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07-0026 (PLBG)P.O.-BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-=00000026 Property Address: 78735 SAGEBRUSH AVE APN: 646-311-023-23 -000000- Application description: PLUMBING Property Zoning: MEDIUM DENSITY RES Application valuation: 4000 Applicant: T4ht 4 4 Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: //D JqN Mq� 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' C36 License No.: 803145 Date: Contractor: 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 (55001.: (_ 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 orher 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(s) licensed pursuant to the Contractors' State License Law.). 1 _ 1 I am exempt under Sec. B.&P.C. for this reason CONSTRU TION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance 40 - work thework for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT 0520 0j Owner: BENJAMIN ALVAREZ 78735 SAGEBRUSH AVE LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760)'777-7011 INSPECTIONS (760) 777-7153 Contractor: DESERT EMPIRE PLUMBING & DRAIN P.O. BOX 1836 CATHEDRAL CITY, CA 92235 760)328-6417 iC. No.: 803145 Date: 1/04/07 -- ------------------------------------------ WORKER'S --------------------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. 1 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 ENDURANCE WC Policy Number WEN0004170-01 '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 Labor Code shattjorthwith comply wit es ovisions. � b � B2fe:I OS ,cant: WARNING: FAILURE TO SECURE WORKERS' COMP NSATION COVER AGF IS IINLA , 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 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize re tatives of this unty to enter upon th bove-mentioned property- nfi s •tion purposes. at %— ature (Applicant or Agent): 4r -- Application Number . . . . . 07-00000026 Permit PLUMBING SEWER Additional desc . . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 4000 Expiration Date 7/03/07 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- .0.0 .00 Grand Total 30.00 .00 .00 30.00 Bin # City a of Luinta Q Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # (n "( Project Address:—IS-73S 9A-6-6-6P_,\XW- ley Owner's Name: rl 41V A. P. Number: Address: Legal Description: City, ST, Zip: L_Ac- Q v I Contractor. w � 04 PI F4 Address: - Z CbLt 4/tl ( Telephone; '? Project Description: City, ST, Zip: c/4- ZfPv Telephone: 60 `�L8 ' (p Y State Lic. # : 301 14 City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New ..Add'n Alter Repair Demo Name of Contact Person: Sq. Ft:: # Stories: Units: Telephone # of Contact Person: d,# Estimated Value of Project: q©p a APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd :. Reed TRACMG . PERMTt FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready [ori ii ,�Tectioos Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan 2" Review, ready for correctionsrasue Electrical Subcoutactor 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 p Lp p, Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees �!:",,. i wi:� �„J ��^if 1"�i 'i r3v $'�`f+r'.:C,E+*t ���j�s�—i''__•`I`D— sa a"'$-�` sf r >.,x•s .. � ,y <�: r^M1?;..�e � ¢.. �(Y'^s�7w! „'fps F•i�Y^—"�-7� .!���i� i c sc,. • I, • COACH E VALLEY,WATER DISTRICT, CASH E RCEIPT DETAIL � 1;54 ! Received From: I .. Address:SO.. lU �,�? / Pt - Account No. f/ tl, Lot(s) ' Tract i �. Service Address _._. i'" is ❑ Meter(s) G.A. Code O Service(s) $ S' O Backflow(s) i ❑ House Lateral(s) ❑ Detector Chedk(s) ❑ Meter Surcharge , s Sanitation Capacity Charge ❑ .W.S.B.F.C. X17. r�o ❑ S.I.W.S.C. O Temporary Construction Meter O Tum on Charge O Uncollected. Account - Name i O Inspection Fee - Tract Fee - a ❑ Plan Check Fees Water / Sewer - Tract - ❑ Bond Payment - A.D. - gond i Assmt O Customer Deposit ❑ Other Remarks: ..- P0 TOTAL ;:i J;] --Copy to: i;. Cash Check 119-5-11 46, Water service L y's Money Order t • y Cashier i _..__..�_�. w_ _.,.......�-_-___—�_�t.:,_ •.,.•__-_..___..�_.,.._ 1 x . t '� s