07-0244 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
-=-•0��.0.0_0OD.2�A4--•% -
79621 CORTEZ IN
649-0.51-014-14 -2667
PLUMBING
LOW DENSITY RESIDENTIAL
3030
Architect -or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
JAN 22 2007
Owner:
M/M MCMANUS
19621 CORTEZ IN
" QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
SERT EMPIRE PLUMBING & DRAIN
JP"O. BOX 183.6
C THEDRAL.CITY, CA 92235
60)328-6417
Lie. No.: 803145
Date. 1/22/07
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 foroe.and effect.
1: have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Ucense Class: C36_ Ucense No.: 803145
_
for by Section 3700 of the Labor Code, for the parformance: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 workfor which this permit is issued. My workers' compensation
OWNER -BUILDER DEC
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 ENDURANCE WC Policy Number WEN00.04170 - 01
following reason:(Sec. 7031.5, Business and Professions. Code: Any city or county that requires -a permit to
_ I certify that,in ths'performanoe 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 forthe
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, H [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, 1 all 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
any applicantfor.a permit subjects the applicant.to a civil, penalty of not more than five hundred dollars (b500).:
�rDetilr' AY,plieanC
(_ ) 1, 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' COMPENSATI OVERAGE 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 (8100,000). 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 3708 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.).
APPLICANT ACKNOWLEDGEMENT
1—) I, as ownerof-the property; am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to,the Director of Building,and Safety for a. permit subject to the
7044, Business and. Professions Code: The Contractors' State Ucense.Law does not apply town owner of
conditions and restrictions set forth on: this,application.
property who builds;orrImproves thereon, and who:contracts'forthe2projects with a contractor(s), licensed
1. Each person upon whose behalf this application is made, each person at whose request and -.for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
f_) I am.exempt under Sec. , B:&P.C. for thWreason
the owner, and the applicant, each agrees to, and shall defend, indemnify and.hold harmless the City
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:
LQpntm r
of La Quints, its off)oers, agenmand 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 186 days will subject
permit to cancellation:
I certify that I have read this application and state that the above information is correct. I agree tocomplywith:all
cityand county ordinances and state laws -relating to building construction,. and hereby authorize representatives
of this county to enter upon the above-mentioned pro for ' �pt+c ' n purposes.
�Os i ftrikuie:(ApOicanti-Ageml:
Application Number . . . . . 07-00000244
Permit . . PLUMBING
Additional desc . .
Permit Fee . . . . 18.00
Plan Check Fee
4.S0
Issue Date . . . .
Valuation
0
Expiration Date ., 7/21/07
Qty Unit Charge Per
Extension
BASE FEE
15..00.
1.0.0 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
------------ ------------------------------------------------------
Special Notes and Comments
NEW 2" POLY GAS PIPE'TO 2 NATURAL GAS
WATER HEATERS'& FUTURE S:TUR(POSSIBLE
POOL).
Fee summary Charged Paid
Credited
Due
Permit Fee Total 18.00
.00 .00
18.0.0
Plan Check Total 4.5.0
.00 .00
4.50.
Grand Total 22.50
.00 .00
22.50
WPERmff
CITY OFLA QUANTA
BUILDING & SAFETY DEPT.
APPROVE
FOR CONSTRUC
Von 000' ort4
Y
79�0�
mac. �,�,,1�- �.• ��'�`
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
1Lr�..
V� Po4y
000
W&rer hfTR. l V
/a
s�
Bin #City
of La Quinta
Building ar Safety Division
P.O. Box 1504, 78-495 Calle Tampico
la. Quinta, CA 92253-- (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:- 7
OwneesName: G oemNS
A. P. Number:
Address:
Legal Description:
City, ST, Zip: A44Qid,//l�7At- Cst • 9!:i ✓��.
Contractor.
Telephon
Project Description:
Address: r 7/ �Q
City, ST, Zip: . q2-26jA
Telephone: J 5�9- Olt
State Lic:# : City Lic: #:�
S
Arch., Engr., Designer.
Address:
City,,ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact•Person: -M7
Estimated Value of Project:. d
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACING •
PERMIT FEES
Plan
Plan Cbeck submitted
Item
Amount
Stru7SCts
l. Cales.
Reviewed, ready for correction
Plan Check Deposit.
Trulcs.
Called Coataet Person
Plan Check Balance.
Energy Cales.
Plan bicked rap
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading: plitn
20' Review, ready for correctioodissue
Electrical
Subcontactor List
Called.ContactPerson
Plumbing
Grant Deed
Plawpicked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for correctionOssue
Developer Impact Fee
Planning Approval
Called ContactPerson
AMP.P.
Pub. Wits: Appr
. Date of permit issue
School Fees
Total Permit Fees
_6