13-0721 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 13-00000721
Property Address: 46560 CAMEO PALMS DR
APN: 643-182-009-52 -2117
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3800
Applicant: Architect or Engineer:
r
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
----------------------- ' --------------------------
LICENSED C TRACTOR'S DECLARATION
I hereby affirm under penalty of m li a provisions of Chapter 9 (commencing with
Section 00 1 of Division 3 of -the Business a d P 0 ssionals de, and my License is in full force and effect.
License las : C42 C36� a No.: 661018
Date: I C tractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty o 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 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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LOPF.RII IT
Owner:
LYNCH KELLY
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: 6/06/13
h e
U
VIN 0'i:20]131
CI'PY 0 1a49UINTA
PINANCF- 139PT
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
I 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.
Thave 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 NATIONAL UNION Policy umber 910606
1 certify that, in or ce of the w k for which this permit is issued, I shall not employ any
person in manner so as o becom subje orkers' compensation laws of California,
and agr that, if I should ome lett to the 'compensation provisions of Section
3700 f the Labor Code all f thwith comply with os ovisions.
Da� b I f4PP^ .
WARNING: FAILURE SE WOR ERS' 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 oid if work is not commenced
within 180 days from date of issuance of ermit, or cessati or 180 days will subject
permit to cancellation.
certify th t I have read this application a state that the above nformati is correc . agree to comply with all
city and c my ordinances and state la "s relating to building c struct' , and hereby auth epresentatives
of this //ty enter upon the above entioned�property f spe on purposes.
Date: It Signature (Appli nt or Age t):
Application Number . . . . .
13-•00000721
Permit . . . . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92
Plan Check.Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 12/03/13
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG
BUILDING SEWER
11.92
----------------------------------------------------------------------------
Special Notes and Comments
PLUMBING - SEPTIC ABANDONMENT,
CONNECT
TO SEWER. 2010 CALIFORNIA BUILDING
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . .
BLDG STDS ADMIN (SB1473)
1.00
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 96.34
.00 .00
96.34
Grand Total 108.26
.00 .00
108.26
I,OYBFN1 t7'
Bin #
City of La Quinta
Building 8L Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Vb--11A
Project Address: (os� Q C p, N�� O �� S
Owner's Name: t) ` t t-�!_ E-(
A. P. Number:
Address: (ps (od
Legal Description:
City, ST, Zip: L-I&-QC6. .
Contractor: t
�•:8>.i}i'r'•}tii^i:v
Telephone-. •.�'•}iF4::t.Y:}{: :. <i: •:
Address: 1�a ��ti 2 G
Project Description: �-- L� �,,,�,,.•1v��
City, ST, Zip.
Telephone: 03 1 Ll q $
:>:>::?:::::->::
f, <: � of %.. ,-:
State Lie. # :
City Lie. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: . . W >' s?::? 4`::%::^"
R•:S'>T:rrYit K^;'Vi'arr}iv(};};;� ;.}
State Lie. #:>#<:><;}:
Construction Type: Occupancy:
project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: . v'- S
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person: 14 � (a t 4 S
Estimated Value of Project: o p U
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 Cales.
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
17
Total Permit Fees
1
xx COACHELLA VALLEY WATER DISTRICT
P.O. [SOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 615/2013
SUBJECT. CC ONLY 116560 C:AML O PALMS OR LA QUINTA, LID 455614
McKINLF:Y P°ALII_ Project:
46560 CAMFO PALMS Oil.
13-4612
Project Date:
6!512013
Amount Due:
LA C?UINTA, (;n 42253 Amount
54.851.00
05-07-30-2
Planner:
CAROL PFANNKUCHE
10 INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
RGMM ANCL AND INCLUDE THE PROJECT ON YOUR CHECK