07-0271 (PLBG)' P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07_00000271 '—_
Property Address: 51655 AVENIDA VELASCO
APN: 773-133-019-7 -000,000-
Application description: PLUMBING .
Property'Zoning: COVE RESIDENTIAL
Application valuation: 4850
Applicant: Architect or Engineer:
----------------------------------------------------
'LICENSED CONTRACTOR'S DECLARATION -
r�,, I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with -
Section 70001 of Division 3 of the Business and Pr a si als de, aond my License is in full force and effect.
License Class: A B Licen e,N�t:' 475515 a
Date:' I 1 C- Contractor.
-- OWNER -BUILDER DECLARATION
1 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,
oconstruct, 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 70001 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 fivehundreddollars 15500).:
( 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
'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 intendedor offered for sale. If; however, the building or improvement issoldwithin
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 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. B.&P.C. for this reason '
1 Date: Owner:
CONSTRUCTION LENDING AGENCY w _
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
. t 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: 1/25/07
Owner:
BROWN RHONDA L
51655 AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor: 2007
TRI STAR CONTRACTI INCJAN
P.O. BOX 542
CATHEDRAL CITY, CA 22 ' 4 CITY OF LA QUINTA '
(760)321-0898 FINANCE DEPT.
Lic. No.: 475515
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 irisurance, 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'STATE FUND . Policy Number . 0019798-2006
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 became 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 Code, I shall forthwith comply vitft se provisions.
Date: Z 6 Applicant: -
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 ofthis 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 infor tion is orrect. I agree to comply with all -
city and county ordinances and state laws relating to build n constru io , an etebp'aujhorize representatives
of this county to enter upon the above-mentioned propert or inspecti os S.
tDate_:A? :^Signature (Applicant or Agent):
Application Number . . . . . 07-00000271
Permit . . . SEWER•
,PLUMBING
Additional desc .
Permit Feel 30.00
Plan Check
Fee
.00
Issue'Date..
Valuation
4850
Expiration Date,. 7/24/07
z
Qty Unit Charge Per
Extension
BASE•FEE
15.00
•
_ 1.00 15.0000 EA PLB BUILDING SEWER
15..00
----------------------------------------------------------------------------
Special.Notes and Comments
SEWER CONNECTION/SEPTIC ABANDONEMENT.
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
Bin #
City of La Quinta
Building 81 Safety Division *
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
roject Address: 5[,05- AVCq,dQ v<JCkSc-c> #0-ner's Name:
A.P.Number: Address:
Legal Description:CAV' Ync,'k it L&QZ�1111t"'i City, ST, Zip: LX Y)+Q CA q -a
........................
........... .......
ontractor: ................ ...
0, -Tyi -51OV/ C&A+Y&C4-( rV, �Vr Telephone: ...................... ..............
Address: Project Description: I.,- Lq'e' 11CL-4—
City, ST, Zip: s-Lfb evvLo—
Telephone:
'ZI
-U-V' 4-0 Cwt
tate Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
.........
... ........ . ..................
Telephone: ................ ......... Construction T pe: Occupancy:
. ........ .. ............ y
. ............
State Lic. X 0.
...................... Priect type (circle one): New Add'n
..... .... ..................... Alter Repair Demo
Name of Contact Person:0 CY, a Nyw 4 Z- Sq. Ft.: # Stories: 4 Units -
Telephone # of Contact Person: 194-- 2 ,v (Tstimated Value of Project: 91150, Ila_
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance
Title 24 CaIcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, readv for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
ASAP
PUMP/NG' Inc. Lic #C42 855 851
760 328-7887 • 1-800-334-7256
FAX 760 328-6607
P.O. Box 2318 • Cathedral City, CA 92235
CUSTOMER'S ORDER NO.
DATE0 DERED
�7_ -30!,0
ORDER TAKEN BY
DATE PROMISED ❑ A.M.
❑ P.M.
BILL TO -
PHONE
ADDRESS
MEC A'f4 C
CITY
HELP,6R�
��►►
JOB �D •CAT
DAY ARK
DESCRIPTION OF WORK
❑ CONTRACT
❑ EXTRA
QUANT.
DESCRIPTION OF MATERIAL USED
PRICE
AMOUNT
Gallons
Pumping Fed -per 1000 gal.
Camera/Power Snake
Out of Area Fee
Locating / Opening Fee (per hour)
$.75/HR
Size System:
Fuel Charge
$25 0 0
A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS.
18% PER YEAR WILL BE CHARGED ON PAST DUE
ACCOUNTS OVER 30 DAYS.
TOTAL
MATERIALS
/
TOTAL
LABOR
WAIVER: Not responsible for secondary damage such as water
damage, chivppedoconcrete, mark on street or driveways or trees.
SIG ATU � DTE COMPLETED
TAX
TOTAL
JAN -22-2007 01:14 PM RHONDA'L. BROWN 310
5764966 P.02
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p plan Check Fees waw 1 Sewer -
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Tit,/ 4-. 4a. rcv
78-105 CALLE ESTADO - LA QUINTA, CALIFORNIA 92253 - (619) 564-2246
May :17, 1991
To Whom It May Concern:
The structure located at 51-655 Avenida Velasco will be
located'in a "B" flood zone per the revised F.I.R.M. (panels
060709 005 A.and 0010 A)..for La Quinta.. This change will be
effective August 13, 1991. The property is.currently
designated as zone AO (depth two (2) feet).
If•you havelany.questions, feel free to contact me.
Sincerely,
BUILD NG AND SAFETY
J6�
Tom Hartung'
Director of Building and Safety
TH/lc
MAILING ADDRESS.- P.O. BOX 1504 - LA QUINTA; 'CALIFORNIA_ 92253