07-1727 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00001727
Property Address:
77595 CALLE CHIHUAHUA
APN:
774-052-001-24 -000000-
Application description:
. PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
5000
c&ty/ 4 4 Q"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: License No.:
Date: Contractor:
OWNER -BUILDER. DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason ISec. 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 s e is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
BOY
a cant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001.:
( 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 pr is 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: G 1� V F Owner: `
CONSTRUCTION RIDING 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:
PEREZ ALEX C
P.O. BOX 1034
LA QUINTA, CA 92247
-------------------
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/14/07
JUN 57007 D
-----------------------------------------------
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.
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 Policy Number
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 become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: Applicant:
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 information i rre agree to comply with all
city and county ordinances and state laws relating to building construction, d y author' .representatives
of this county
to
enter upon the above-mentioned property spection r
Date: l n ' 1 1 ' / Signature (Applicant or Agent):
Application Number . . . . . 07-00001727
Permit . . . PLUMBING SEWER
Additional desc .
Permit Fee . . . . 30.00'
Plan Check
Fee
00
Issue Date
Valuation
5000
Expiration Date•. 12/11/07
Qty Unit Charge Per.
Extension
. BASE FEE
15.00
1.00 15.0000 EA PLB BUILDING SEWER
15.00
-------------------------------------------
Special Notes and.Comments
---------------------------------
SEWER HOOK-UP SEPTIC ABANDONMENT. June
14, 2007 4:39:49 PM AORTEGA
Fee summary Charged Paid
--------------------
Credited
----------
----------
Due
-----------------
Permit Fee Total 30.00
.00
.0.0
30.00
Plan Check Total .00
.00
.00
.00
Grand Total 30.00
.00-
.00
30.00
Q
LQPERMIT
f>
COACHELLA VALLEY WATER DISTRICT CASH.RECEIPT DETAIL,
10 1 90 H
F. {
Received Fro f
I Address: 0 AD 6 1_C' /
" Account No. � Lots Tract
!:
Service Address �'( i• G.A. Code
i. ❑ Meter(s) $
❑ Service(s)
h" ❑ Backflow(s)
❑ House Lateral(s)
I ❑ Detector Check(s)
❑ Meter Surcharge
anitation Capacity Charge
❑ WS.B.F.C.
❑ S.I.W.S.C.
❑ Temporary Construction Meter
❑ Tum on Charge
! ❑ Uncollected Account — Name
i
❑ Inspection Fee — Tract —
Fee.=
{ ❑ Plan Check Fees -Water/ Sewer — -
j
Tract—
j ❑ Bond Payment—A.D.--'Bond—Assmt
❑ Customer Deposit
`
0 Other
TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (760) 77-L7011
7111 1e) -1 4--10
ROPERTY ADD SS
PERMIT NUMBER(S)
Bin #
City of La Quinta
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 #
�1-1121
Project Address: < _
Owner's Name: .
'A. P. Number:
Ad.dress':V,O Vox 1034
Legal Description:
Contractor:
City, ST, Zip:
Telephone: —
Address:
Project Description:
City, ST, Zip:
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
1.
Construction. Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. FL:
# Stories:
# Units: .
Telephone # of Contact Person:
Estimated Value of Projec nou I()()
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
hte,
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
204 Review, ready for corrections/iissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
7rd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
6
School Fees
Total Permit Fees
D FST (851)E5B W
❑ LAKE ELSINORE (%1) 874.2312
11 FALLBROOK 8 FONSALL (760 728-7497
i ®�_ ®� U EIN0 0(951)W -w
G (961)89B066b
O OCEANSIDE, CARLSBAD (760) 722.3155
® U t (951)(157-110
0 REDLANDS LLAMA (909) 797-8697
❑ VISTA &TRI -CRIES AREA (760 726.6260
U 8FALMNT (%I) Bf3.'i338
U PALM SPRWADHS (760) 322.2622
❑ ENCINITAS & CARDIFF (750) 753.2574
U SLA4 CITY (961)8796919
U INDIOlPALM DESERT (760) 3461736
U DEL MAR 8 SOLANA BEACH (&W. 481-1633
I) sion of RotoCo.. Inc.
License Number 422155 • Federal ID Number. 33-04750.32-
U 1NEST RANCHO BERNARDO 8
WEST RANCHO PENASCUITOS (8.58) 484-2138
O LAKE SAN MARCUS 6 LA COSTA (160) 716.6720
J RANCHO SAr1TA FE S OLIVEHAIN (858) 7563396
796 N. STATE STREET o HE -MET, CA 92563
Toll Fria: (dt10) 491-7686 . Fax; (951) 662.7615 • I -M GET ROTO (438-78A8)
FIXTURE 'MAIN LINE: FT ❑
CLEANED: TOILET ------------1
BATHTUB ---------0
SHOWER ---------0
ES71MATE: My estimate for perfomling this work is: S
DATE
WORD( ORDER NO.
�jL 0-�P
JOB #... ..:.........
- -- , -
TECH #1 `z....._ ... TECH #2
BATH SINK - - - - - - -
- Fj
FLOOR DRAIN
- �J
KITCHEN SINK - - - -
�—j
FLOOR SINK - - -
- - - -O
LAUNDRY ---------0
AREA DRAIN ------{J
URINAL -----------0
OTHER
❑
WWK ORM AUFHORQATM / WAVIER: I authorize Ra'o-Rooter to perform the deserbed cervices and 1 agree to pay the anwurMo
Indicated. I understand that Ratoiloofm is not responsible fa broken, solnea noted, deteriorated, OF toad pipes, fthires, or clean
outs arW oM damage renftV ham dearft or rapakfng such Naos.
