06-3893 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
f):6'-00003:893
Property Address:
5T5,6 DA CORTEZ
APN:
774-101-003-3 -00.0000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
46.50
Annlirant-
Tiht 4 4 Qum&
Architect or Engineer:
PIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------- I --------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with
Section 7600) of Divisien.3 of the Business and Professionals ode, and 'cense:is in full force and effect.
License Class: A 'B a No.: 08 15515
ate: ontractor:
1,40, Pr7
OWNER -BUILDER DE LARATION
I hereby affirm under penalty of perjury that.I am exempt from the Contractor's State Ucense,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 repairanystrueture, prior to its issuance, also requires theapplicant for the
permit to file a signedstatement that he or she is licensed pursuant to the provisionsof the Contractor's State
License Law (Chapter 9 (commencing with Section 9000) of Division 3 of the Business and Professions Code) or
that he or she is exempttherefrom and the basis for the.alleged exemption. Any violation of Section 7031.5 by
anyapplicent.form permit subjects the applicant to a civii•penalty of not more than five hundred dollars (8500)•:
(_ 1 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
Convectors` State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work, himself or.hersetf 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 I, as owner of theproperty, em 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 I with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _) I am exempt under Sec. B.BP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury thatthere 'is aconstruction 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
VOICE (760) 777-7012
FAX. (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/06/06
Owner:
ARREDONDO HERALDO
P O BOX 2452
INDIO, CA 92202
aContractor:{CTRI
FY
STAR CONTRACTING.,.
�g o
Ci2006
P.O. BOX 5.42
CATHEDRAL CITY, CA 92
(760)321-0898
Lie. No.: 475515
------------------
WORKER'S COMPENSATION DECLARATION
I herebyaffirm under penalty of perjury 'one ;of the following declarations:
_ I have and will mainta(ma certificate of consent to self4nsure forworkers' compensation, as provided
for by Section 3700 of the.Labor Code, for the performance of the work for which this permit is
issued.
Yl1 have and will maintain workers' compensation insurance, as required•by Section 3700 of the Labor
Code, for the,perfonnance of the work for which tfiis permit is issued. My workers' compensation
insurance.cerrierand policy numberare:
Carrier STATE FUND Policy Number 0019798-2006
_ 1 certify that, in the performance of the work for which this permit is issued, I shall not employ any
persomin any manner so as to become subject to the wor compensation laws of California,
and agree that if I should become Vt he workers' o pensation prvisions of Section
3700 of the bor Code, I all foply with a provisions.
plicant:
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 (8100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 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 resulYof this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quints, Its officers, agents and'employees4orany:act or omission related to tha 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 1B0 dap 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 corrert,,- I agree to contply with ell
city,ppd county ordinances and laws relating to.buildin struction, a her authorize reptatives
of is county to enter upon t - bove-mentioned proper[ - r inspection _
Date: flA ature (Applicant or A
7
Application Number
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . .
Expiration Date . .
. . . . 06-00003893
PLUMBING SEWER
30.0.0 Plan Check Fee .
Valuation . . .
5/05/07
. 0 0.
4650
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 30.0.0
Plan Check Total .00 .00 .00 .00
Grand Total 30.00 .00 .00 30.00
LQPERMT
Bin 9
Permit le
• City of La Quints .
Building & Safety Division
P.O. Box 1.504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
i�
Z
Owner's Name: �D� �-
A. P. Number.
Address:
Legal: Description:
City, ST, Zip:
Contractor: r (
-�'t:. _
Telephone:
Address:
L e mk—
\?4Q4-0
Project'Description:
City, ST; Zip:
QZ�
Telephone: ZS`i
State Lic. # :
City Lic. #:
Arch.,.Enge, Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person
Construction Type: Occupancy:
Project type (circle one):. New - Add'n Alter Repair Demo
�( ,y�y.� Sq.'Ft : # Stories #Units:
Telephone # of Contact Person:
Estimated. Value of Project:
APPLICANT: DO NOT WRITE BELOW'THIS LINE
p
Submittal
Req'd
Reed
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calca.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy .Calim
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan
V Review, ready for correctiouslissae
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted .
Grading
WHOM:-
''' Review, ready for correctioi�s/issue
Developer ImpactFee. r
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of,permit issue;
School Fees
Total Permit Fees.-,. -.
Nov 02 06 10:20a ELC CIIT 7604822870 p.1
: VALLEY WATER DiSTRW Q45H MCWT MAIL N! 116421
Received
tj
oI
Address: jL-
s
MM'M No.
Tract
Service Add reaa `
DA Code
0 Meter(e)
S
❑ Service(s)
❑ Sackflow(s)
O House Lateral(s)
O Detector Chack(s)
•
Ca�Ry
d Charon L. : J V
��_L? J [.L
❑ W.&IL C
❑ s.i.rus.c.
❑ Temporary Construction Meter
❑ Tian on Cha -
❑ lhrcollected Account - tiamfl -
❑ Inspection Fee - Tract -
Fee -
O Plan Check Fees Water / Sewer -
Tract -
❑ Bond Fayment - A.D. - Bond Asunt
❑ Customer Depos'
❑ Olher
TOTAL a
Remarks:
Cash
Water Service
Check
Cashier
Money
Order
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