13-0513 (PLBG)c5i
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000513
Property Address:
51489 AVENIDA VILLA
APN:
773-102-010-5 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
392
Applicant:
Architect or Engineer:
�lM,
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT \--�
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License CI ss: 2 Lice N .:
D to aContractoi Vill
- v -
OWNER -BUILDER D LARATION
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
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.)-
`llof')lI am exempt under Sec. , B.&P.C. for this reason
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:
LQPERMIT
Owner:
JOSEFINA SOLIS
51489 AVENIDA VILLA
LA QUINTA,.CA 92253
(760) 601'-6079
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: c 4/23/13
u DAPR zs 2013
OF LA QUINTA
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 - - - - - - - - - - - ------- -----PolicyNumber
,'I C=at, 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
700 of the Labo e, all forthwith co �PIY with t�epvisions.� / f }i �j Q [�/ITLI��•J``v//Io/�/i/rwr
Daie. `7 Applicant•. J J
WARNING: FAILURE TO SECUR RS' 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 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 co ty to nter upon the above-mentioned property for i ion purposes.
Date Signature (Applicant or Agent)/ /
.T
Application Number . . . . . 13-00000513
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00 Plan Check Fee
4.50
Issue Date . . . . Valuation . . .
. 0
Expiration Date 10/20/13
Qty Unit Charge Per
Extension
BASE -FEE
15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
------
Special Notes and Comments -
GAS LATERAL,.77LF OF 1 % GAS LINE.
2010" CALIFORNIA BUILDING CODES.
-----------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 18.00 .00 .00
18.00
Plan Check Total 4.50 .00 .00
4.50
Other Fee Total 1.00 .00 .00
1.00'
Grand Total 23.50 .00 .00
23.50
' LQPERMIT
isin.#
Of 1.c7 Qutnta
Build pg 8T Safety Division
P.O. Box 1504,78-495 Calve Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application' and Tracking Sheet
Permit #
Project Address: 5l —��
Owner's Name:.
A. P. Number.
Address: V 1✓ '
Legal Description:
City, ST, Zip:
Contractor.
Telephone:7410 &,01 &0 7
Address:
Project Description: , J
City, ST, Zip:
Telephone:
P,•L
State Lie. # : City Lic.#;
Arch., Engr., Designer
71
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
# Submittal Req'd Reed TRACMG PERMITFEFS
Plan Sets
Plan Check submitted
Item Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mech2nlc11
Grading plan
2-! Review, ready for correctionsirmue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SALL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Reylew, ready for correctionvlssoe
Developer Impact Fee
Planning Approval
Called Contact Person
41
A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner-Bullders Applying for Construction Permits
L WORT'ANT! NOTICE TO PROPERTY OWNER
Dear Property Owner.
Anapplication for a building permit has beenod in ur yourself as the builder of the property
improvements specified at .
We are providing you with an Owner -Builder Acknowledgment and t tion erificahm Fo,-m to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will stat issue a building permit until you have read, initialed your understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the oviaer cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OV 's ACID 4OWLEDMi'V'T AND VERIFICATION OF IIt?M ' R-
DIRECTTONS, Read and initial each statement below to signify you understand or very this uI formadon.
10
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
ding permit that erroneously implies that the property owner isrovi ' his or her own lalaor and material personally. I' as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance ma) not provide coverage for those
injuries. I am willfullY acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on MY property-
A2. I understand building permits are not required to be signed by property owners urless they are responsible for the
truction and are not hiring a licensed Contractor to assume this responsibility.
&3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
If from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
I understand Contractors are required by taw to be licensed and bonded in California and to list their license numbers on
"pdmiis and contracts.
5.1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
Z3Ay construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employee'
under state and federal law.
6. 1 understand if I am considered an "employer" under state and federal taw, I must register with the state and federal
rament, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." l also understand my failure to abide by these laws may subject me to serious financial
risk.
7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residentia'
(tures cannot legally build them with the intent to offer them for sale, unless all work is performed by license(
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performe(
under contract with a licensed general building Contractor.
