12-1379 (PLBG)P.O. B
78-495 CALLE TAMPICOQX 1504 !__-__� VOICE (760)777-7012
,
FAX'(760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number: r1 '--"12=00001379==�'"
Property Address: 53161 AVENIDA` VILLA
APN: 774-063-020-8 -000000-
Applicationdescription: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 4000
13
Owner:
EARL FRAWNER
53161 AVENIDA VILLA 't
-LA QUINTA, CA 92253
Contractor:
Date: 11/26/12
NOVI 6,626 2012
TOF LA QUINTA
Applicant: r Architect or Engineer U t TOMMY ROOTER FINANCE DEPT.
t'OV 6 10�� 'III 80975 INDIO BOULEVARD #C3
U INDIO, CA 92201
CITyOFL,gQU1NTQ. (760)574-4444
FINgNCEpEpr -Lic. No.: 930133
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of - perjury that I am licensed under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will -maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C36�11L
930133 , r for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
/ Z`" � have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
/ Date: 1 tractor.
,--'--Date:
Code, for the performance of the work for which this permit is issued. My workers' compensation
RATION - insurance carrier and policy number are: '
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier NORGUARD INS Policy Number THWC220257 -
following reason ISec. 7031.5, Business and Professions Code: Any city or county that requires`a permit to - _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to becomesubject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the.Business and Professions Code) or '3700 of the Labor Code, I shall ply with those provisions.
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 fivehundreddollars (5500).: Zt.11_147 plicant:
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 - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property.who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the - DOLLARS 15100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION "3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or F
improve for the purpose of sale.). - ' APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
-
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of - - conditionsandrestrictions set forth on this application. --
property, who builds or improves thereon, and who contracts for the projects with a contractor(sl licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors'.State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
- - of LaQuinta, its officers, agents and employees for any act or omission related to the work being
- - performed under or following issuance of this permit.
Date:Owner: - 2. Any permit issued as a result of this application becomes null and void if work is not commenced
- - - within 180days from date of issuance of such. permit, or cessationof work for 180 days will subject
CONSTRUCTION LENDING AGENCY - + permit to cancellation. _ -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. 1 agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction,, and hereby authorize representatives
,of th' county too enter he above-mentioned property for inspection - -
Lender's Name:: /ate: "�S ature (APPlicant or Agent):
Lender's Address: - -
LQPERMIT -
r
Application Number 12-00001379
Permit -PLUMBING SEWER
Additional desc
Permit Fee 30.00 Plan Check
Fee
.00
Issue Date Valuation
4000
Expiration Date 5/25/13
Qty Unit Charge Per
Extension
BASE FEE
30.00
Special Notes and Comments
SEPTIC ABANDON, SEWER CONNECT. 2010"
CODES.
-------------------------- - -----------------------
Other Fees . . .. BLDG'STDS ADMIN (SB1473)
1.00
Fee summary Charged _ Paid Credited
Due
Permit Fee Total 30.00 .00
.00
30.00
P1an.Check Total .00 .00
.00
.00
Other Fee Total 1.00 .00
00
1.00
Grand Total 31.00 .00
.00
31.00
LQPERMIT
wn if
Permit #
0'L/
J(Project Address: 5 la
A. P. Number:
Contractor:? �. �
Address: �p9 7y� 1�r�i0/'��
City, ST, Zip: 1 o70iv
Jc Telephone: 'nO S -7y cj/yyy
State Lic. #
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
N
City Of La Quinti
Building 8t• Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tra,_king Sheet
i% wner's Name:
gwit-tom
AddressSS3/6/ ((9
City, ST, Zip:
7�„yt elephone: ?e,-7 ZZ% G'Z fZ
C % Project Description:
4 -4 S �
City Lic. #:
n�
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
ame of Contact Person: 7
Sq. Ft.:
*11
Telephone # of Contact Person:
^
�;%c fo =C'?=�:�`
#Stories
# Units:
Estimated Value
of Project: y0peq
APPLICANT: DO NOT WRITE BELOW THIS
LINE
#
Submittal
Req'd
Rec'd
TRACKING
Plan Sets
PERMIT FEES
Plan Check submitted
Structural Calcs.
Reviewed, ready for corrections
Item
Amount
Truss Calcs.
Plan Check Deposit
Called Contact Person
Title 24 Calcs.
Plan Check Balance
Plans picked up
Flood plain plan
Construction
Plans resubmitted
Grading plan
Mechanical
2"' Review, ready for corrections/issue
Electreal
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Gradin
IN HOUSE:-
) A Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
A.I.P.P:
School Fees
Total Prrmit Fees
c
1A�L�Y. COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
` INVOICE Date: 11/26/2012
- F
SUBJECT: SANTA CARMELITA, 53161 AVENIDA VILLA, LA QUINTA, LID 687.176, "SC--- FEE ONLY"
EARL FRAMER Project: f 12-4237
_74923 HIGHWAY 111, NO. 223 Project Date: 11/26/2012
Amount Due: $4,231.00
INDIAN WELLS, CA 92210 GEO: 06-06=12-4
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CREDIT; PLEASE RETURN THIS PORTION WITH '
`• REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT:SANTA CARMELITA, 53161. AVENIDA VILLA, LA QUINTA, LID 687176, "SCC FEE ONLY"
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651•
Pagel
S AND.G PUMPING SERVICE INVOICE #4 8 2 2
73-680 Hwv 111. Suite 123 • Palm Desert. CA 92260
Cell (760) 766-5074 • (760) 404-6325
Date:
, p- / 2
eill T '
Ph#:
Address:
Mechanic::
e�+\ C—
His:
City:
Helper:
Pump &, Dump Fee per 1000 gal (Septic Tank)
Job�Namr Lgcation:
F
t
" Y
ye.
D ription of Work:
'-a
2 S
Amt. Pumped Gal ❑ Septic Tank ❑ Seepage Pit ❑ Cesspool ❑ Grease Trap ❑ other
❑ System is Failing ❑ System Passed Inspection ❑ Excessive Sludge ❑ Roots
Quantity
I y.• ❑C
Y:
Description of Work or Material Used
Price
Amount
Pump & Dump Fee per 1000 gal (Grease Trap)
Pump &, Dump Fee per 1000 gal (Septic Tank)
Locating & Opening Fee (per hour)
High Pressure Water Jet (First Hour)
High Pressure Water Jet (Addtional Hour)
Labor per hour 1 '
i
Rooter Mainline
Rooter Lateral
Rooter On -premise
❑ After Hours ❑ Sat. Charge ❑ Sun. Charge
Fuel Surcharge
Thank You
Total
0-;
M�
heck# ❑ BIII To.
Signature = Date Next Service Due
1