08-1667 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001667
Property Address:
51975 AVENIDA JUAREZ
APN:
773-154-023-11 -000000-
Application description:
PLUMBING
Property Zoning:
Application valuation:
COVE R76? DENS
6 �Y
BUILDING
---
& SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
KINSTLER CHARLES V
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/06/08
I hereby affirm under penalty of perjury that I a'm:li55ffb!e9jlftdel provisions lI-� f Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals-C-ode-and-m� License is in full force and effect.
License Class: C21 C42 License No.: 482180
�Date:Ad �-Contractor: N'oi Un i� E CA
OWNER -BUILDER DECLARATION �f
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).:
(_) 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.).
(_) 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 pdrjury 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
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 CALIFORNIA INS Policy Number 460093580104
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 Cede, I shall forthwith comply with those provisions.
Date: '' licant:
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 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 to enter upon the above-mentioned property for inspection purposes
`Date: n ignature (Applicant or Agent): -ft 7c e-0
Contractor:
Applicant:
COO
erarchi ,r Engineer:
o
ALMS UNDERGROUND CONST, INC.
38703 VISTA DRIVE
N r/�_•
CATHEDRAL CITY, CA 91M4
3�
(760) 324-1911
Lic. No.: 482180
-------------------(-
-----Z--------------------------------------------------------------------
I hereby affirm under penalty of perjury that I a'm:li55ffb!e9jlftdel provisions lI-� f Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals-C-ode-and-m� License is in full force and effect.
License Class: C21 C42 License No.: 482180
�Date:Ad �-Contractor: N'oi Un i� E CA
OWNER -BUILDER DECLARATION �f
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).:
(_) 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.).
(_) 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 pdrjury 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
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 CALIFORNIA INS Policy Number 460093580104
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 Cede, I shall forthwith comply with those provisions.
Date: '' licant:
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 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 to enter upon the above-mentioned property for inspection purposes
`Date: n ignature (Applicant or Agent): -ft 7c e-0
LQPERMIT
Application Number . . . . . 08-00001667
Permit . . . PLUMBING SEWER
Additional desc .
Permit Fee . . . . 30.00 Plan Check
Fee
.00
Issue Date Valuation
. . .
. 4674
Expiration Date 4/04/09
Qty Unit Charge Per •
Extension
BASE FEE
15.00
1.00 15.0000 EA PLB BUILDING SEWER
15.00
• ----------------------------------------------------------------------------
Special Notes and Comments
SEPTIC ABANDONMENT / SEWER HOOK-UP
Fee summary Charged Paid Credited
----------------------------------------------------------
Due
Permit Fee Total 30.00 .00
.00
30.00
Plan Check Total .00 .00
.00
.00
Grand Total 30.00 .00
.00
.30.00
LQPERMIT
i
ALMS UNDERGROUND CONSTRUCTION, INC.
38703 VISTA DR.
CATHEDRAL CITY, CA. 92234
760-324-1911;FAX:760-324-9541
; s i s ko� � z� �r� rico A r -e -v oLl o -�c)
INVOICE
* ATEIq
POST OFFICE BOX 1058 COACHELLA, CA 92236 (760) 398-2651
O1STRIC�
PA •
Invoice No: 508
To: CHARLES KINSTLER OCT 0 6 2006 Date: 10/06/08
Customer No: 980/980
COACHELLA VALLEY
WATER DISTRICT
BY—& -T "'p' g -•---DEVELOPMENT SERVICES
1.00 SCC. -TREATMENT FAGILI•TY 4,674.00
COMPONENT 2.0 ED
1.00_ SCC -COLLECTION SYSTEM 3,316.00
COMPONENT 2.0 ED
SUBJECT: 51-955 AVENIDA JUAR Z, LA QUIN':
ACCOUNT NO,
& ,
51-975 AVENIDA JUAREZ, LA QUINTA
ACCOUNT N0:=,
DTM
TOTAL DUE:
a ••� ��
4, 674-. 00
3,316.00
PLEASE DETACH AND SEND THIS COPY WITH REMITTANCE
------------------------------------------------------------------------.---
Name: KINSTLER, CHARLES
Date: 10/06/08 Remit and make check payable to:
Due Date: 11/05/08 COACHELLA VALLEY WATER DISTRICT
Customer No: 980/980 POST OFFICE BOX 1058
COACHELLA CA 92236
Type: DS - DEVELOPMENT SERVICES
Invoice No: 508
Terme: 30 DAYS Total Due: $7,990.00
i.. CVWDINPD
_ _ Q
.a� t
www.hammerpumping.com
760/360-7448 760/321-7448 FAX 760/324-6434
Customer Name
Address
City
Ph#
Additional Service -❑ Required ❑ Recommended
Description/ Remarks/ Drawings
RO, ROX 2448 - C.lthrdral Cit , CA 92236-2448 - LIC# 661018 ,SOB INVOICE
108 DATE: TIME IN� , �^ TIME OUT: TECH`N`CIAN 91 TECHNICIAN 02 IMELPERJS)
ORDERED BV: P.O. M START DATE: END DATE:
JOB LOCATION
SERVICE
BACK UP
Ej CONTRACT
MAINTENANCE
❑ REPAIR
❑ MAINTENANCE
ESTIMATE
CONSTRUCTION
❑ OTHER
Credit Card -- MC / VISA # EXP.DATE
I hereby authorize Hammer Pumping, Inc. to charge my credit card for the above charges.
I understand that by signing below 1 am agreeing to all charges incurred on this ticket and
that the work was completed"to,my satisfaction.
n' i� C>loa It)
COMMENTS
-A
_ U
❑ Leach System Failing ❑ Roots ❑ Excessive sludge/grease
SERVICES COMPLETED