&8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be he!A liable. tc,. l
—ancial or personal. uyurms sustained. by any subsequent owner(s) that result from any latent construction defects in th.1
worlananship or materials.
-'I. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
ce, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cs[b.ca gov for more information about licensed contractors.
10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
arty legally and financially responsible for proposed construction activity at the following address:
. 51 _440,0 A .. _ - .... _.D,. . n. r i _
- l •%V Lrl t.OF--k V1 If K
L I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
plicable laws and requirements that govern Owner -Builders as well as employers.
I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
h provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license, are Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil count. It is also
important for you to understand that if an udwoosed Contractor or amployce of that individual or firm is intured while woddng
on your property; you may be field liable for damages. If you obtain a permit as Owner -Builder and wish to him Contractors,
You will be respom Me for verifying vAnther or not those Contractors are properly licensed and the status of dMir wotkers'
compensation insurance ooverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for invft tube permit. Note: A copy of the property owner's driver's fioettsco firer rwtar*01M or
other verifwadon acceptable to the agency is r+equtred to be presented when die permit is issued to verify the pt+uperty
owner's signature. �J� S tore of r
rgna property owner Date.
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder_
AUTROR17ATION OF AGENT TO ACT ON PROPERTY ONNEWS BEHALF
Excluding the Notice to Property Owner, the execution of which I understand. is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date:
.441&-mpraEnergy mry' RESIDENTIAL GAS SERVICE
Please type or use legible BLOCK lettering to complete form
elaAru be ujsery
PROJECT
QUESTED GAS PIPE INSTALL DATE(REQUIRED) °� REQUESTED GAS METER TURN ON DATE
GAS INSTALLATION REQUESTED (Check One): CONSTRUCTION TYPE (Check One):
Gas Line to Structure w/Meter(s) ❑ Meter(s) Only Single Family ❑Condos/Townhomes
❑ Sub-Division/Tract Dev ❑ Extend Stub(s) in Tract I ❑ Apartments ❑ Other
INSTALLATION METHOD:
Gas Company Provided Gas Only Trench
❑ Applibant Provided Gas Only Trench
❑ Applicant Provided Joint Trench
Planned # of Dwelling Units: SCG Marketing Representative, if known:
Planned # of Central or Community Facilities (Recreation Center, Pool Heater, Spa, Lausdry, Room, Etc.)
Gas Appliance Quantity MBTU
Gas Appliance Quantity M 3TU
Range (Cook -top)
PROJECT LOCATION (REQUIRED) ✓ y�
C TY , COUNT -f
i ��Ye►�s
�laL
Water Heater - Tank (standard)
❑ Patio Stub
CROSS STREET
TRACT(S) LOT(S)
Space Heating - Furnace, Wall Heater, etc. (pQ
('A Ili
APPLICANT O' /
i
NAME - As it should appear on the Contract,
SOCIAL SECURITY # TAX ID
DAY PHONE # (w/Area Code)
✓v � ia� S19 /iS —A/o/ u�`071!ea
y--/t'o1/el 7
767o -_3P q2--0 2—
STREET ADDRESS (Include A t/Suite, or Bldg Info - No .O. Box)
CI'liY
STA EIP
CODE
PARENT COMPAN AME
(If applicable)
MAILING ADDRESS Of different than street address)
ACITY
STATE
ZIP CODE
CONTACT NAME & TITLE (if different from applicam)
DAY PHONE # (w/area code)
FAX # (w/area code)
EMAIL ADDRESS FOR CONTRACT DELIVERY (REQUIRED)
CELL 1 # (w/area code)
CELL 2 # (w/area code)
/ to weal/.
--lPO(-1007 IF
PROJECT
QUESTED GAS PIPE INSTALL DATE(REQUIRED) °� REQUESTED GAS METER TURN ON DATE
GAS INSTALLATION REQUESTED (Check One): CONSTRUCTION TYPE (Check One):
Gas Line to Structure w/Meter(s) ❑ Meter(s) Only Single Family ❑Condos/Townhomes
❑ Sub-Division/Tract Dev ❑ Extend Stub(s) in Tract I ❑ Apartments ❑ Other
INSTALLATION METHOD:
Gas Company Provided Gas Only Trench
❑ Applibant Provided Gas Only Trench
❑ Applicant Provided Joint Trench
Planned # of Dwelling Units: SCG Marketing Representative, if known:
Planned # of Central or Community Facilities (Recreation Center, Pool Heater, Spa, Lausdry, Room, Etc.)
Gas Appliance Quantity MBTU
Gas Appliance Quantity M 3TU
Range (Cook -top)
Clothes Dryer Stub J 2-2—
-ZGasGas
GasOven
❑ Fireplace Stub
Water Heater - Tank (standard)
❑ Patio Stub
Water Heater - TanklessElNatural
Gas Powered Spa/Pool Heater
Space Heating - Furnace, Wall Heater, etc. (pQ
❑ Natural Gas Powered Air Condituning
Other Gas Appliances (specify): Please provide information on: ❑Applicant Design
APPLICANT INSTALLA TION OPTIONS
Applicant Install - Rule 20 section G allows the applicant to receive a competitive gas installation bid, if desired. If the M bid option is selected, a gas line
extension may be installed by the Applicant's SoCalGas certified and approved Installer arid installed per SoCalGas design and installation specifications.
If selected, the Applicant is responsible for, but not limited to, all applicable permits, paving, trenching, approved mate-ial, and SoCalGas inspection.
SoCalGas does not refer or recommend Applicant Installer's to Applicants due to anti-competitive preferential treatment rules.
Please select one (REQUIRED): Option 1 - SoCalGas Install
F-1 Option 2 - Request Applicant Install Competitive Bid Information
Application Submitted By: �p J�/S �fyv�0#11e: Date:
Please save form as "Zip Code -Project Location'i.e "90013-555 W 5th St. " and
Submit saved file to SoCalGas by either E-mail or Fax:
E -Mail to hewbl sineSS�JrOCeSSteQfi &ei1<1prautllltleS com or Fax to (866).593- 7380 Form 4 (09/2010)
Socthem
Cafitomia
Gas Com""
A Sempra Energy utility'
Vincent Alvarez
Field Planning Associate
Customer Servlco, South Inland
New Business Projects - Palm Desert
75095 Mayfair Dr • SC8051 • Palm Desert • CA 92211-5102
Tel: 760.346.8198 Fax: 760.773.9243 Cell: 760.218.6956
valvarez@SempraUtilities.com
001_iC.036
JOSEFINA SOLIS-HOLGUIN
81125 KING PALM DR
1 INDIO CA 92201-
I TOTAL
CASH TENDER
CHANGE
TYPE OFFICE
$767.31
�ITH
NTS
$767.31
return.
$770.00
$2.69
SAVE TIME. DO' MORE ONLINE. s.com
GO TO MYACCOUNT.SOCALGAS.COM
TO VIEW, PRINT. & PAY YOUR
BILLS ONLINE.
THANK YOU
****************************
guthem
Clifornia Tom Chesnut
Gas Company Field Planning Associate
Gas Distribution -Palm Desert '
A *, Sempra Energy utility'
75095 Mayfair Dr., SC 8052, Palm Desert, CA 92211-5102
Tel: 760.674.0371 Fax: 760.773.9243
tchesnut@)semprautilities.com
DO NOT INCLUDE PAYMENT WITH SIGNED
CONTRACT DOCUMENTS
Line Extension Contract payments are
accepted ONLY at SoCalGas Bre a� n�ch
Link to payment offices: SoCalGas Payment Offices
Payment Locations
Cl 4N Pi)Ttlp LOtlUIXtS ®' PJNYA•J74CL l�L�mtCf9 valmbt lOC�Or5 l7 Mx JR':o MxssiNe
QA 0-s
OR
mailed with the Exhibit A to:
Southern,Califlornia!Cas Company '
.Sundry�Billing;.M 711D;
O. 2007 r
Monterey Park, CA 91754-095.71-,--'-
Please
1754-0957'- -
Please include the Exhibit A with Payment
cmec•c
..!:. 1-: •l:l.:'sld*.'.E 132G:dT:SP .r'1[7:.:C'
`.R..
1 1 1
SoCalGas Field Representatives are NOT AUTHORIZED.to receive signed contract
documents or customer payments. DELAYS will occur if documents or payments are
sent to field personnel.
To avoid delays, be sure to follow these 3 simple rules:
I. Sign and return documents promptly via email or fax
2. Always attach Exhibit A with payment
3. Make payment at either a SoCalGas Branch Payment Office or mailed to the above
address
Lonstructlon scneduifng cannot proceed until contract and payment have been processed and recorded
by SoCalGas.
(Allow 3-7 days for payment to be recorded)
The
Gas
Company
ASernlira Energy utility"
Applicant: SOLIS-HOLGUIN'•JOSEFINA'" Fax: 760 6016079
Contact: JOSEPHINA SOLIS-HOLGUIN Tel: 760 342 0212
From: . VINCENT ALVAREZ Fax: 760 773 9243
Address: 75095 MAYFAIR DRIVE
Email Address: NBProcess-Inland@semprautilities.com City/ST/Zip: PALM DESERT, CA 92211-5102
Tel: 909 335 7634
Date: 2/7/2013
The project planning and cost estimating for Project# 165708 has been completed and included
with this letter. Under the Line Extension Rules, you have agreed to have SoCalGas perform the
following gas facility installation:
INSTALL GAS SERVICE AND METER, COMPANY WILL DIG TRENCHES
SoCalGas estimated construction costs, (prior to applicable allowance, site prep fees & taxes) are broken
down as follows:
Main 0
Stub 0
Service 1586.6
MSA 170.34
Paease-execute'-your Line Exiension:coFltracf-and-retum:bv=emaiIZr.fax-to the following
Email: NBProcess-Inland@semprautilities.com
Fax: 1-866-448-3821 '
w�-• If payment is due;+please; remit•payment with Exhibit AStub to:;•:,- ,.} , ' `
Southern California Gas Company
Sundry Billing ML 711 D
P.O. Box 2007
Monterey Park, CA 91754-0957
Construction cannot begin until Vour signed Line Extension Contract documents
and payment have been received and recorded by SoCalGas.
If you have any questions regarding this matter, please reply via email or fax to the above listed.
Thank you,
Southern California Gas Company
New Business Process Team
SCG Cover Sheet 51489 avenia villaxls
Revised: 01/18a012
i
Exhibit A-1 Contract
Where two or more
ies are Applicants f
s1y.uQL-Ccd—r.(J(J-1-1-Gd'R-G',—Du'L---d-1-1—
jointly and severally liable to comply with all terms and' conditions he
Stub costs are refundable only to the extent the allowances generated by stub extensions exceed
the main to meter installation costs, and only for ten years from the date of the stub
installation. Refunds will be made without interest, and no refund will be made in excess of the
amount advanced.
If Applicant is'a corporation, partnership, joint venture, or a group of individuals, the'
subscriber hereto represents that he has the authority to bind said corpo=ation, partners, joint
venture, or individuals as the case may be.
My signature below represents my agreement and acceptance of the Project confirmation, Exhibit A
and Southern California Gas Company's General Conditions For Linextensicn. I acknowledge and
agree that The Gas Company's cost and allowance estimates for this Projec_ were based on
information provided by me or my authorized.representative. I further ackr:owledge and agree that
my signature represents-my/my company's agreement and understanding that subsequent changes in
Project scope may affect the installation price and further,.that if allowances have been
granted, an additional contribution may be required if the future -loads on which the allowances
were based do.not materialize.
APPLICANT: 'JOSEFINA SOLIS-HOLGUIN
By.
orize igna ure
J Ina
.
rin a e
Title:
Date
Address:
(Future bills, refunds, and correspondence will
be mailed to the address given)
Pfd boy lesglg3
PA 0&4 A. 4Vs57
Telephone:
�'1O1v1P�N►1,PV -Apo- 3N2 -o ZI2
212�(�g
Social Security or Eederal Tax,ID No.
No. ON 1b_4 x"12
Please Complete all fields**
U .
