13-0740 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000740
Property Address:
55581 WINGED
APN:
775 -182 -006 -
Application description:
PLUMBING
Property Zoning:
LOW' DENSITY
Application valuation:
185
Applicant:
FOOT
RESIDENTIAL
Architect or Engineer:
BUILDING &SAFETY DEPARTMENT. .
BUILDING PERMIT
Owner:
ROUND VICKI
_ 55581 WINGED FOOT
LA QUINTA, CA 92253
(
---------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 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.
C License Class: C36 LicenseNo.: 930133
Date L— y — i 3 Contract r:
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 155001.:
(_) 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.).
( 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 performanceof the
work,for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
Contractor:
TOMMY ROOTER
80975 INDIO BOULEVARD
INDIO, CA 92201
(760)574-4444
Lic. No.: 930133
LTJ
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-71.53
Date: 6/14/13
r� J
JUNE 142013
CITY OF LA QUINTA
FINANCE DEPT.
-7 ---------------
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 NORGUARD INS' Policy Number THWC435917
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 workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the L ode, !,,sqall forthwith comply with those provisions.
Date: ,.' LW Applicaq /-�
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 ($100,0001. 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 isnot 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 ro I ty for inspection purposes.
Date: _(1:2- I U-e36ignature (Applicant or Agentl: -
LQPERMIT
1
Application Number 13-00000740
Permit" •.. PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/11/13
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG WATER'HEATER/VENT
11.92
-- - - -
Special Notes and Comments
- - - - - - - - - - - - - -
WATER HEATER CHANGE OUT - 403ALLON/ CTAS
(2008 ENERGY] CARBON MONOXIDE ALARM(S)
TO BE INSTALLED PRIOR TO FINAL
INSPECTION. -2010 CALIFORNIA BUILDING
CODES.
- -- ---
Othe"r Fees BLDG STDS ADMIN (SB1473)
--------------
1:00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING -
7.15
Fee summary Charged Paid .Credited
Due
---------------------------------- -- ----------
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 98.72 .00 .00
98.72
Grand Total 110.64 .00 .00
110".64
l -
'
LQPERMIT
06/06/2013 THU 15:09 FAX La Quinta Bldg & Safety
Bin #
2001/001
Total Permit Fees
City of La Quinta
Buildingo Safety Dhtlon
Permit #
P.O. Box 1504, 78.495 Calle Tampico
U Quinta,. CA 92253 - (760) 7777012
f
Bulling Permit Application and Tracking Sheet
PMj6d Address:
Owner's Name:
A P. Number:
Address:Ll 1
Legal Description:
1 OOT
City. ST, Zip: C s
Contractor -'OM m
()
Telephon :
Address O
-C
Pro'oa
J Description:
.
City, ST, Zip:
Tefepho �J? b 51 —4444 h
® \
State Lie, # : 93 0 133
City Lic.
ArrIL, Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State
Construction Type:()
O
l
Lia #
PmJ= type (circle one): New Add'n Alter Repair Demo
Name of Contact Person;
Sq. FL:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Valueof Proj ect con, --.
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACING
PERMIT FEES
Pian Sets
Plan Check submitted
Iran
Structural Cates.Reviewed,
ready for corrections
Amount
Truss Calm
.Plan Check Deposit
Called Contact Person
Plan Check Balance
Title 24 Caics
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2� Review, ready for correetionMaue
Electrical
S»beontactor L[st
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
U-04 Approval
Pians resubmitted
Grading
INHOUSE-,
3" Review, ready for corrections/issne
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub Wise Appr
Date of permit issue
Schodl Fees
Total Permit Fees
pmcri tive Certificate of Com l
Residential Alterations
:.Residential' CF-IR-ALT-DHW
Climate Zoe:j Permit g:
General Information
Site Address:_'LAD n Enforcement nix Date -6
Building T Sin le Family 0 ultiFarntly I Project T Re lac-ement or Change Out of Water Heater
WATER HEATING
List new{r installed water !waters and boilers for both domestic hot water heaters (DWH) and h►d►onic Voce heating. Ne%IY installed
DWH heaters and boilers must be as e. or use the existingel n
Wats Licata
TypdFvd Type
D;u�
Numbci In Tank �8y Factor �
t u�dud. System Capacity (Fall Ttxtmal F(6cirncy
�uemal Tank
4uuhiiau .
tt-Yalue'
AS
1)4QQQ
1. I'mdkwe Type (Storage Gas. Heat Pmip. Instantaneous.. etc.)
2. Recirculating systems serving nudtiple. dwelling units shall ''macer the ncirrulation requirrrnentr of §lAn).
-Vairrtnents do am allow the installation of a recimdating water heating s weer for single dwrlling axits.
y. The e.aerrurl water heating tank and p4ws, shall be insulated to meet the requirrinents qf
The Preicriptive
1 1
Contractor or Romeowoer (Documentation Author's/Responsi Ae Building Designer's Dedaration Statetueat)
• 1 certify that this Certificate of Compliance documentation is accunre and complew.
