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04-3716 (PLBG)a�Q 'ce R 27 2004 Cl/ V OF LA QUINTA ANCEnFo, BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760) 777-7012 (; OF��` 78-495 CALLS TAMP.ICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760)777-7153 BUILDING PERMIT Application Number . . . . 04---0-0-003-716f Date 4/27/04 Property Address . . . . . . 51295 AVENIDA DIAZ APN: 773-043-030-4 -000000- Application description-. PLUMBING Property Zoning MEDIUM DENSITY RES Application valuation_ 3000 Owner Contractor KIM ERIN H ALMS UNDERGROUND CONST, INC. 51295 AVENIDA DIAZ 38.703 VISTA DRIVE LA QUINTA. CA 92253 CATHEDRAL CITY CA 92234 WCC: VIRGINIA INC WC: 00500016007 01/01/05 CSLB: 482180. 11/30/05 CCC: C42 -C21.• ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING SEWER Additional desc Permit Fee 30.00 Plan Check Fee .00. Issue Date Valuation 3000 Qty Unit Charge Per Extension BASE FEE 30.OG 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 P.O. BOX 1504 a VOICE (760) 777.7012 78-495 CALLS TAMrico FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: f2t - 37/ b Applicant: Applicant's Mailing Address: Date: Architect or Engineer. Architect or Engineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS LKXNSED CONTRACTOR'S OECLARATIOH I hereby affirm under penalty of perjury that I am licensed under provisions of Chaplet 9 (commencing with section 7000) of Division 3 of the Business and Prolessionsis LkxnCode. e'License Is f�fo��and el(edLicense No. g - Date —'-7AD f- 2ZDConaxmr -^ s lel h Ir ro L., C U N S r -BUILDER DECLARATION I hereby affirm under penalty of perjury flat I am exempt from Mro Contractors' Slats License Law for the following reason (Sec. 7031.6. Business and Professions Code: Any city or county Viat requires a permit to constru L atter. Improve. demolish, or repair any strut ue. prior b Its issuance, also requires the appicsntfor the permit ioiia s signed sWerna t that he or she Is licensed pursuant b rue provisions of Mme Cw*aebW Stela License Law (C WW r (commencing with Section 7000) of Division 3 of the Business and Professions Code) or Mat he or She Is exempt rhe ehcn and the basis for the alleged exemption. Any violation of section 7031.5 by any appicard for a permit subjects the applicant to a CM penally of not mate than five hundred dollars %=).7 U I. as owner of the property. or my employees with wages as troll sate compensation. will do rue work. and the structure is not Mended or offered for sale (Sec 7044. Business and Professors Code: The Contractors' state License Low does not apply lo an owner of property who builds or inpmoves thereon. and who does to work himself or herself or through his or her own employees, provided that the improvements are not Mended or ollm for sale. K, however. the I A I n or improvement is sold within one year of Comrpletion. Mae owner -builder will have the burden of proving that he or she did not build or inprove for the purpose of sale.). U 4 as owner of the property, am exdusively contracting with licensed contractors to cosinxi the project (Sec. 7044. Business and Professions Code: The C *wives' State License Law does not appy to an owner of property who builds or improves thereon, and who contracts ler the projects with a conbador(s) licensed pursuant to the Contactors' State License Law.). UI am exempt under sec . B.& P.C. for this reason Date owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: —I have and will maintain a certificate of consent to aeWns" for workers' oonpensafion as provided for by Section 3700 of the Labor Code. ler the performance of the work for whihch thus Permit lsissued —I have and will maintain workers' conpensstion irsuranoe, as required by Section 37M of the Labor Code. for the pertomnance of the work ler which d is permit is s'1 workers' enation Insurance ramter and policy number aro: C Polxy Number jam. ��n G O O 7 _ 1 notify Murat, in Move work for which Mrs Perri is issued, i shall not employ any person in any amus r so as to beconhe subject b is workers' compensation laws of CaMomi& and agree taL if I shoto become subject Oft workers' compensation provisions of section 3700 of the Labor Code. I shall forowwit, comply with those provisions. Date Applicant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T"OVSAND DOLLARS ($100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I herby affirm under penalty of peft that two Is a conshuction WxkV agency for are performance- the worts ler which Minis Perri le issued (Sec MT. Civ. C.). Lender's Name Lendees Address EKT IMPORTANT Appication is hereby made to the Direckm of Buildingand Sat for all permit s EDG to the ntY P� subject to the caedntions and restrictions set foAln on tis appicaion. 1. Each person upon whose behalf tris appicetion is made. each person at whose request and for whose benefit work is performed %under or pursuant to any per"* issued as a result of tit application, the owner. and Move applicant, each agrees lo, sad shall. defend, indemnity and hold hanriess the Cly of La Ouinta. ks officers. agents and employees for any ad or omission related to the wok being performed under or following issuance of Minis peril! L Any permit issued as a result of tis appicafion becomes null and void M work is not commenced within 190 dupys from date of issuance of such permit, or cessation of work for 180 days will subjeci Permit locancellation. 1 certify that I have read this application and state that the above kNormation is correct. I agree to comply withal city and county ordinances. and state laws rehsting lobuiding conoucfion, and hereby authorize represeruafives of this countr1q,.enter upon the above{nerntioned property ler inspection purposes. Date n 20Signature (Applicant or AQent): _u r 1i APR -4-2004 02:44P FROM: C- -2 . TO:3249541 P:2/2 COACHELLA VALLEY WATER DISTRICT J L CASH RECEIPT DETAIL �je L/ 1�S 101244 Received From: ' Aaaress: Account No. ' � . �� • 149-_ Lot Is), � Tract Service Address `~ /:•I -�/ l� , GA. Coae L: meter(s) $ — M Service(s) , House Laterals) — J DetectorCheck(s)—. M. Meter Surcharge- t�$anitation Capacity Charge .D WS.B.F.C. C. Temporary Construction Meter --. — Ct Turn on Charge — i 1 Uncollected Account - Name— L", ame — — Inspection Fee -Tract . _ Fee- Plan Check Fees Walar I Sewer - Tract - BonO Payment - A.D. - . _Bond Assn'tt. - .: customer Deposit F) Other TOTAL S C � Remark,:�1 Copy to: _. Cash -- WaterService � Money Cashior-.. Order CVWD-e3a(11/89) APR -21-2004 WED 07:20AM ID: i PAGE:2 HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 17RA1 7QA - 7AAQ I DANT. 760) 321 7 . 8 (760)321-7448 (760) 321- 7448 PRICE CUSTOMER'S ORDER NO. DATE ORDERED _ ,- 7 Gallons ORDER TAKEN BY 0-0 DATE PROMISED ❑ A.M. loo /On ( ❑ P.M. BILL TO mo Dumping Fee per 1000 gal. PHONE ADDRESS ME l//J CITY Out of Area Fee H LPER JOB NA A LQC$71ON ❑DAY WORK S�`�JJ` Locating / Opening Fee (per hour) ❑ CONTRACT ❑EXTRA SCRIPT[ ON OF WORK V�✓V c �7 � I DANT. DESCRIPTION OF IMATLRml USED PRICE AMOUNT 6 �) Gallons 0-0 Pumping Fee per 1000 gal. loo /On ( mo Dumping Fee per 1000 gal. J^� Out of Area Fee Locating / Opening Fee (per hour) Size System: L=am 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. HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS Q HELPERS Q TOTAL LABOR I hereby acknowledge the satisfactory completion of the above descriped work: TOTAL LABOR TAX SIGNATURE DATE COMPLETED TOTAL