I have asked Rotoltooter to prow lde services. under Section 1689.13 of Me California CNN Cods, In order to Induce Ra "oo m to
provide Meso servicim t) krAloted negoMaNar and oonhod; 2) executed this contrad In convection with th% of emergency
or hrorisdo0e necessary repairs Or services necessary for the kronedkde prdaefbn of Ia detaked on this
Invoke; and 3)1 expressly admawledge and waive the right to cancel this contract three or sev days, whichaver
(PRINT NAME)
COMIKETION I acknowledge completion of tho above described work which has boon doer to my
PLEASE INATIAL FOLLOWING:
A. The serviceman discussed Roto- tooter products with me.
B. I have been advised additional lines cleaned of this time are halt prices.
C _ i have been advised that running my main line from a 3- roof vent is
improper access and can only be given a 10 day guarantee, a 2- main line has a
zero guarantee. In order to get a 120 day guarantee a cleanout must be installed.
i^I I¢T/)W'P rrtCw
TIME IN TIME OUT
CC _E)(RDATE APPROV. #
I hereby authorize Rotoco, Inc. to charge my Credit Cord for the above charW. I understand that by signing below i
am agreeing to all charges incurred on this invoico and that the work was completed to my salisfoction.
�Cordholder Signature X --
SEE REVERSE FOR TERMS & CONDITIONS 0 CASH �81LC X, CK # � `.' i_I CREDIT CARD/TYPE
FIXTURE MAIN LINE: FT 0 BATH SINK - - - - - - - -F
L' hi$1R£T (951)65641541
L' LAKE ELWOkk (451) 674.7312
U SAL! bK)UK a NUNSALI. (7W) 720-7497
U ryry I IHANC-HU I*RNAR00 6
WORK ORDER NO.
•®� ®
C UM40(051)0724491
C3 RANCHOlT9KQAA(951)W4W
L OCEANSIDE. CARLSBAD (760) 772.3155
WEST RANCHO PENASOUITOS (856) 484.2138
AREA DRAIN -------0
��--
SHOWER
O PEND (951)@S7�W
G REDLANMYUCAIPA (909) 797.8667
0 VISTA 6 TRI -CITIES AREA (760) 726-6260
❑ LAKE SAN MARCOS 81A COSTA (760) 726-6720
3'Ta
—:377,13
.
A
C BEAl4ft W (951)1) 845.3338
E) PALM SPR84GSIDHS (760) 322-2622
U ENCINRAS B CARDIFF (760) 753-26?4
C RANCHO SANTA FE 8 OLrvEHAIN (658) 75&3398
TIME OUT
Plumbers
C Sllt4CfrY(951)87tt`8019
0INDOPALM DESERT (760) 346-1736
C� OEL MAR 8 SMANA BEACH (858) 461-1631
DATE
JOBr#J:
...........
Div Sion 0! i7010.a- 11 "C.
798 N. STATE STREET . HEMET, CA 92543
License Number :2215.5 • Federal IC- NurrWr. 33-0475032 Tall I'me: (6W) 491-7080 . Fax; (851) 682-01.15 + 1.800 GET ROTO (43<4 7886) TECH #1
TECH #2
FIXTURE MAIN LINE: FT 0 BATH SINK - - - - - - - -F
FLOOR DRAIN -----
---
CLEANEp: TOILET -----------Ci
CLEANED:
KITCHEN SINK ----43
FLOOR SINK-------
C)
BATHTUB
---------0 LAUNDRY --------4J
AREA DRAIN -------0
SHOWER
-------- O URINAL-------
0
OTHER
❑
t
,D�C�E�
C7 ��+ari3E.tA4E'r�T`�':
TIME IN
TIME OUT
ESTIMATE: My estimate for pertorming this work is: 5
WORK ORDER AIANOR"TION / WAVER: I osthortse Rote- tooter to perform the described services and I agree to pay the amount
indicated. t understand that Roto4looter Is not retpondble for broken, settled, nated, deteriorated, at teat pipes, fixtures, at dean
outs and any damage resAfhrg from clean" an ropahheg such 11na&
I taw asked Rofo4looller to provide services, undo section 14811.13 of the California Civil Godo, In order to kKbxo Roto4tootw to
provide time servloes; 1) Initiated negotiation and contract; 2) executed this contract In connection with fie rrx*kv of emergency
or irnrtediate aedaory roprdrs or services necessary to the Immediate protection of alon fhb
invoice; and 3) 1 expressly admowledge and waive the right to cancel this cordtad Nn throe or`s�er► business whiehsrmr
oto-
(PRN4f NAME (WNATURW--r-- 7e
COMPLETION i oeb)swfedge completion of fie above desCdbed wort Which tae been
INITIAL FOLLOWING:
_ the serviceman discussed Roto -Rooter products with me.
B. I have been advised additional tines cleaned at this time ore half prices.
C i have been advised that running my main line from a 3- roof vent is
improper access and can only be given a 10 day guorantee, a 2- main line has a
aero guarantee. in order to get a 120 day guarantee a cleanout must be installed.
r (� CAStt.'_1 BILL O CK # CREDIT CARD/ TYPE
JEXCELIP+tt C1ATAdr �.' SEE REVERSE FOR TERMS 81 CONDITIONS
CuST "MER CoPy