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07-1729 (PLBG)le t r I P.O..BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 04-40M We ff�# Application Number: 07-0.0001729 Property Address: 53720 AVENIDA CORTEZ APN: 774-102-011-14 -00'0000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 8000 Applicant: Architect or Engineer: ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I hereby affirm under penalty of perjury that Fam 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: C42 I A AlLicenseNo.: 661018 f Date: v Contractor:. Gt aL OWNER -BUILD R DEC;TION I'here6y affirm under penalty of perjury that l 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, after, improve, demolish, or'repairrany '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 Ueense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the, Business and Professions Code) or that: he or she rs exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permitsubjects the applicant•to a civil penalty of not more than five hundred dollars (5500).: I, as owner of the property, or my employees with wages as theirsole 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 town 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, as�owner of the property, am exclusively contracting with�licensedi contractors to construct the project (Sec. 7044, Business and Professions Code: The Cont rectors' 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 pursuent.to the, Contractors"State License Law.). (_) 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: I-QPER1uT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/15/07 Owner- DOMINGUEZ LORAINE 53-72.0 AVENIDA CORTEZ LA QUINTA, CA 02253 Contractor: HAMMER PUMPINGLL'' 1 48 CATHEDRAL 4CITY., 922JUN (760,)360-7448 QWNTA tic. No . e 66101E3 CITY OFLA _.,�er 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 LaborCode, for the performance of the work•for which this permit is issued. I haveiand•will maintain workers' compensation insurance, as required by Section 3700 of the.Labor code, for the performance of thework.for which this'permit is issued. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number 1828655-2007 _ 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'subiect'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 Cod s II forthwith c p w those provisions: Date: �rs-6 Applicant: � t 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,agreesrto, and shall defend,indemnifyand hold harmless the City of La Quints, its officers, agents and employees for any actor omission, related to the work being performed under or following issuance of this', permit.. 2. Any permit issued aae 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'certifythat I have read this application=and state that the above irjt_r %._ is correct. I agree to comply with all oily and county ordinances and state laws relating to buildin n ti ere horize representatives of this ounty to enter upon the above-mentioned pro ion purp Date. -'� Signature (Applicant or Ag Application Number . . . . . 07-00001729 Permit . . . . PLUMBING SEWER Additional desc . . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 8000 Expiration Date . . 12/12/07 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 15.0000 EA- PLB BUILDING SEWER 15.00 Fee summary Charged Paid Credited Due --------------------------- Permit.Fee Total ---------- 30.00 ---------- .00 ---------- .00 30.00 Plan Check Total .00 00 .00 .00 Grand Total 30.0.0 .00 .00 30.00 LQPEW,n' JUN -15-2007 11:21 PM P. 01 ` � Q 1 II1 �I II11lMllf��� �1 �1 l�lllll�ll{ I IIIIlAlf VC 1 Bin #. 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 Permit ;# - Project Address: s 3 7D, o AveAlf— . Owner's Name: �rx—lie- ,%,(,ce,Z A. P. Number: Address: 5737�d Legal Description: City, ST, Zip: c�.niw Contractor: " e4- Address: Telephone: �{ Project Description: City' ST, Zip: `CCA\4 -{- Telepbone: 2.60J State Lie. # : City Lic. #: ' Arch., Engr.,.Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #'Stories: # Units: Tele hone# of Com P p Zbp — Estimated Value of Proj C90 APPLICANT: DO NOT WRITE BELOW THIS. UNE # Submittal Req'd Reed TRACMG • . PERMU FEES Plan Sets Plan Check submitted ` Item Amount Structural Cala. Reviewed, ready for corrections Plan Check Deposit Truss.Calcs. Caned Contact Person Plan Check Balance Energy Cales. Plans bicked.up Construction. Flood plain plan .. Plans resubmitted Mechanical Grading plan. V. ,Review, ready,for correctionslissue . Electrical Subcontactor List Called ContactTerson . Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans,resubmitted Grading IN HOUSE:- '"' Review, ready for correctionsfusue Developer Impact Fee Planning Approval Called ContactPerson Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees.