06-0698 (PLBG)P:O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00000698
Property Address:
55377 SOUTHERN HILLS
APN:
775 -181 -023 -
Application description:
PLUMBING
} Property Zoning:
LOW DENSITY RESIDENTIAL
r` Application valuation:
1000
Applicant:
Architect or Engineer:
�IG1�1,IGt/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
0
FEB 1 f
CJS Cu L4 QI//Alra
----------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury a I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus eVand Professionals Code, and my License is in full force and effect.
Licensne/Class: Ell License No.: 594043
Date p` ^Qv Contractor:
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 17e, empt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business andsions 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 exempttherefrom 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 (5500).:
1 _ 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 intendedoroffered 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
�j improve for the purpose of sale.).
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.).
( ) 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: '
1
LQPERMIT
Owner:,
GREG JOHNSON
55377 SOUTHERN HILLS
LA,QUINTA, CA 92253
1!
Contractor:
7C'S CONSTRUCTION & MAINT
48236 VPSTA DE NOPAL
,LA QUINTA, CA 912253
(760)564-5811.
Lic. No.: 594043
VOICE (760) 777 -7012 -
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/16/06
WORKER'S COMPENSATION DECLARATION
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 EXEMPT Policy Number - EXEMPT
I certify that, in the perfor nce of the work for which this permit is issued, I shall not employ any
person in any manner as to be ome subject to the workers' compensation laws of California,
and agree that, if I sho Id baconsubject the workers' compensation provisions of Section
3700 of the Labor Co e, I shat orthwit comply with those provisions.
Dat I _01 Applicant:
WARNING: FAILURE TO SECURE WO KERS' C PENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER'TO CRIMINAL PENAL IES 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 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
L- - permit to cancellation.
I certify that I have read this application and state that t abov information is correct. I agree to comply with all
city and county ordinances and state laws relating to b Iding c nstruction, and hereby authorize representatives
of this county to enter upon the above-mentioned prop y for nspecti purposes.*
Date + 0 Signature (Applicant or Agent):
4
•
Application Number 06-00000698
'
Permit PLUMBING
Additional_:desc-
`
Permit -Fee. 18.00
Plan Check_ Fee
4_'.50 -
Issue Date
Valuation
0
Expiration Date .-8/15/06
=a
Qty Unit Charge Per
Extension
'
BASE
FEE
15:.00
7'
1.00 3.0000. EA PLB GAS PIPE 1-4 OUTLETS
3.00
,.
------------------------------------------------
• Special Notes and Comments
,�•
}
ADD._38 LF NEW. GAS =LINE TO FUTUR'Ek
•
APPROVED APPLIANCE. `
Fee' summary ""ChargedPaid
Credited
Due
-----------------
Permit Fee Total. 18.00,..
.00 ;.00
4
18.00, `
.t
Plan Check Total: 4.50
.00 .0.0
4.50"
Grand Total 22.50
00 -.00
22.50
LQPERMIT
- -
_
®, NSW GAS'��Np �� �� ®�e� is i �-h -��4Cer in��'rC• Y(:'i�ow�
t
1
A RE INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
CITY OF LA QUINTA
SUILDING $ SAFETY DEPT.
--
''APPROVED"
^"FOR CONSTRUCTION
04-
DA a'!G'ob
Ire-
zw
r
" � � WUA)
jjV?t
Moi )ws famoo 1,101
Bin #
City of. La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: (3- re '
yv50A/
A. P. Number:
Address: %'7 .SOV+�Pw I .
Legal Description:
Contractor: C S ca/S
City, ST; Zip: v lr� S
Telephone:m
Address: 1� o' �� a ,
Project Description:
City, ST, Zip: I`/ CL Cl J
�J'y 3 cQ
Telephone: (_ �0.�
-' 'd • _ ,
I1� = �/� Ini. GQj
State Lic. # : . I J O.y f City Lic: #:
Arch., Engr., Designer:
h'N(f 1 L flri U(
Address:
City, ST, Zip:
Telephone: �
qa, �
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories::#
Units:
Telephone # of Contact Person:
Estimated Value of ProjectO ()UC)
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
Plan Check Deposit
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/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
11.0.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'`" Review, ready 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