Loading...
9904-037 (PLBG)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am 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 # Lic. Class Exp. Date 422153 CM C42 NNW Date « Signature of Contractor s OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ,.4 ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section B&P.C. for this reason Date Signature of Owner 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 & policy no. are: Carrier Policy No. (This section need not be completed if the permit valuation is for $100.00 or less). () 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 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 with those p ovision Date: �� Applicants - s. u /Warning: Failure to secure Workers' Comprensation cove age is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions Set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) `-g n �)�p .Date BUILDING PERMIT PERMITS. i �! DATE VALUATION�'79��.�� LOT TRACT 1 �yy- r JOB SITE ADDRESS 77-170 CA. LF, ENLEd.UL APN OWNER CONTRACTOR/DESIGNER/ENGINEER 1WAR1 V 8LA KFORD RUT'C R?,00TER 77'770 C/ LL8. ' EMECULA 700 N. S'r11 m S'7'. LA QUINTA. CA 92233 F- EN1,01, CA 92M_3 (•01". i58-8541 CRIR 111" USE OF PERMIT 1.',l,UivdL;ltVt� SEWMI. COM'1 TC -N, SOYUC AIIANOOMRuNT ,�.�} 4i a!i 1! L,.►/ l.V'�'a 1..f!' 411 i� sr.Y YO/J i� d A,iit'� 3� i i�K,t�� PfluM.BiNO FRE -- SGWI.."R 1.014M.419 -0(1U S:1+J:lai `4,1114-71MAL ff.YNS':t'ROC"TT(.liV AND FLAN CT -TEC K ESS. P E-PAJ•T1 RIES TOTAL PERNU FEMS DUE' NOW �ilJ7I•�'tl Y r r RECEIPT r '� DATE BY DATE FINALED INSPECTOR e w i �`r INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Piaster Sewer Lateral Pool Cover Sewer Connection 4-7-22 Encapsulation Gas Piping Gas Test Appliances Final COMMENTS:. Final - Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) FROM PHONE NO. Mar. 09 1999 09:42AM P3 .' PETITION FOR THE ANNEXATION OF CERTAIN LAND TO IMPROVEMENT DISTRICT NO. 55 AND REQUEST FOR SANITATION SERVICE OF COACHELLA VALLEY WATER DISTRICT *etitioner alleges: (1) That it is the owner of certain land in the County of Riverside, State of California, described as: Zg�C4/�� Tract (Name or Number) te17 AXII)eh ,9 A F_ Block 300 Lot / T Record of Survey: Book Page Map Book: Book J�Page 9 Lot — Legal bescription 1v /3 t,� o Z Sec. T S, R E Street Address Assessor's Number (2) That it hereby petitions, requests and consents to the annexation of such land to Improvement District No. 55 of the Coachella Valley Water District. (3) That it understands that the conditions of such annexation are: _ (a) That the land so annexed to such Improvement District No. 55 shall be ysubject to the existing bond issues"and indebtedness of such Improvement District and shad.. likewise be'subj.eat to all assessments, taxes and charges which may be levied within such Improvement District. (b) That the land so annexed to such Improvement District No. 55 shall be subject to the payment of an annexation charge in accordance with the amounts set out in District Rules and Regulations in effect at the time of execution of this petition. (4) That the Board of Directors of the Coachella Valley Water District may proceed with such annexation and conclude the same at any meeting thereof without further 0 otice to petitioner. (5) The undersigned applies for sanitation service subject to all Regulations of the Coachella Valley Water District and agrees to pay a monthly service charge which shall begin ninety (90) days after receipt by the District of this petition (when a District sewer is available) or ninety (90) days after a District sewer becomes available, whichever is later. Any failure to comply with any of the preceding annexation conditions may cause the District to terminate all District services provided the land being annexed herein. (Type or Print). SiQnsturo o! Po�ielor.: arc• oiontaopo� ,^' ��D `r�^ �n �v�� Sianstvro o! i�otiEionor D�io This document requires `ithe f_signatures' of all owners of the above described property. Wount No. Date (FOR DISTRICT USE ONLY) MCR No. Class EDUs ALEX926 915053027 IC97 25_03/10/99 ME EXP RTN TO SEND Un2ETMURNTO E 2-2056 SENDER 3193) - -- 3 Address: Y ML-.) �:�lvr /IV 4 `� `. •i `..