06-2662 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002662
Property Address:
54900 AVENIDA DIAZ
APN:
774-291-008-17 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1400
T4ht 4 4 Q"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
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 Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
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
a plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
r ( ) 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.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Owner:
I hereby affirm under penalty of perjury that there is a construction lendinlyagency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
TAMEZ DAVID & BERNICE
54900 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/13/06
-----------------------------------------------
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 Policy Number
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 w�hro�s
compensation laws of California,
and agree. that, if I s ecoma subject tot pensaion provisions of Section
3700 of.the Labor ode shall forthwith crovisions.
Dat Appl cant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSA ON COVERAG42S 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 cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
l
Application Number . . . . . 06-00002662
'Permit . . . PLUMBING SEWER
Additional desc .
Permit Fee . . . . 30.00
Plan Check
Fee
00
Issue Date . . . .
Valuation
1400
Expiration Date 1/09/07
Qty Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and Comments
SEWER CONNECTION/SEPTIC ABANDONEMENT.
.4
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
r
.00
30.00
_
LQPERMIT .
1
'COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL 114991
Received From - Date:
11 --)y
Address: '1 42
Account No�
Lot(s)
Tract
Service Addi
%G.A.
Code
• Meter(s)
• Service(s)
• Backflow(s)
• House Lateral(s)
• Detector Check(s)
• Meter, Surcharge
LTJ Sanitation Capacity Charge
• .W.S.B.F.C.
• S.I.W.S.0
• Temporary Construction Meter
• Turn on Charge
• Uncollected Account - Name
• Inspection Fee - Tract -
Fee -
• Plan Check Fees Water Sewer -
Tract -
• Bond Payment - A.D. - -Bond
Assmt
• Customer Deposit
• Other
TOTAL
Remarks:
i.
Cash
Check
Money
Order
A
CVWD-438 (1/05)
Bin #
City of La Quinta
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.#
Project Address:*
Owner's Name: Y1) 4 1 m •Z
A. P. Number:
Address: i ' 0. bD)5
Legal Description:
City, ST, Zip:
Contractor: 6
Address: O
Project Description:
City, ST, Zip: Y
Telephone: 1
State Lie. # : City Lic. #:
Arch., Engr., Designer: -
Address: _
City, ST, Zip:
Telephone: _—
Construction Type: Occupancy:aon Pr
State Lic. #:
Project type (circle one)• New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
1 # Units:
Telephone # of Contact Person:
Estimated Value of Project: " _
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.
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
TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNERBUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/Budder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (76 777-7011
OWNER'S SIGNAT/URRE/DATE 061 a
`�-7 - q0,9 Z, /�( C (tel/! /2 �/`� C
PROPERTY ADDRESS
PERMIT NUMBER(S)
07/13/2006 11:26. 7608635112 PRECISIONONE ESCROW PAGE 02/02
J700MR16,
PLUMS ERS
i ❑CORPORATE HEADOUARTERS; 796 N. STAIE ST. • HEMET, CA 92543 - (951) 658.8541 - (800) 491-7686 • FAX (951) 652-9515
PRECISION ONE ESCROW
ESCROW#1793 Invoice # 355293
80150 HWY 111 C-8 Work Order:
INDIO CA 92201 Inv. Date 07/07/06
i
I.av0I C E
Service at: 54900 AVENIDA DIAZ X
DIGGING/SEPTIC 195.00
SEPTIC TANK PUMPING - 1000 GALLONS 185.00
DUMPING FEES 40.00
CERTIFICATION - SYSTEM FAILED SHOULD HOOK UP TO SEWER 150.00
ESTIMATE TO HOOK UP TO SEWER $9500.00
SUBTOTAL 570.00
TOTAL 570.00
SERVICE CHARGE of 1 1/2% per month (APR 18%) on all invoices over 30 days old.
---------------------------------------------------------------------------------
(Please detach and return with your payment)
?RECISION ONE ESCROW Invoice # : 355293
;SCROW#1793 work Order:
10150 HW5' 111 C-8 Inv. Date : 07/07/06
.NDIO CA 92201
4900 AVENIDA DIAZ X
BALANCE DUE: 570.00
543 Remit to: Roto -Rooter, 796 N. State St., Hemet, Ca. 9
07/13/2006 11:26 7608635112
PRECISIONONE ESCROW PAGE 01/02
(951)1D58M11
d LAKE ELSINORE (951) 6742312
❑ FALLBROOK & BONSALL (760) 729-7497 U WEST RANCHO BERNARDO 6
WORK ORDER NO.
43(61)=4 01
❑ RANCNQrI91tECL9,A(061)W45%
f_1' OCEANSIDE, CARLSBAD (760) 722 -MSS (NEST RANCHO PENASOUCT'OS (8156) 4842139
1(551)9674652
O REOLANDSNUCAIPA (909) 79748 97
0 VISTA & TRI -CITIES AREA (760) 7266260 O LAKE SAN MARCOS & LA COSTA (760) T266'720
_
3 5 7 2 93
10W (061) 6589
O PALM SPRIN=HS (780) 322-2622
1) ENCINITAS & CARDIFF (760) 7512674 O RANCHO SANTA FE & OLIVEHAIN (868) 7563396
Pf (061) 679'68t>I '
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D INDIO# ALM DESERT POO) 3461736
❑ DEL MAR 6 SOLANA BEACH (859) 481 -ism -7 /
DATE,, ........... ......... JOB #.................:..../....•..........................
798 N. STATE STREET - HEMET, CA 22U3
12 Toll Free: (600) 401-7648. Fax, (961) 662.8616 - 1.800 GET RM (438-7668) ! � !/1
TECH #1.....,..�......... . ............ TECH #2 ........................................
F1=- RE MAIN LINE: FT O BATH SINK • • - - • --0
FLOOR DRAIN - - - -
-0
{31'9 f"
'�". 'Y - { ir"'`.•,p ''?�YS;. `�'~��
CLEANED: TOILET ----------- O KITCHEN SINK - - - - -p
FLOOR SINK - - - • - -
40t'I
:fns xx
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BATHTUB ---------0 LAUNDRY •-- -----p
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OTHER
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F.STiMATF: My estimate for performing this work Is; S
WORK ORDER AUTHORIZATION / WAVIM, I aulhodw Retodfooler re, perform tfw descrtbod %mvicos and I corse to pay the amouMi
Indicafod. I understand that Rotodtooter It not responsible for broken, sallled, rustod, dolerlororod, or Toad pipes, (ixtures, on Moan
ouh and any domaga rowIltnq From cleaning or repairing such Ilnos.
I have oskad Roto -Room to provide, sarv4Cof, Under Sodlon 1669.13 of the Cvlitomta CMI Code, In order to Induce, Roto-Roator to
pravtda theao services; 1) Wtiatod negotiation and caMrad; 2) oxoevtad this conf=1 M connection with the mak" of emergency
or Rnmodiaro necessary regain or services necamary for the Immediate protection of persons or personal property datalled on Mrs
ihvolco; and 3)1 oltpre * ackhowtodga and walvo the right to cancel this contract within three or &oven busirwm days, Whichavor
apptlec
(MRT NAW.) _ (SIGNATURE)
COINPI.Mon I ackrwwfodge comptolfon of tho above desodbod work whiten has boon done to my Camplafo sotlstadlon.
400ter produ,ts with me.
Ilnes cleaned pt this fime are haft prices.
iing my Mair line from a 3" root vent Is
10 day guorrantee, a 2- main line has a
guarantee a cleanout must be Installed.
TIME IN TIME OUT
CC EXP. DATE, - _ APPROV. #
1 hereby authorize Roloco, Inc. to charge my Credit Card for the above charges. I understand that by signing below I
am agreeing to all charges incurred oh this Involce and that the work was completed to my sa IsfactiorL
Cardholder Signature x
SEE REVERSE FOR TERM S & CONDITIONS
cXa�?.k-4L-L'
❑ CASH �EIILL O CK # E) CREDIT CARD/TYPE
f