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06-1423 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00001423 Property Address: 52719 AVENIDA VELASCO APN: 773-294-024-11 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL- ESIDENTIAL-Application Applicationvaluation: 3800 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: ----------------------------------------------i UCENSED ONTRACTOR'S DECLARATION hereby affirm under penalty of per' that m lic nsed under provisions of Chapter' 9 (commencing with Section 7000) of Division 3 of t Business a d P siona Code, and my License is in full force and effect. License Cl4ss: C42 L ense No.: 661018 . oat -A -116h oat—A—r ctor• OWNER -BUILDER DECLARATION I 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 cityor county that requires a permit to construct, 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 7000) 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 five hundred.dollars ($5001.: 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 ' f Contractors' State License Law does not apply to an owner of property who builds or improves thereon, r 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 i. 'improve for the purpose of sale.). 1 _ 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 C - 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 Owner: MITCHELL BRENDA 52719 AVENIDA VELASCO LA QUINTA, CA 92253 Contractor: HAMMER PUMPING INC P O BOX 2448 CATHEDRAL CT,'T'Y, CA 92235 (760)321-7448 Lic. No.: 661018 VOICE (760) 7771'1012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/07/06 ------------------ 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 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 insurance carrier and policy number are: Carrier STATE FUND Policy Number 13717252006 I certify that, in the performance of the work for which this permit is issued, I shall not employ any' person in an s to beco a subje the workers' compensation laws of California, and. agree at, if 1 should ecome bject to e w rkers' compensation provisions of Section 700 of he Labor Code, all hwith comp) h those provisions. /Date: scant: 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 1$ 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 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 tha information i corr ree to comply with all city and county ordinances and state laws relatin o building co struction, a d her rite representatives oft ' cou ty t enter upon the above-mentio d propert for ' spection rposes. Date: ignature (Applicant or gent): Application Number 06 -0.0001423 -- Permit PLUMBING SEWER I Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date- Valuation ". 3800 Expiration Date 10/04/06 Qty Unit Charge Per Extension. -� BASE FEE 30:00 Special Notes and -Comments SEPTIC ABANDONEMENT/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 LQPERMIT - h Bin# �. ��A. •. Uty, of La ;Qu n Building` a Safety Division P.O. Box 15.04, ,78-49.5'Calle Tampico` Ls Quints, CA 92253 : (760) 777-7012 ..Building Permit A li • g pp cation and Tracking Sheet - • Permit #' , Project Address:'Owner's Name: A. P. Number: Address,:..52; Legal Description: , . City, ST, Zip: L A '.. li l� • - ZZ�L . Contractor'. Telephone;9 0 2--.30 Address: Project • Description: - City, ST, Zip: y ;. a SS ?`7 L Telephone: ------------ State Lic. #.: City. Lic. #: Arch., Engr., Designer: t Address: City, ST, Zip: .. �.' Telephone: State Lic: #: Name of Contact -Person: k Construction Type: Occupancy: ' Project type (circle one): New: A_ dd'n. Alter . Repair 'Demo Sq. Ft.; #Stories: #Units:. Telephone # of Contact -Person: - 6v Estimated Value of Project: dp—. '. APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING . PERMIT FEES Plan Sets , Plan Check submitted' Item Amount Structural Calcs. Reviewed, ready for corrections a Plan Check Deposit F # Truss Calcs. Called Contact Person Plan Check' Balance Energy Calcs. Plans picked up Construction Flood plain plan. Plans resubmitted Mechanical Grading. plan 2"" Review, ready for corrections/is"sue 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, ready for corrections/issue Developer Impact Fee Planning Approval_ Called Contact Person Pub. Wks. Appr Date of permit issue ,. School Fees • Total Permit Fees JOB INVOICE y POST OFFICE BOX 2448 CATHEDRAL CITY, CA 92235-2448 (760) 360-7448 (760) 321-7448 LSC. #661018 Date s Ordered b Y Bill To Cust. Order # Address Ph. # City Mechanic f i �./ Job Name and Location s%�,� ^ r ��- ,, Helper . Description of Work 4. S Amnt. Pumped Gal []Septic Tank ❑ Seepage Pit4' ❑ Cesspool ❑ Grease Trap ❑ Other ❑ System is Failing ❑ System Passes ihsi pec(ion ❑ Excessive Sludge ❑ Roots Quantity Description of Work or Material Used Price Amount �^ Pum & DumpFee per 1000 al j l A Locating & Opening Fee(per hour Septic Inspection Out of Area Fee Fuel Surcharge Snake Line ❑ Roof Video Pie Inspection Camera 1st hour Additional hours High Pressure Water Jet Additional Hours Labor per hour A service charge of $20 will be due on all returned checks 18% per year will be charged on past due accounts over 30 days Total 3t/'. �; Paid By .' ` -Na Next Service Due Check # ❑ MasterCard/ Visas' ❑ BillingOn Card # ,Exp_ -Date Signature Date Completed 3 x.-06 2006 1.3.;56 ..4B H01 -'E :FDX TONE ' ' R/VBdFfpjry i i i ray J. o„r Ar.` RIC7 CA,$}l IPTI NAIL 1 Y" l tlleae �' «J �/ t r L . ,•r te�`--++z+_ i .�.��� V4: O Houee:.Leterel(ej LO ae>pcmrCfiedctaj . D Ate18t Sitrd,tr _ t `5.PhQ lon Cepadty Charge O wo.a.FC. p Taw "m Mleie► IJ tum On Chn [] unoolleated qpm _ Na�n f 0 bwpecftn Feb-71act- F— d Plan ChecJc Fees Water/ S&W _ Team—..- Sow eamx— Bond ftYme!rt - A.D. - - O Cus=omsr Doposn - D t2r,CoAY to: 16014 .7 2?44 P 02102 . . —}. TOTAL .136 :Dale` - TOTAL P.02 ! '