��,;` / � / �� • J Vl � L :I Account No. 6 '� r . J �•� _Lot(s) _ Service Address '� /^� �-L IYi� u(.A ❑ Meter(s) Z. ❑ •Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) I ❑ Meter Surcharge Sanitation Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter '❑ Turn on Charge ' ! ❑ Uncollected Account - Name ! ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - • Tract - I• ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit t ❑ Other Remarks: .. ,. �Copy to: � u� Cash Check Money Y Order ;(1 .. r' p - /� 72343 / �7 N43 •Date: A gf3zz„ G.A. Code TOTAL $ Water Service Cashier • .a, T: CVWD-438(11189) • , 1AW ❑HEMET (909) 658.8541 ❑LAKE ELSINORE (909) 674.2312 , � 150120 •' ' ❑ BANNING (909) 922-9491,- 1:1RANCHO/fEMECULA (909) 699 0555' WORK ORDER NO. IT® ❑BEAUMONT,909) 845-3338 ElREDLANDS/YUCAIPA (90>) 797-8697 I: ❑ PERRIS 909 657=9852 ❑ PALM SPRINGS/DHS (760 322-2622 _ ❑ SUN CITY (909) 679-8919 WINDIO/PALM DESERT (760) 346-1736. , DAT ��� - / JOB # w"; Plumbers 790 N. STATE ST.- HEMET, CA 92543 � � Aj. TECH #1 _ _ TECH #2 Toll Free: (800) 491-7696 Fax: (909) 652-9515 ; tIQB NAME PV / PURCHASE ORDER; " w FIXTURE MAIN LINE: FT 0 BATH SINK - - - - - - -� FLOOR DRAIN - - - -� q . � f� Q � ' ' '- '' TOILET - - - - - - - - -0 KITCHEN SINK ----- P FLOOR SINK ------- CLEANED: � :. JOB ADDRESS �.'..,•� {M: BATHTUB ---------0 LAUNDRY ---------0 .AREA DRAIN -------0 77 N - -- ------------ 7770 Z r xY. SHOWER -0 URINAL 0 OTHER 0 { CITY STAT ' QIP + - - - - `110 YES: -GUARANTEE- NO ❑ TIME IN TIME OUT COURTESY INSPECTION t� ` ACCSSEQ VIA, f CAUSE OF STOPPAGE DRAIN CLEANING'. ' + Q DRAINa• ❑ CLEAIRl OUT ; , ❑ ROOTS Q GREASE 1 X - ❑..7ENT ' ' + ❑OTHER ❑ UNKNOWN. ; ADD.'L.FOOTAGE ` V� �.+ FIXTURE OK NEED: $ AUTH. " DESCRIPTION / RE KS'/ REPAIRS NEEDED r, . ADD'L FIXTURES SERV.1� MAIN LINE J� n f r P P `�/JJ //� ~ /// P_LU_M¢ING LABOR �!_ Yip' ��\I'L--/ _ W;.'�+. ` - ♦ _ J. f•4« F_'.' TOILET - PARTS PRODUCTS/TREATMENT 'BATHTUB , - /_ C_ //]/u�/• �1'.. - - w ., /r/� �,_ /yL_,JL� f' �~ VIDEO INSPECTION ` d: SHOWER V! .+� `tPfG. /L/. :V A OATH SINK _;I _ _ . L Y, STS A/ �� S'.. -� - <� HYDRO-JETTER KITCHEN SINK - J,� � ,• MINI JETTER r �. . T/ . si �'�,.,.:'-�-/�f��' 7�/� C_ �._.,_7� *�- '�,,� ��►_ LINE/ LEAK LOC .(ON ' ,DISPOSAL i LAUNDRY ' f T PUMP SEPTIC/G EASE , ' ' -� OTHER N`"" URINAL PARTS ( " //(/�� -�!. I FLOOR D 'IN ( i QTY �RART NO r _ DESCRIPTION _ yl (PRICE µ: - FLOOR SIN ✓ _ I - .� r .r; a TAX AREA DRAIN I' TOTAL � a PAYMENT RECEIVED WATER HEATER%� - - • � . "C/O REQ. PLEASE INITIAL THE FOLLOW 14G: ❑ CASH ❑ CHG ❑ CK '# 11 CREDIT CARD APPROV. # A. The serviceman, discussed Roto- meter products with me., B. I have ben ad ised add' ' rfal lines cleaned at this time are half priced ' CC # EXP.DATE C. I have been advised that running my main line from a roof vent is Improper access and can only be given a 10 CLEAN UP ' day guarantee. In order to get a 90 day guarantee a clean out must be installed. A two inch main line roof vent Q EXCELLENT ❑ SATISFATORY ❑ POOR has a zero guarantee. - Division of RotoCo., Inc. License Number. 422155 - Fedwal ID Number: 33-0475032 CUSTOMER COPY , IGrPE ACKNOWLEDGEMENT COMPL TION 'COURTESY INSPECTION ,. 0 0 f, X ACCESSED VIA CAUSE OF STOPPAGE . ❑DRAIN [)CLEAN OUT ' ' ❑ROOTS "❑ GREASE ❑VENT ❑'OTHER El UNKNOWN DRAIN CLEANING $` ADD`L FOOTAGE *` p "❑. HEMET (909.) 658-8541 0,I]ANNING 922-9491 ❑ LAKE ELSINORE (909) 674-2312 ❑ RANCHOTfEMECULA (909) 699-0555 e ® p w WORK ORDER No..,: ,va.; (909) FIXTURE MAIN LINE ” TOILET `BATH TUB OK T-1 �a�� S Rv ROTER _ ❑ BEAUMONT (909) 845-3338 ❑; CON1V111 1t 1LGHS AND 1LeXCL lV MONS Roto -Rooter Service & Plumbing Co. guarantees the services performed as set forth in this invoice to be free from defect in materials or workmanship for the applicable, time period stated above. If within the Guarantee Period a drain stoppage or other defect in the repair of plumbing fixtures or plumbing parts installed by Roto -Rooter Service & Plumbing Co. occurs, Roto -Rooter Service & Plumbing Co. will clear the drain stoppage or, repair rn• replace (at Roto -Rooter Service & Plumbing Co.'s option) the plumbing fixture or plumbing part previously installed at no cost to customer. subject to the following exclusions and limitations: L This Guarantee applies only to the specific sewer lines cleaned, or plumbing fixtures or plumbing parts supplied and installed by Roto -Rooter Service & Plumbing Co. 2: ,Roto -Rooter Service & Plumbing Co. must receive notice of the detect within the Guarantee Period. 