4 f
http://nbms.sempraoom9-.. rch&page?nl8cvdtr{12OlPrmt&Bro,tvwdD?3318939&abc?abc&id?()W(10188204&billType?ADNBILL&collStat?&[2/72013 31-04:32 PM]
southern
California VINCENT ALVAREZ
Gas Company Field Planning Associate
75095 MAYFAIR DRIVE
LM
AWSempra
Energy utility PADESERT, CA 92211-51.)2
909 335 7634 (phone)
02/07/13 760 773 9243 (fax)
Applicant SOLIS-HOLGUIN**JOSEFINA**
81125 KING PALM DRIVE INDIO CA 92201
Contact: JOSEPHINA SOLIS-HOLGUIN
760 342 0212
Project # 165708
Location: 51489 AVENIDA VILLA
Subject: Grade & Riser Setback
Accurate finish grade and riser locations are necessary to complete the integrity of the gas
installation. The Gas Company installation crew will install the'gas risers to the location
and grade that developer provides. In the event of a location or grade change, or any other
reason that a riser location is deemed to be unsatisfactory, such as, too Gose to an air
conditioner, or too close to a source of ignition, etc., all relocating costs incurred are the
responsibility of the developer.
Thank you for your cooperation.
Tract # SOLIS-HOLGUIN**JOSEFINA**
M EO # 0 Signatul e'
(De3 to rfSuperintender )
Grade & Riser Setback 51489 avenia villa.xls Revised: 01/18/2012
s�
car��a
Baa roapm
A �Sempra Energy m iny'
Project # 165708
Signs of a Natural Gas Leak: In addition to the distinctive odor of natural gas, other signs of a gas leak ma} include: a damaged
connection to a gas appliance; an unusual sound such as a hissing, whistling or roaring sound near a gas appliance or pipeline; dead
or dying vegetation in an otherwise moist area over or near pipeline areas; a fire or explosion near a pipeline; dirt or water being blown
in the air. Bubbling pools of water on the ground; or an exposed pipeline after an earthquake, fire, flood or other natural disaster.
Purges and Other Planned Releases of Natural Gas: Purging of gas lines, blow -downs and other planned releases of natural gas
should only be performed by qualified gas professionals. Such gas release operations should only be performed in well -ventilated areas
or by safely venting the contents of gas lines and equipment to the outside atmosphere away from people, animals, structures and
sources of ignition. All possible ignition sources should be extinguished before and during such operations. Consider using gas
detection equipment during all gas release operations to prevent gas from accumulating and creating a combustible or hazardous
atmosphere.
DO NOT RELEASE THE CONTENTS OF A GAS LINE INTO A CONFINED SPACE
The National Fuel Gas Code, the California Plumbing and Mechanical Codes, applicable Building and Safety�Codes and local
Departments of Building and Safety should be consulted for more information and before gas release operaticris begin. When installing
gas appliances and/or equipment, the manufacturer's instruction manual should be followed in conjunction with the local code authority.
ANY RELEASE OF NATURAL GAS PRESENTS THE POTENTIAL FOR EXPLOSION AND FIRE THAT COULD RESULT IN
SERIOUS INJURY AND DEATH. PUGING AND OTHER RELEASES OF NATURAL GAS SHOULD ONLY BE PERFORMED
BY QUALIFIED GAS PROFESSIONALS AND REQUIRES THE EXERCISE OF EXTREME CAUTION.
Please be sure to provide this letter to and discuss its contents with those that will be using natural gas at this location as well as to the
design professionals, contractors, and others working with you or on your behalf to design, install, place into service, maintain, replace
and/or repair the consumer's gas piping, regulators, appliances, fixtures, equipment and apparatus.
If you have any questions or concerns regarding any of the above, or require further assistance, please contacta licensed, qualified
professional. You may also visit our website at www.sdge_com/safety/naiuralgas for more information.
In order to proceed with your project, please print your name and provide your signature and date on the provided lines below,
acknowledging receipt of this safety bulletin. Please return the signed letter in the envelope provided.
We appreciate this opportunity to serve you.
SOUTHERN CALIFORNIA GAS COMPANY
6
MR . tom-)
r`(Sgnaturej
Applicant signature acknowledges receipt of this notice
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