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11-0421 (PLBG)'P.O.4 BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSP CTIONS (760) 777-7153 BUILDING PERMIT. Da 4%27/11' Application Number: 00000421 — Owner: Property Address: -- 54560 AVENIDA VALLEJO FARROW STEPHEN APN: 774-282-004-21 -000000- 54560 AVENIDA VALLEJO O �M Application description: PLUMBING LA QUINTA, CA 92253 r� Property Zoning: COVE RESIDENTIAL Application valuation: 3200 u' Contractor: Applicant: Architect or Engineer: HAMMER PUMPING INC u P O BOX 2448 G CATHEDRAL CITY, CA 92235, (760)360-7448 Lic. No.: 661018 - ---=--------------------------------------------- LICENSED C CTOR'S DECLARATION - - I hereby affirm under penalof perjury tha am lice ed under visions of Chapter 9 (commencing with Section 7000) Divisio 3 of the Business d Prof ss Is Code and my License is in full force and effect. Licen lass: 42 Lic o.: 661018 Date: 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 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.). - (_) 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 ------------------ WORKER'S COMPENSATION DECLARATION 1 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. V_ 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 SELF - INSURED Policy Number 2246 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any m ner-s s to becom the workers' compensation laws of California,' nd a gr t ,-if'I should ecome s act to the - orkers' com enation provisions of Section 9 P 700 of Labor Code hall f twit pl with those provisions. pplicant: WARNING: -FA LURE 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 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 ce)rpoWi. n of work for 180 -.days will subject permit to cancellation. I certify that I have read this application and sta at the•abo informatcorrect. I agree to comply with all city and ciunty dinances and state laws rI ting to building,c structio1m-rn-h�v-n� orize representatives of this county tolenter uoon,the above-mentioned property for spection LQPEPMIT' - Application Number . . . . . 11-00000421 Permit .. . . PLUMBING SEWER Additional desc . Permit Fee . . . . 30.00 Plan Check Fee.. 00 Issue Date . . . . Valuation 3200 Expiration Date 10/24/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00. ---------------------------------------------------------------------------- Special Notes and Comments SEPTIC ABANDON, SEWER CONNECT. 2010 CODES -------------------_------------------------------------------------------- Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 A0 31-.00 LQPEPMIT' - Bin # Qty of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quint;, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I I a,I l Project Address: Owner'sName:_— r A. P. Number: Address: S q 5 (d O Aj F—& L L C— S 0 Legal Description: City, ST, Zip: L 6, — Q i Contractor: ( ` � (� V S -� ry Y.�;i'<^Y;,'•;.c7_�,:;.;fit`.`,;.. Telephone: «y �k;,s��«<•>':;: �;�,�>:f: Address: `' �% �S�z `�� Lli" Project Description: City, ST, Ziip:// /2c Telehone:3 L(((, p 1 l4 C)• ('ad •;1;i::.::w.tjcfti.„.:•d,:<:• n .:�::�a:��:...;•:.<°::f State Lic. # : City Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: r.,u .{. ;:.y;•:Sri \.vn�iiiii': is .f�.!: g ;nuc::;? f.,;:::::>. ;;.:;y>;:;<.: �:'.�,••:�.:.::..:.>4..:.,..h:::..:. Construction Type: Occupancy: State Lic. #:;;}„•• Project type (circle one)(TRAdd'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: — APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Pian Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 20° 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:- ''a 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 W ATe . • 4 COACHELLA VALLEY WATER DISTRICT ®ls�Tia+� P.o." Box 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date:4/19/2011 SUBJECT: SCC ONLY-54,560 AVENIDA VELLEJO, LQ, 774-282-004 - FARROW, STEPHEN A c Project: 54560 AVENIDA VALLEJO 11-2885 Project Date: 4/19/2011 LA QUINTA, CA 92253 Amount Due: $4,231.00 GEO: 06-06-13-1 �• Planner: CAROL PFANNKUCHE TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH, • 'REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 1 `` h r - '* k` r - b ° 7 :' ..'-,', o ,,.,rs.c'zdr.,. ' • ' f / ' 7-r. ro d 1.00 SCC-COLLECTION $1,836.00 $1,836.00 $2,395.00 $2,395.00 Lt7AMILA VALLEY aA ER Di-STRICT $4,231.00, cJper: CA iIE�TOMER RECEIPT Tyre: OC' Drawer- Date: '4/20/11 @2 Receipt ni a P: 657775 DescriRtiont 211 ynto y . Rnount t PZ > �Itia�VIt+1i 5 G6lt1EERi% 1.00X4231. d`i? t y Trans nusber: 1t-�5n5 ?.7374? JL 'c'Yi�P DA i+�j tender detail CK CHECK Total tendered '4`3'•=� , Total paysenti $4231. f$ Trans date:i 4/i9/12 Ti3e: TIE: 42:23 %QAC; TELL 41. V/sLLIE- Y *!PIE MSERVATION irc ITEK eIIcEL ATER Cil TRICT SY-. , (762) 2-:28-7z51 SUBJECT: SCC ONLY— 54560 AVENIDA VELLEJO, LQ, 774-282-004 COACHELLA VALLEY WATER P.O. BOX 1058, COACHELLA, CALIFORNIADIS92236C(760) 398-2651 Page 1 - -- P.O. BOX 2448 • Cathedral City,, CA 92235-2448 • LIC# 661018 JOB DATE: TIME IN: JTIME OUT. TECHNICIAN Bt TECHNIC ORDERED BY: - P.O. k START DATE; Y` ED www.hammerpumping.com 760/360-7448 7601321.7448 FAX 760/324_-6434 JOB LOCATION Customer Namea -+ //7 Z�C! , , f , 5 () sZ/f 0 1/d \` Address Q IP ZA A. / C) City Ph# Additional Service -❑ Required ❑Recommended Description/Remarks/ Drawings SERVICE ❑ BACK UP ❑CONTRACT MAINTENANCE ❑ REPAIR ❑ MAINTENANCE ❑ ESTIMATE CONSTRUCTION ❑ OTHER. I= :redit Card — MC i VISA # FJCP.DATE I hereby authorize Hammer Pumping, Inc. to charge my credit card for the above charges. I understand that by signing below I am agreeing to all charges incurred on this ticket and that the work was completed to my satisfaction. X��A JOB INVOICE System Failing ❑ Roots ❑ Excessive SERVICES COMPLETED PUMPING PLUMBING CONSTRUCTION SERVICE ta,SEPTIC' ❑ Water Line ❑ Leach Line ❑ Snake I Rooter SEEPAGE PIT ❑ Sewer Line ❑ Seepage Pit ❑ Hydro Jet ❑'GREASE El ❑ Gas Line Toilet ❑ Sewer Hook -Up Video Inspection E]P ❑ DRYWELL ❑ Water Heater ❑ Tank Install ❑ C-42 ❑ CATCH BASIN ❑ Hose Bib ❑ Landscape Drains El Products /Parts ❑OTHER ❑ Fixture ❑ Other ❑ Leak Detection QTY SfERVICE! d ry t✓ "tel AMOUNT. TOTAL NEXT SERVICE - DUE ON ❑ Billing TOTAL AMOUNT DUE ;' ❑check# A service charge of $20 will be due on all returned checks, 18% per year will be charged on past due accounts. MAMM Problem'Solved!