3: This Guarantee does not apply to: a. Multi Unit Dwellings sewer and drain lines, plumbing fixtures or plumbing parts. b. Materials furnished or work performed by other than Roto -Rooter Service & Plumbing Co. e. Drains, sewer lines, plumbing fixtures and plumbing parts which have been misused, abused. damaged ornrodifred by others; d. Drain or sewer line stoppages caused by fbreigir objects, including but not limited ro"�anittuy articles, paper towels, toys, etc.: or e. Sewer lines which are settled, broken, offset deteiiorated, damaged or improperly or illegally installed. f. Stoppages caused by septic systems, 4. The Guirantee Period commences on the date or original service and shall not be extended by subsequent services or repairs made pursuant to the terms of the Guarantee. The Guarantee hereunder extends to the customer invoiced for the services and is not transferable. 5. Roto -Rooter Service & Plumbing Co.'s liab_lity hereunder shall be limited to recleaning of drain or sewer stoppage (Max. two repeat visits) or the repair or replacement of defective plumbing fixtures or plumbing parts: Roto -Rooter Service & Plumbing Co. shall not be liable for (1) Incidental or consequential damages: (2) "dater or other damage; (3) Loss of use: or (4) Loss of anticipated benefits or profits; any of which result from the furnishing of services or products, or from the breach of die Guarantee, even if Roto -Rooter Service & Plumbing Co. knew of the likelihood of such damages. 6. Any implied warranty of merchantability, or fitness for a particular purpose of use, shall be limited to the duration of"the foregoing written guarantee. The foregoing �aritten gutrrantee is the customer's sole and exclusive remedy and in lieu of all other guaranties and warranties, express or implied. written or oral. This guarantee may only be modified in writing, signed by an officer of Roto -Rooter Service &Plumbing Co. 7. This guarantee does not apply in the event customer breaches any of the Terms and.Conditions of service. including but not limited to timely payment of all charges. TERMS: llgET 10 DAYS. A 1Fl[NANCIE CHARGE will be computed on the unpaid balance by a single period rate of l-1/2% per month, which is an ANNUAL PERCENTAGE RAT1E OF 181%. "State law require% any one who contracts to do construction work to be licensed by the Contractors State License Board in the license category in which the contractor is going to be working - if the total price of the job is $300 or more (including labor and materials). Licensed contractors are regulated by laws designed'w protect the public. if you contract with someone who does not have a license. The Contractors State License Board may be unable to assist you tviti. a complain. your only remedy against an unlicensed contractor may be in civil court, and you may be liable for damages arising out.of any injuries to the contractor or his or her employees. You may contract the Contractors State Licensc Board to find out if Illi, contractor has a valid license. The board has complete informa of licensed contractors including any possiNe suspensions. revocations. judgements and citations. The board has offices throughout check the government pares of the white pages for the office nearest you or call (800) 321-CSLB for more information" 01 (Single) Family Owner Occupied t 1. Basin, Tub, Shower, Kitchen'Sink, Laundry and Sewer in Good Condition with Clean Out ..:.90 days 2- Seger From Root Vent (2" Roof Vent -G Guarantee) '. .......... ........................10days. 3. Toilet Stoppage and Area Drain..................................................10 days Single Family dental (Single .9nit Only) ......................... ....................30 days 5. All Plumbing, Repairs and Replacements...............................1 Year Parts & Labor CON1V111 1t 1LGHS AND 1LeXCL lV MONS Roto -Rooter Service & Plumbing Co. guarantees the services performed as set forth in this invoice to be free from defect in materials or workmanship for the applicable, time period stated above. If within the Guarantee Period a drain stoppage or other defect in the repair of plumbing fixtures or plumbing parts installed by Roto -Rooter Service & Plumbing Co. occurs, Roto -Rooter Service & Plumbing Co. will clear the drain stoppage or, repair rn• replace (at Roto -Rooter Service & Plumbing Co.'s option) the plumbing fixture or plumbing part previously installed at no cost to customer. subject to the following exclusions and limitations: L This Guarantee applies only to the specific sewer lines cleaned, or plumbing fixtures or plumbing parts supplied and installed by Roto -Rooter Service & Plumbing Co. 2: ,Roto -Rooter Service & Plumbing Co. must receive notice of the detect within the Guarantee Period. 3: This Guarantee does not apply to: a. Multi Unit Dwellings sewer and drain lines, plumbing fixtures or plumbing parts. b. Materials furnished or work performed by other than Roto -Rooter Service & Plumbing Co. e. Drains, sewer lines, plumbing fixtures and plumbing parts which have been misused, abused. damaged ornrodifred by others; d. Drain or sewer line stoppages caused by fbreigir objects, including but not limited ro"�anittuy articles, paper towels, toys, etc.: or e. Sewer lines which are settled, broken, offset deteiiorated, damaged or improperly or illegally installed. f. Stoppages caused by septic systems, 4. The Guirantee Period commences on the date or original service and shall not be extended by subsequent services or repairs made pursuant to the terms of the Guarantee. The Guarantee hereunder extends to the customer invoiced for the services and is not transferable. 5. Roto -Rooter Service & Plumbing Co.'s liab_lity hereunder shall be limited to recleaning of drain or sewer stoppage (Max. two repeat visits) or the repair or replacement of defective plumbing fixtures or plumbing parts: Roto -Rooter Service & Plumbing Co. shall not be liable for (1) Incidental or consequential damages: (2) "dater or other damage; (3) Loss of use: or (4) Loss of anticipated benefits or profits; any of which result from the furnishing of services or products, or from the breach of die Guarantee, even if Roto -Rooter Service & Plumbing Co. knew of the likelihood of such damages. 6. Any implied warranty of merchantability, or fitness for a particular purpose of use, shall be limited to the duration of"the foregoing written guarantee. The foregoing �aritten gutrrantee is the customer's sole and exclusive remedy and in lieu of all other guaranties and warranties, express or implied. written or oral. This guarantee may only be modified in writing, signed by an officer of Roto -Rooter Service &Plumbing Co. 7. This guarantee does not apply in the event customer breaches any of the Terms and.Conditions of service. including but not limited to timely payment of all charges. TERMS: llgET 10 DAYS. A 1Fl[NANCIE CHARGE will be computed on the unpaid balance by a single period rate of l-1/2% per month, which is an ANNUAL PERCENTAGE RAT1E OF 181%. "State law require% any one who contracts to do construction work to be licensed by the Contractors State License Board in the license category in which the contractor is going to be working - if the total price of the job is $300 or more (including labor and materials). Licensed contractors are regulated by laws designed'w protect the public. if you contract with someone who does not have a license. The Contractors State License Board may be unable to assist you tviti. a complain. your only remedy against an unlicensed contractor may be in civil court, and you may be liable for damages arising out.of any injuries to the contractor or his or her employees. You may contract the Contractors State Licensc Board to find out if Illi, contractor has a valid license. The board has complete informa of licensed contractors including any possiNe suspensions. revocations. judgements and citations. The board has offices throughout check the government pares of the white pages for the office nearest you or call (800) 321-CSLB for more information"