• 1 am eligible under Division -3 of the'Califomia Business and Pwfessions Code to accept responsibility Cot the building design
identified on this Catificatee of Compliance.
• 1 certify din the energy features and pc for natxx spedfications for the building design ida tifiora on this Certificate of Compliance
conform to the mlRuit"ients of Title 24. Fart I and 6 of the California Code of Regulations.
. The building design features identified on this Certificate of Comptiesiee are consistent with the inlorination peovided to document this
building design on the other appl'ic" oomplW" forms, woeidioas, calculations, plans and specirx*ions., submitted to "the
enfomcinctt for building val with this bud' it aw, atior�
C C3. Y r i
Come -y: - Daae:
tom.
City/SuAdlip: Phone:
PLUMBING WORK ORDER/INVOICE
TOMMY ROOTER 10259
4
HELPING THE DESERT
o-
,�
ONE FRIEND AT A TIME Co.
••
ITEM
, ,ART • ® •
J
Plumbing, Drain Cleaning & Jetter Specialist I nv.#
''r `
.J
80975 Indio Blvd., #C3 Auth.#
Indio, CA 92201
760-574-4444
InFax 760-444-2717
WWW.TOMMYROOTER.COM Out
"All Clear!"
CA LIC. #930133
NAMEo ` , e- ATE ULED
vow
sllieel
O\
CI Y TATE P ❑ WAR NTY
❑ CONTRACT
MAKE ! MODEL SERIAL NUMBER ❑ SERVICE CONTRACT
❑ NORMAL
TOTAL MATERIALS
❑ RES. ❑ COMM.
❑ NOT ❑ COMPLETE
DESCRIPTION OF ••
•
LA
ro
SD 6 83 CM Li
-Po Lk D 5
in \r
8I10 .
• •
•
TO OUR CUSTOMERS: Service men are required to have work slip signed.
This is done in order to protect you, the workmen, and ourselves and 10
DRAIN CLEANING
ADD'L FOOTAGE
7 77
enable us to give you absolute satisfactory service. You are respectfully
requested to examine material and labor statement before workmen leave
ADD'L FIXTURES
PLUMBING LABOR
the job, and if you find everything satisfactory, okay this ticket. If service is
unsatisfactory, in any way, please phone our office immediately.
PARTS
A PENALTY WILL BE CHARGED AT THE RATE OF 1"7% PER MONTH ON UNPAID
BALANCES AFTER 30 DAYS OF INVOICE DATE. ANNUAL PERCENTAGE RATE 18%.
pRODUCTS/fREATMENT
VIDEO INSPECTION
RETURNED CHECK FEE $25.00
I find the time and material charged above satisfactory and agree to pay
HYDRO-JETTER
for same on presentation of invoice, and further agree to pay reasonable
charged for collection including attorneys fees in the event of my default.
MINI JETTER
TOTAL LABOR
LINEILEAK LOCATION
X
SIGNATURE DATE
PUMP SEPTIC/GREASE
❑ WARRANTY
NOTES• , •
❑ 5 Day ❑ 1 Year
WORK ORDERED ey
OTHER
❑ 3 Month ❑ NO
"NOTICE TO OWNER" (Section 7019 -Contractors License Law) under the
❑ 6 Month
Mochanles' Uen Law, any contractor, subcontractor, laborer, material man or other person who helps
to Improve your property and is not paid for his labor, services or material, has a right to enforce his
TAX
claim against your properly. Under the taw, you may protect yourself against such claims by filing,
WARRANTY CALLS
before commending such work or Improvement, as original contract for Ore work of improvement or a
modincatim thereof, in the office of the aunty recorder of the county where the property Is situated aro
TOTAL
ARE SCHEDULED
FROM M -F 8AM=5PM
requiring that a conlractor's payment bond be recorded in such office. said bond shall be in an amount
not less than fifty percent (50%) of the contract price and shall, in addition to any conditions for the
PAYMENT RECEIVED
❑ cnsH ❑ C.C. ❑ BILL ❑ CHECK # ❑ X
periohing la of the contract, m ntor ater for the payment s ibe of the claims of eff persons
fumisNng labor, ssrvices, equipment or materials for the work described in said oontrect.
PAYMENT DUE
35t L