The URL can be used to link to this page

08-0139 (PLBG)4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 ` BUILDING PERMIT Date: 1/14/08 Application Number: 08-00000139 Owner: Property Address: 53095 AVENIDA DIAZ SKRAMSTAD JON B APN: 774-041-017-5 -000000- 53095 AVENIDA DIAZ Application description: PLUMBING LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL ( Application valuation: 3000 Contractor: D A Applicant: Architect or Engineer: HAMMER PUMPING INC P O BOX 2448 JAN 14 423 CATHEDRAL CITY, CA 92235 (760) 360-7448 CITY OFLq( �IttA Lic . No.: 661018 FINAWIC non - LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lice der provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business r f sionals dam, and my License is in full force and effect. License Class: 0442 nse 661018 Date: `�yw Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the fallowing 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.). ( ) 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: LQPERMLT 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 1828655-2007 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 beco e*rubject to the workers' compensation laws of California, and agree that, if I should be su - compensation provisions of Section 3700 of the Labor Cod comply 'ih hose provisions. Date: Applican . WARNING: FAILURE 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 issuedas 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 i crrrd io i corse I agree to comply with all city and county ordinances and state laws relating to build' > ' ___-authorize representatives of this county to enter upon the above-mentioned for in p purposes. Date /y -,P Signature (Applicant or A Application Number . . 08-00000139 Permit . . . PLUMBING SEWER r. Additional desc . } Permit Fee 30.00 Plan Check Fee .00 Issue Date Valuation . . . . 3000 Expiration Date 7/12/08 Qty Unit Charge Per Extension BASE FEE 30.00 --------------------------------------------------------------------=------- Special Notes and Comments SEPTIC ABANDONMENT / SEWER HOOK UP. 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 LQPERDIIT Bin # City of La Quanta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # i I Project Address: 0� r � A 0.11z Owner's Name: A. P. Number: Address: Legal Description,` 1 Contractor: M jr� City, ST, Zip: Telephone: _ INVAUM Address: (7 -7 ,e(P. Project Description: �- e w City, ST, Zip: G �, / a— kc- Telephone: 76o 36c) -7q -(f o State Lic. # : 6 ((J ( City Lic. #: Arch., Engr., Designer: Address: ' City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:. # Stories: # Units: Telephone # of Contact Person: Estimated Value of -Project: APPLICANT: DO NOT WRITE BELOW THIS LINE Req'd Rec'd TRACKING PERMIT FEES ff#Submittal Sets Plan Check submitted Item Amount ctural 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. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" 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 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL ® Received From: �� 1L" `�T([� ep Address:�Og r>, 28 Date: L3 6Y Account No. � • �-• Lot(s) Tract Service Address G.A. Code ❑ Meter(s) $ ❑-Service(s) O Backflow(s) ❑ House Laterals) O Detector.Check(s) O Meter Surcharge Sanitation Capacity Charge O W.S.B.F.C. O S.I.W.S.C. O Temporary, Constructien Meter O Tum on Charge O Uncollected Account - Name O Inspection NO - Tract - Fee - ❑ Plan Check Fees Water / Sewer - Tract - O Bond Payment _ A.D. - Bond A. O Customer Deposit O Other TOTAL $ ( S • c Remarks: " Copy to: Cash Check - I Money C/ Order Water Service Cashier CVWD-438 (1/05) 0 1I9fII'f1 �F JOB INVOICE LIC. #661018 POST OFFICE BOX 2448 CATHEDRAL CITY, CA 92235-2448 (760) 360-7448 • 176.0) 321-7448 Tme-In Date Time -Out Ordered by Bill To Cust. Order # Address �— - Ph. # City eeha iic`� Job Name and Location ti Helper Description of Work Amnt. Pumped-- ._ Gal Q'Septic Tank .El Seepage Pit ❑ Cesspool ❑ Grease Trap ❑ Other ❑ System is Failing ❑ System Passes Inspection ❑ Excessive Sludge ❑ Roots Quantity Description of Work or Material Used Price Amount - Pump & Dump Fee per 1 000al y� Locating & Opening Fee(per hour Septic Inspection Out of Area Fee Fuel Surcharge Snake Line ❑ Roof Video Pipe Inspection Camera 1 st hour Additional hours High Pressure Water Jet Additional Hours Labor per hour ❑ After Hours ❑ Sat. Charge ❑ Sun. Charge A service charge of $20 will be due on all returned checks Total 18% per year will be charged on past due accounts over 30 days Paid By Check # Master Card•/ --Visa -Card #_ 1 Signature _- • 4 f Next Service Due ] Billing On Date Date Completed i