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06-0093 (PLBG)P.O; BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 K. Application Number: Property Address: APN: Application description Property Zoning: Application valuation: COP – ft 06-,00000093_: ` 78710'_1VENfiDA TORRES 770 -171 -013 -152 -000000 - PLUMBING LOW DENSITY RESIDENTIAL 1200 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Busin ss and Professionals Code, and my License is in full force and effect. License Class: C36 'cense No.: 650999 Oate :- Contractor:' y OWNER -BUILDER DECLARATION I hereby affirm under penalty o 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, 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 ($500).: 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 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 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 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 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/10/06 Owner: RIDDLE LON 78710 AVENIDA TORRES LA QUINTA, CA 92253 Contractor: D A WES CLARKE PLUMBING INC 35450 PEGASUS COURT PALM DESERT, CA 92211 JAN 9 C (760)345-6166 O C��U Lic. No.: 650999 CITy�F 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 WVS001251201 _ 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 ecome s ject to the workers' compensation provisions of Section 3700 of the Labor Code,hshall fo with cDmply with those provisions. WARNING: FAILURE TO WOR ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TP PMMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000). INA DITION 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 Ouinta, 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 that the bove informat' n is correct. I agree to comply with all city and county ordinances and state laws relating to buil i construct , and hereby authorize representatives of this county to enter upon the above-mentioned prope or inspec purposes. LQPERMIT Application Number . . . . 06-00000093 Permit PLUMBING SEWER Additional desc . Permit Fee . . ... 30.00 Plan Check Fee .00 Issue Date . . . . Valuation 1200 Expiration Date 7/09/06 Qty Unit Charge Per Extension . BASE FEE ------------------------------- 30.00 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 J "COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL N• Q 1 O 9 5 9 8 Received From: CY1 2i .a 8 `-e; u 1 V V;� L+,' �,S 11 ' Date: O 'Address: �g" _.�1 J(P!Yl l I 0r Y —4e—. Account No. ('b�_j b , Q ♦a LOt(S) 1 '� o� Tract -AS- Service Address'TMR G.A..Code ' 0 Meter(s) r ❑ Backflow(s) ❑ House, Lateral (s) ❑ Detector Check(s) h " , 11 .Meter Surcharge C9nitation Capacity Charge 35� O ti � ❑ W.S.B.F.C. ❑ S.I.W.S.C. )" ' O Temporary Construction Meter O Turn on Charge r Ci.'Uncollected Account -Name ❑ Inspection Fee - Tract ... -Fee- 0. Fee-❑• Plan CheckFees Water'/Sewer -+' Trach_.. , ❑ :Bond Payment- A.D. o -Bond Assmt ❑ ,Customer Deposit i ❑ -Other T TOTAL Remarks. Carve p 1 e-� bc►'�1 c 004 �py'to: q - Cash. Water Service Check ii- 1 Money. j ) Order Cashier D-438 (i/05) 7'„-5-+' ^•x -. x ,ry l`C-. - ns. �; I Y ,a - - � ..�,y. .� � iGt,`�`,�y � 4s�' '•`£:i>� -'' h�1��'� ice, �a�'- _" � �� ' f ��...,. w• ` �` a'`'` -`n. - a ' x<e 1 a"d.1J a'Fi�, k�yE 4 •� tZ`a t" .,'i� '�"L�' ..Y t51• 5 . _ • �`� -�h . �` "tm��y�r�`'`�,+��" s x' ,r90 -385e/1222 a � :� - p, a � .• �„� r�':a. w -z' ,� �x� ` 1 � �� ;OU9209433��'• �'' r T '�'�-,�'"i� ,��`: .00 gag 1 Ah ARR � � , .��i.�;,,6� ��r{;��6-64'S7 1� �k��s�kK!'/� �� a� E �G;�•�'r't�„a�3'�4 .�� , t� _ ' � �. �_ i, 5`� '.�-��`n i•!cy a4: ��'� - 6a ,b�i�fr- � � ��5��' r�� 4 `��kd;� �'P��r t�y�� i .. I wr7� 7oita�iG#�.iorFes. €��' CLy 4 t ow? �•as t �q �t.< �- - r ! � f -S.. � •" �. ak -,S� ir° ..og& ✓� r �� Y �' 54. gy - g rf a }�La ;�:�:ag,' �� ra Washington Street�u ni ?" .� v��7� r"•-` s'h'�4'.i� W+i �CA 97253 f ` •r C � ?� .0 t 2.�•„ � ro � �Y � Yo +� a•5 0�.� �` ,.'�X� k t Si ewK; u 'w0— hMl, N K� M2 [mss .� ,�-� ;�i:�'L�'2�2�2�38.��i5�Bs5ii: -.r 2SSgY•"�fx"{�.5'��it�t� �00,•9..tp � �r�2-0�9�;��,3 l��'`;�^�5s �`x i7 iAq��k��F��.kc�"t"� �1 �.K d Total Permit Fees Bin # e City of La Quinta Building u Safety Division Permit # A P.O. Box; 1504, 78-495 Calle Tampico , -13 La Quinta; CA 92253 -.(760) 777-.7012 o 6 Building Permit Application and Tracking Sheet Project Address: G►�(119 wner's Name: O9. A. P. Number: . Address: / U. ,4C /l I �/ Legal Description: City, ST, Zip: ��Contractor: Ccs � Telephone: � � • �z , - Address: Project Description: City, ST, Zip: P - Telephone: State Lic. # : �p City Lic. "iD62f O% Arch., Engr., Designer: Address: - City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one):.. New . Add'n Alter Repair Demo Name of Contact Person: u Sq. Ft.:#Units: Telephone # of Contact Person: Estimated Value of Proj-03z no APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd, TRACHING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Calcs. Plans. Picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan r' 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, ready for corrcctions/issue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees SANCOl� 2502 Mo;ongo Trail PUMPING SERVICE Palm Springs, CA 92264 (760) 327-8859 No. 012645 SOLD J..Q.11 '--C.F3✓(.�fi.1+ I r(.fIiw�s( ^'" , TO SHIPPED S! cz-4 .e STREET `7 1� 7/6 STREET DATE CITY ,/- STATE ZIP CITY STATE ZIP CUSTOMER ORDER % SAL+ESS,,MAAN..TERMS F.O.B. DATE .® - PAYMENT.DUE UPON RECEIPT