07-1721 (PLBG)t
TAW
P.O: BOX 1504 ^' VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA. 92253 BUILDING &" SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/14/07
Application Number: �7' "00001721 Owner:
Property Address: 52150 AVENIDA VILLA CORONEL LUCANO '
APN: 773-234'008-15 • 000000'- P O BOX' 389-ite93®3t)
Application description: PLUMBING LA QUINTA, CA 92253 vi.NinnV1
Property' Zoning: COVE RES-IDENTIAL b. VIII
Application valuation: 2000 BOOZ V
Contactor: L a
Applicant: Architect or Engineer. CORONEL CONSTRUCTION 0
P.O. BOX 389
LA QUINTA, CA -92247
_ (760)564-4604
' Lic. No.: 634981
LICENSED CONTRACTOR'S DEC AT N - WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of a ry that I am licensed der provisions f Ch ter 9 (commencing with - I hereby affirm under penalty of perjury one of the.following declarations:
Section 7000) of Division 3 of th B iness a Professio als Code, and y Lic nse 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: B -C13 - License No.: 63 81 - for by Section 3700 of the. Labor Code, for the performance of the work for which this permit is
issued.
lateL- Ii - _1 � Contractor. _ 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
OWNER -BUILDER DECLARATIO - insurance carrier and policy number are:
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the,' Carrier STATE FUND ' - Policy Number 0015999-2007 '
' following reason (Sec. 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 ermit 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 anyUnerso becom ject to the ork rs' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractor's State and agree thatmesu ject'to the wor ers' ompensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 oft a Lall forth vith comply wit t se provisions.
that -he or she isexempttherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany applicant for a permit subjects the applicant to a civilpenalty of not more than five hundred dollars (5500).: atepplican
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and £ Z - -
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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGESASPROVIDED 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
improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT -
1 _ 11, 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 conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractorls) 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 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. " '-
Date: Owner: - 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 c
essation180 days will subject -
CONSTRUCTION LENDING AGENCY - permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agencyfor the performance of,the 1 certify that I have read this application and sta t t the above inform ee to comply with all
work for which this permit is issued(Sec. 3097, Civ. C.). city and county ordinances and state laws relatin to ildin constructs orize representatives
of this county to enter upon the above-mentioned op rty f inspectio
Lender's Name: ,
„ Date-�iL.' Signature (Applicant or Agen -
Lender's Address:-. . _�
LQPERMIT - a
Applicatioir Number 07-00001721.
Permit . . . PLUMBING -SEWER
Additional desc
Permit Fee - 30.00
Plan Check
Fee
00"
Issue Date . . .
Valuation"
2000•
Expiration Date 12/11/07
Qty Unit Charge `Per
Extension
BASE. FEE
30.00
----------------------------_------------------------_---
Spediai Notes and Comments
,
SEWER HOOK -UP -AND SEPTIC ABANDONMENT
Fee summary Charged Paid
Credited
Due
Permit Fee Total 30.00
00
.0.0
30.00
Plan Check -Total .00 _
.00
.00
.00:
Grand Total 30.00
.00
.00
30.00
- LQPERMIT
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Buildink a Safery'Division' 14
P.O., Box 1504 •
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-18-495 Calle Tampico +
la Q6inta',•CA 92253
7
Buildin g Permit Application and'Tracking Sheet
Project Addre�ss:SgL,-1.(5��
.Owner's Name*
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A. P Number:
Address: c C,
Legal, Description:
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Telephone:
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r9ject type circle one)�' New Add'n Alter ,Repair. Demo
Name of C&ntact Person:
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Telephone = of Contact Person:
'Estimated Value of Project:
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06-14-2007 01:06pm From-CVWD PO SATELLITE
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COACHELLA VALLEY WATER DISTRICT
CASH RECEJPT DETAIL
+7603919638
Received
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Servlce Addreae •! neri� -
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❑ House Lateral(s)
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CORONEL ENTERPRISE INC. IrA taIJIIVTA, CA 92263 r
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P.O. BOX 388 PH (760) 564-4804
LA QUINTA. CA 92253 ;'= '"1'',:;.•h �:'1.6 rY✓r3'....A.c�.. �\'::-'•'- ••'�''
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PAY TO THE.. _ .. - "' -� � •�:_;�:', •:. •-••-k_. �:';:..:.,: - •' •..,
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ORDER OF GGAGWrall A UAIIIEY WATER DISTRICT00
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COACHELIA.VALLEY WATER DISTRICT .,'; :: 't =��' :;'`;;`;�e��'•`.g�:: ::- == Y -
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P.O. BOX 1058 �. :�, .: ,, .; :; -` .• =;,•r";: _
COACHELI-A, CA 92236
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MEMO
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