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06-0475 (PLBG)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: 1/31/06 Application. Number: -'06-00000475 Owner: Property Address: -52770 AVENIDA VILLA KOCHELL STEVE. M APN: 773-334-001-26 -000000- P O BOX 882 Application description: PLUMBING LA QUINTA, CA .92.253 Property Zoning: COVE RESIDENTIAL " Application valuation: 2700 Contractor: Applicant: rchitect or Engineer: SO CAL PLUMBING,& REPIPE CO P.O. BOX 955 YUCCA VALLEY, CA 92286 1AA 3 e�ot1C Q� (760)369-4104 1Hp, • 1 6 UU �` Lic. No..: 793482 COY®�QU114 A F CE DEPT LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I 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-C42-B License No.: 793482 for by Section 3700 of the Labor Code, for the performance of the work'for which this permit is - issued. - /uat&3�_ ntr _ 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 DECLARATION - 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 EXEMPT Policy Number EXEMPT _ following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to 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 become subject 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 (Chapter9 (commencing_ with Section 7000) of Division 3 of the Business and Professions Code) or - 3700 of the Labor Code, I shall forthwith corn ' 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 ($500).:- D ZT� is I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and r i' 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, 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 - - - improve for the purpose of sale.). ' - APPLICANT ACKNOWLEDGEMENT - - 1 _ 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 fora permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an ownerof conditions and restrictionsset forth on this application. • property who builds or improves thereon, and who contracts for theprojectswith a contractor(s) 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, (_) 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 cessation of 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. I 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 this ounty to enter. upon the above-mentioned property for ins ec i . Lender's Name: ate�U��ature (Applicant or A _ Lender's Address: LQPERMTT - '- Application Number. . . . .. 06-00000475 Permit PLUMBING SEWER Additional desc r - Permit Fee 30.00 - _ Plan Check Fee .00 Issue Date Valuation 270.0 Expiration Date, 7./30/06 Qty : Unit Charge Per. Extension BASE FEE 30.00 Special Notes and Comments - SEPTTC: ARANDON. SRWER CONNFCT Fee summary Charged Paid .. Credited Due Permit Fee Total 30.00 - .00 .00 30.00 _ Plan Check "Total, .00 ..00 .•00 .00 Grand Total .: 30.00 .00 .00 30.00 LQPERMTT 61n # City of La Quinta- Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253'- (760) 777-70-.2 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: Kbak e �, A. P. Number: a,� 7 1 Address: Legal Description: City, ST, Zip: Contractor: �t Telephone: Project Description: cY Address: City, ST, Zip: �_ v'i'i Telephone: State Lic. # : u Z City Lic. #: Arch., Engr., Designer:l Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New p_dd'n Alter Repair Demo Name of Contact Person: _ Sq. Ft.: # Stories: # Units: Telephone # of Contact Person:—--- Estimated.-Value-of of Projec 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 CLeck Deposit Truss Cates. Called Contact Person Plan CL•eck 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:- 3' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person ?I.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total P9rmit Fees ti, 01/26/2006 23:13 7777154 CITY OF LA QUINTA PAGE 02 Al ` gECE1PTD�TA1l A J242� { �� CpACNEt1A VALLEY WATER OISITRICT CASH L. r o,_...... , Address:�.. r ( �: f % �• lode) '—" G.A. ACOWM 40. tiervlt:e iirddrese--'—`—"—• 1 p taetiir(e) t l7 Seri. ��- p BeQiKflow(a) } p Noj�ee LBte►A1(b) �r._`: �,M1r, �I p D�ItiCto s ...-��r--•—�� p Aq�Usr sureherge r ( i. , , , ""' Inwion Capack y L) O 1lAmyor�rY GorOn M6ter�� - C) dim on Gfia p 9$.jjaCted ACCOUrd - Kerne C7 I;p5pectlon Fee - Tract - Fee - d IPlan Check Fees Water 1 Sewer - Trac) - �. L) !r Bond. Payment - A.D. - Bonder—' Abemt�.— �� p ji cu9rome r i 01; OthW TOTAL ? R6merkb' Water Ufa i+ BaNICe � � � � �• 1 1 ,(',�....%. opy to: 7 Cashier".,y'M$) �. (',VWD4'88 ( ---AwNwAwPw FPL1wP11v& ._ •www www �ww� _ Lic #c42 855 851 OV .3&0- / 00 / *-1-ODU-334- /,900 FAX 760 328-6607 P•O. Box 2318 • Cathedral City, CA 92235 CUSTOMER'S ORDER NO. DATE OV Ep / ORDER TAKEN BY DATE PROMISED ❑ A.M. ❑ P.M. BILLTO PHCNE ADDRESS MEC IC CITY HEL-ER JOB NAME AND LOCATION ❑ DAY WORK DESCRIPTION OF WORK ❑ CONTRACT ❑ EXTRA Dumping Fee per 1000 gal. QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT Gallons Pumping Fee per 1000 gal.: Dumping Fee per 1000 gal. 1 Out of Area Fee Locating / Opening Fee (per hour) Size System: A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OV.ER.30.DAYS..,_ TOTAL MATERIALS TOTAL LABOR WAIVER: No� pons1611 secondary•da_m'age�suc as-wate►1 d ge, chipped concretppma oP neo • rlveways or treess t SIG. ATURE _ DAT.E'COMPLETED f TAX TOTAL "��