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10-0058 (PLBG)0- P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:.--'16-00000058J.�J Property Address: 51300 AVENIDA JUAREZ APN: 773-043-036-23 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL - . Application valuation: 2500 Applicant: Architect or Engineer: P 'k 4 4Q" 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:::B C36 C42 License No.: 793482 ate: -; 10ontraTter� 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 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 herown 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—) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: CLARKE WILLIAM H 51300 AVENIDA JUAREZ. LA QUINTA, CA 92253 Contractor: SO CAL & ASSOCIATES P.O. BOX 955 YUCCA VALLEY, CA 921 (760)369-4104 Lic. No.: 793482 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 77777153 n - 'HNC 2CIg 7q g Date: 1/25/10 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 STATE FUND Policy Number 1820769-2009 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 subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section ���0 of the Lab r Code, I shall fo Ibsompl rovisions. 65te: (O A - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001- 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 representatives of this county t ter upon the above-m�entio�ned property for in ' D © Si a g re IApplicapwr 1j• ,�� J! % h Application Number . . . . . 10-00000058 Permit . . PLUMBING SEWER , Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . 2500 Expiration Date 7/24/10 Qty Unit Charge Per Extension BASE FEE 30.00 t--------------------------------------------------------- Special Notes and Comments SEPTIC ABANDON, SEWER CONNECT. 2007 �. CODES. -----------------_-_------------------------------ - Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1'.00 ` Fee summary Charged Paid 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 t LQPERMIT COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 1/25/2010 SUBJECT: 51300 AVENIDA JUAREZ, LA QUINTA 606013,073.0.3 MICHAEL S. HELDERBRAND Project: 10-2124 SO CAL & ASSOCIATES PLUMBING Project Date: 1/25/2010 PO BOX 955 ` Amount Due: $3,995.00 YUCCA VALLEY, CA 92286 + GEO: 06-06-01-3 Planner: REBECCA MILWARD TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 1.00 SCC -COLLECTION $1,658.001 $1,658.00 1.00 SCC -TREATMENT $2,337.001 $2,337.00 $3,995.00 • JAN 2b 2010 COpC AE O1S?�1C�Y WpS SUBJECT: 51300 AVENIDA JUAREZ, LA QUINTA 606013,073.0.3 I COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 r 1 Page 1 Bin # Permit # 5� Project Address: ALJ _ City of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet pr Owner's Name: A. P. Number: Address: 5 Legal Description: City, ST, Zip: L�+ Contractor: Telephone: Address: W211L Project Description: City, ST, Zip: Telephone: r lQ0 - (off -3 �y °~<. " r , a M. M? State Lic. # Arch., Engr., Designer. City Lic. #; 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: Estimated Value of Project: # Submittal Req'd APPLICANT: DO NOT WRITE BELOW THIS UNE Recd TRACIONG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Caped Contact Person Plan Check Balance Tldc 24 Cities. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'' Review, ready for correctionstiissue Electrical Subeoutactor 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 correctionsrmue Developer Impact Fee Planning Approval Called Contact Person A•I,PX. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees