06-0992 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number. X06:.00000992
Property Address: 47090 VIA ORVIETO
APN: 643-160-044-170 -26152
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation:* 330
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RICHARD MEYERS
47090 VIA ORVIETO
LA QUINTA, CA 92253
r
Contractor:
Applicant: Architect or Engineer: VALLEY PLUMBING COMPANY
46780 CLINTON STREET
INDIO, CA,92201
r (760)347-3629
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tic. No.: 273088
LICENSED CONTRACTOR'S DECLARATION
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: C36 LicenseNo.: 273088
Date: Contractor:
i
OWNER -BUILDER DECLARATION
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 (5500)-.:
(_ 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
ate—
ner:
TRUCTION LENDING AGENCY
I hereby affirm/undenalty
perjury that t s a construction lending agency for the performance of the
work for whicm'[ i
sued ISe . 30 Ci
Lender's Name
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/14/06
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, .asprovided
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 HAM INS A Policy Number F,)T33090901
I certify that, in the perfor ance of the work for wW this permit is issued, I shall not employ any
person in any manner o as to come subjec the workers' compensation laws of California,
and agree that, if I uld be subject t workers' compensation provisions of Section
3 00 of the Lab o e, s forthwith o I with th rovisions.
L ,li AA ,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COCERAGE 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 b mes null and void if wo s not commenced
within 180 days from date of issuance of such rmit, or cels
essation of r or 180 days will subject
permit to cancellation.
I certify that I have read this application and state that th ove inf tion i orr agree to comply with all
city and c ty ordinances and state laws relating to bui con ion, an her uthorize representatives
of thi Wty to %Aer upon tID"bove-mentioned prop y or� 'orypuryo
(Applicant or
Application Number 06-00000992
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . . .
Valuation . . .
.
0
Expiration Date 9/06/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 3.0000 EA. PLB
GAS"PIPE 174 OUTLETS
3.00
--- ---------------------------------------_-----------:---------
Special Notes and Comments
GAS LINE EXTENSION FOR NEW BBQ
Fee summary Charged
Paid, Credited
Due
Permit Fee Total 18'.00
-------
.00 . 00 -----18.00
Plan Check Total 4.50
.00 .00
4.50
Grand Total 22.50
.00 -00
22.50
LQPERMIT
,Vy .I� 1 "
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 787495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 7 O V, A i0elk.g70' _
Owner's Name: Q
A. P. Number:
Address: 4-7-0417 VA DQVil Era
Legal Description
r..
City, ST, Zip: �"� a '7 Z �. ,� 3
Contractor:
Address:7-'
L:il L C14 �
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Telephone: ._ 0
Project p
j t Descri tion:
City, ST, Zip:, t n AL" I eS7
Telephone: 34 d : ZZo Z
,
State Lic. #: City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:tr
State Lic. #:
Name of Contact Person: �, 4 Gr q'f'E,5
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: elpz Estimated Value of Project 330
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
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