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05-3567 (PLBG)r 4• P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: C05-00003567 54510 AVENIDA.JUAREZ 774-263-001-24 -000000-[IF PLUMBING COVE RESIDENTIAL 3000 Architect or E BUILDING PERMIT Owner: aMARRUJO GLORIA MARIE �''v 99999 AUG 1 1 1005 CITY OF LA QUINTA VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/11/05 Contractor: ALMS UNDERGROUND CONST, INC. 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 (760)324-1911 Lic. No.: 482180 ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers'. compensation, as provided License Class: C21 C42 License No.: 482180 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is , I te: ^� Contractor: �� (aO (c U Y% ]� 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier CALIFORNIA INS Policy Number 460093580101 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by A any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: e: /� scant:�[tO ` (_ 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not.intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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. , B.&P.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 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 abov -mentioned property for inspection purposes. . I t D ature (Applicant or Agent): �"�� / / 0 V LQPERMIT Application Number . . . 05-00003567 Permit .. . . . PLUMBING SEWER Additional desc . . Permit Fee . . . . 30.00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 3000 .Expiration Date 2/07/06 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 .00 .00 Grand Total 30.00 .00 .00 30.00 u O'. i, fir, 4 m 1i wj L r.m.N, i cm -) 4. n 74174 COACt'ELLA *VALLEY WATER DISTRICT CASH RECEIPT DETAIL I , VO— 10004400 LTLCAdez--, LA 0, Account Lot(s) Service address 0 Mster(s) 0 Servico I. 1 0 eacAibw(s) i 0 House Lateral(s) C2 Detector Check/, 0 Meter Surcharge — Sanimfion Capacity Gh.Lge 0 W.S.B.F.C. 0 S.MS.C. U Temporary Constructio' Sdeter CJ Turn on Ctkwgo— : 0 Uf1COII&CtW ACCOurit - Lrf-fe-- 0 Inspection Fee - T -ac, Fee Ii- Plan Chpck Fees water 1 Sealer - Tract - - Ol Bond Paymenj - A.D. - Sona- Assmt— !� Cl GuStorner devcsit (Y �..�^ r1y%MNV J Kt',U-5LAJNt (•,A . A�VMQAJ - Tract TOTAL to i kit) I C;Z7 --Q. Water Service F! e M I Copy Cash Chtck ij/ Money UAREZ Cha )564 ,6 5221-v. CA 9225Y . A�VMQAJ - Tract TOTAL to i kit) I C;Z7 --Q. -Or s n -e o 1 2200076C. 0 L, L. E0, 0 58 5 C) :2 � V x AUG -10-2005 1,4ED.02:44PIl TD: PAGE: 1 Water Service rd M .ORIA MARRUJO my DWYER UAREZ Cha )564 ,6 5221-v. CA 9225Y V to 71 4L uc itik-of-America -Or s n -e o 1 2200076C. 0 L, L. E0, 0 58 5 C) :2 � V x AUG -10-2005 1,4ED.02:44PIl TD: PAGE: 1 Bin 11 Permit # Project Address: A. P. Number - *1' l Contractor: A I Name of Contact Person: is Telephone a of Contact Person: M Submittal Plan Sets Structural Coles. Truss Calcs. Energy Coles. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A: Approval IN HOUSE:. Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building at Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: I" �.. � if1 i a► City. ST. Zip: Telephone: Project Description: Citv Lic. sr: x Address: - Zee —43 X City, ST. Zip: X Telephone_. State Lic. Arch., Engr., Designer: Address: City. ST. Zip: Telephone: State Lic. #: A I Name of Contact Person: is Telephone a of Contact Person: M Submittal Plan Sets Structural Coles. Truss Calcs. Energy Coles. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A: Approval IN HOUSE:. Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building at Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: I" �.. � if1 i a► City. ST. Zip: Telephone: Project Description: Citv Lic. sr: I I Total Permit Fees Construction Type: Occup ancy: ' Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: N Stories: 8 Units: stimated Value of Proiect: APPLICANT: DO NOT WRITE BELOW THIS LINE Rec'd TRACKMG PERMIT FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Klechanical 2'' Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S.I.I. Plans resubmitted Grading Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.1.P.P. Date of permit issue I I Total Permit Fees SANCO! I=L 2502 Morongo Trail PUMPING SERVICE J Palm Springs, CA 92264 X.(760) 327-8859 N0. 012425 SOLDTTO SHIPPED TO �i F.O.B. DATE � STREET STREET AD CITY ✓ STATE ZIP CITY STATE ZIP CUSTOMER ORDER 4SALftSMAN � TERMS F.O.B. DATE � AD PAYMENT DUE UPON RECEIPT