil Additional Service- Required[] Recommended Description/ Remarks/ Drawings Card — MC / VISA # MO P.O. BOX 2448 - Cathedral City, CA 92235-2448 - Lr#661018 ' OB INVOICE J08 DATE: TIME IN: TIME OUT: TECHNICIAN 01 TECHNICIAN #2 HELPER(S) jr ORDERED BY: P.O. N START DATE: END DATE: t Jos LOCA'nON SERVICE F BACK UP OCONTRACT MAINTENANCE REPAIR n MAINTENANCE 0 ESTIMATE 0 CONSTRUCTION n OTHER I hereby authorize Hammer Pumping, Inc. to charge my credit card for the above charges. I understand that by signing below I am agreeing to all charges incurred on this ticket and that the work was completed to my satisfaction. 1/l r+ C ✓ �''jl� Cr Ct --2 rl COMMENTS l r ❑ Leach System Failing ❑ Roots ❑ Excessive sludge/grease SERVICES COMPLETED