06-1593 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: r' 06-00001593
Property Address: 48751 SAN DIMAS ST
APN: 646-130-002- -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 8000
Tav1414aQ"
BUILDING & SAFETY DEPARTMENT
Applicant: Architect or Engineer:
-
-----=----------------------------^--------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busind Professionals C90b, b, a d my License is in full force and effect.
ess a
License Class: B Lic se: 521890
"417 lopl�
( G Date: '�G -Contractor
OW R -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 _ I 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 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. , 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 (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
RMIT
Owner:
JEAN STEPHENSON
48751 SAN DIMAS
LA QUINTA, CA 92253
Contractor:
KIRK CONSTRUCTION INC, MIKE
72677 BEAVERTAIL STREET
PALM DESERT, CA 92260
(760)346-1820
Lic. No.: 521890
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/20/06
----------------------------------,-------------—
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 STATE FUND Policy Number 1090480-2006
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 subject to the workers' compensation laws of California,
and agree that, if I should becoTp subject to the workers' com ensation provisions of Section
3700 of the Labor Code, I o wit eMply w'fh rhos rovisions.
Date: 1 20� Applicant: '
WARNING: FAILURE TOURE 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 information is correct. I agree,W comply with all
city and county ordinances and state laws relating to buil c structio and here aur ize representatives
of this county to enter upon the above-mentioned pr rty 'nspe n purpose . C
Dated RO-a Signature (Applicant gent):
LQPERDIIT
Application Number . . . . .
06-00001593
Permit .PLUMBING
Additional desc .
Permit Fee . . . . 60.00
Plan Check
Fee
15.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 10/17/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 45.0000 EA PLB
SEPTIC
45.00
-------------------------------------
Special Notes and Comments
---------------------------------------
NEW 2,000 GAL SEPTIC TANK & TWO
20X6
PITS, PER HEALTH DEPT APPROVED
PLANS.
.PREVIOUS SEPTIC ABANDONED UNDER
DEMO
PERMIT, THIS SYSTEM FOR NEW
ADDITION(REBUILD).
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 60.00
00
00
60.00
Plan Check Total 15.00
00
.00
15.00
Grand Total 75.00
.00
.00
75.00
Bin #
' City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .#
o�
Project Address:' �-- ��j ��� S
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: Aff CG4-'� T(e"-�
City, ST, Zip: 14- y�
Telephone:
Address: 2-77 44:4 6I )*c59'
Project Description:
City, ST, Zip:
Telephone: " 1 -- �%
City Lic. #:
j� T( G�-
State Lic. # : ( �.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: J
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE'
#
Submittal
Req'd
Recd
TRACIONG
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
Energy Calcs.
Plans. picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan'
211 Review, ready for correctionsrissue
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
U
tI
AU
IN
VC I
I fLC
14. PROVIDE A COMBUSTLON � TEMP. !704 5s.{.
E
A.—I2.'S F.—
1776
S.I. E
FEN
ERE
NCE C
E
.C�
D
E�
SETTO OPEN AT`NOT MORE THAN 150 P51. DRAIN P1PE'SHALL EXTEND
4
AL
24.9
4S
.F.
35
91
36
:.TOT ,
OR IFO NIA
A 2 N I CAL R
E THAN THE 200
DR WITH �
NOT M PLY W
TERMINATE ALL COM . i r
AND TER ION 'SH HwY I
DING CONSTRUCTION BUIL NS R
OF CO
TO O
U
TS
IDE ALL
A
TH THE
END
-WNW DWI R
GROUND A
ND POINT DO
LESS
THAN 6
ABO
VE GR
.SHALL REQUIRE
UNOBSTRUCTED. ANY OTHER TERMINATION
I IAL.
"OFF IC
IAL.
THE BUILDING
APPROVAL B
R
E
VICE WHERE
ATE S R
FO WATER TOR R
P
15. PROVIDE
SURE REGULATOR R
PRESSURE EXCEE
DS 80 P51 U.P.C.6
08.2.
.
B E i=OR
THE
NT
CTO O
WNER S R
ES
PONSI L
PE C
O RA
E
DEV
ELO R/
I6
G. THE R/
VER T
PAVING I
NO
IFICATIO
N OF
EXISTING
CURB O
R EDGE R
EET PAV F
THE PROPERTY LINES
CURB EXISTS} LOCATION...FROM LINE(5) WITH THE PUBLIC
WORK
S DEPARTMENT
F N 6 FROM
18. COMBUSTIBLE MATERIALS S
HALL NOT BE PLACED LESS THAN
.B.C3{0
2.7.8
NTNG. C
THE _FIREPL
ACE OPE )
19. EXCEPT FOR
FR
EPL
ACES
THAT OPEN
TO
THE EXTERIOR IORO
F THE
BUILDING,
,
THE OM
THE
I HABLE FR
READILY DISTINGU S
' E HEARTH SLAB SHALL BE R
SU RROUNDING`OR ADJACENT FLOOR. C.B.C. 3 102.7.I2 )
DE
BD. UNDER TUB
HO
WER E
N
CLOSUR
E
ATE RESISTANT GYP.
20. PROVIDE W R
MATERIALS TO 'A HEIGHT OF 70" MIN. ABOVE
THE DRAIN INLET.
BUILDING,: PLUMBING, MECHANICAL,
2004 ELECTRICAL, AND
E AND OR
5
AL CODE5 CODES AND L
ALOTHER OC
'.:2005 ENERGY "
AN ES
DIN C
:.EXISTING
A1RE A CALCU LATIONS
LOT A AREA
13 , 127 +'SQ . T. =.30 AC ES
I ENC E
RES DFT.
2,738.00 :
SQ
FT
`FT.
I ENCE
R, ES D
_
4 079 .00 `SQ.
2 CAR GARAGE/A.C.
50 7.0 0
SQ .
2CAR G RAC A.C.
6 7G.0 0 SQ FT
:TOTAL
3,245.00
SQ.
`FT.
TOTAL LIVING AREA
4,755.00 SQ FT.
NEW
AREA
ALLOWABLE R
'
l 3 127 / 4 755.00` SQ.
_ '
F'f. 36%
E IDENCE
- RS
.00
4,079.00
S.
Q
fT.
E A. C.
R GARAG /
CA '
2 CA T
67 G.00
SQ.
FT.
TOTAL
4,755.00
4,75
5Q.
IT.
An SQU R AGE
A E FOOT
I3
4 I `.00
SQ
FT.
AP SCALE`
R
ESiD
ENCE VICINITY 1NITY
M No
2 CAR RA .
'169 S. FT.
Q
.00
G
GE
`
`/A.C
NORTH
16':
Of sheets
ets
-TOTAL 1,50
I .0
0 SQ
FT.
r-
TT
i
1
r
i I I
I
i
I
�� I
•
•
•
r
I3
4 I `.00
SQ
FT.
AP SCALE`
R
ESiD
ENCE VICINITY 1NITY
M No
2 CAR RA .
'169 S. FT.
Q
.00
G
GE
`
`/A.C
NORTH
16':
Of sheets
ets
-TOTAL 1,50
I .0
0 SQ
FT.
r-
TT
i
1
r
i I I
I
i
I
�� I
ee sd o" lad, JOB INVOICE
POST OFFICE BOX 2448
CATHEDRAL CITY, CA 92235-2448'/
,(760 360-7448 (760) 321-7448 LIC. #661018
Date
U(.5
Ordered by
Bill ToT- , t, /
;/ w
Cust. Order #
r_7
Address `"S�`q,u Y S i' M aS
Ph. #
r
City �. Q
Mecdha 'ic r
Job Name and Location
Helper
Description of Work '
Amnt. Pumped/ /" F� 2G.al=O SeptickT na a Seepage Pit ❑ Cesspool ❑ Grease Trap ❑ Other
❑ System is Failing ❑ System Passes Inspection ❑ Excessive Sludge ❑ Roots
Quantity
Description of Work or Material Used
Price
Pump & Dump Fee per 1000 galf
/Amount
Locating & Opening Fee(per hour
Septic Inspection
Out of Area Fee
Fuel Surcharge
Snake Line ❑ Roof
Video Pie Inspection Camera 1st hour
Additional hours
High Pressure Water Jet
Additional Hours
Labor perhour
A service charge of $20 will be due on all returned checks Total
18% per year will be charged on past due accounts over 30 days
Paid By Next Service Due
Check # L/ f ❑ MasterCard/ Visa ❑ Billing On
w
Card #
Signature
Exp. Date / /
Date