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05-5335 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00005335 Property Address: 52585 AVENIDA HERRERA APN: 773-293-016-3 -000000- Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 2500 C&hf 4 64& a" Applicant: Architect or Engineer: �tpr 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 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: C36 -C42 -B License No.: 793482 tracto / - r� ioECL1iA1IO1- Ihereby affirm under penalty of perjury that 1 am exempt from the Contractor's State Licensb 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).: (_) 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.). (_ 1 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 Date: Owner: 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: LQPERMTf Owner: LA QUINTA REAL,ESTATE P.O. BOX 1511 LA QUINTA, CA 92247 Contractor: SO CAL PLUMBING & REPIPE CO P.O. BOX 955 YUCCA VALLEY, CA 92286 (760)369-4104 Lic. No.: 793482 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/06/05 ------------------ 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: Carrier7 MPT Policy Number • EXEMPT I certify that, 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 3700 of the Labor Code, I shall forthwith comp) r_with those provisions. WARNING: FAILURE TO SECURE RS' COMPENSd evERR�1 IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 re resentatives of this county to enter upon the above-mentioned property for ins Safe. � nature (Applicant or Application Number .. . . 05-00005335 Permit . . . PLUMBING SEWER Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation 2500 Expiration Date . . 6/04/06 Qty Unit Charge Per Extension BASE FEE 30.00 -------------------------------------------------------------- Special Notes and Comments ------------- SEPTIC ABANDON; SEWER CONNECT 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 LQPERMIT A-M-SmAmPm PUMP/NG Lic #C42 855 851 low .3A90-1001 I" FAX 760 328-6607 P.O. Box 2318 - Cathedral City, CA 92235 CUSTOMER'S ORDER NO. ORDER TAKEN BY DATE ORDERED DATE PROMISED ❑ A.M. ❑ P.M. BILL TO v PHONE ADDRESS NIC CITY HELPER JOB NAME AND LO ION ❑ DAY WORK DESCRIPTION OF WORK / ❑ CONTRACT ❑ EXTRA Dumping Fee per 1000 gal. QUANT. DlESCRIPTION OF MATERIAL OSED PRICE AMOUNT C Gallons Pumping Fee per 1000 gal. Dumping Fee per 1000 gal. Out of Area Fee Locating / Opening Fee (per hour) Size System: A SERVICE CHARGE OF $20 WILL BE DUE ON ALL RETURNED CHECKS. 18% PER YEAR WILL BE CHARGED ON PAST DUE ACCOUNTS OVER 30 DAYS. TOTAL MATERIALS TOTAL LABOR WAIVER: Not responsible for secondary damage such as water dama to rmd s Fee or as. SIG OMPLETED i TAX TOTALC FROM : LA U IINTA REAL ESTATE PHONE NO. . 760 SG44.728 Nov. 01 2005 12:20PM P1 0 VVII F'' ........... _...--- ......_..... .......... �~ I COACHa.LA VALLEY WATER DISTRICT CASH WECEIPi DS?TAIL �� q �39 Received F ! 1/� �t',�'U,YC u�.z� _ �C . !:y'�r.i r�'Date:/� -- C5 ACCO ti0,_ c> G.A. Coao ti 0 Wefts) -- — 5 ! 0 Hnuse taterW(e) 0 Detector C %$Ck(S) _ 0 Meier Sur+%vge ---T_ �. GA%rutation Capacity Chutta. __ —1 • S/7. L!t� !' 0 W8.0,RC. G S.LW.3•C- — __ — t O Tampon" Constrpm n Meter-- 0 eter 0 Tum on Charge 0 Uncollected Account - Name -- -- - i 0 Inspection free - rrm - i. Fee - _... _ 0 Plan Check Fees Water / Sewer i Treat - j 0 Bond Payment - A.D.-..._...... Bon4 - --- Atiemt--------- — —•—• OCustomer Depoelt . _...._ . _.. _. r- � ❑Other -- 1.,1. TOTAL S Remanct: "pytv. )64Q=!L _- — Cash Water Barad.. ?, Check � Money a Cashier Order Cw/G•4w 0/08) Bin # City of La Quinta Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 0 Project Address: P Owner's Name: Qr A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: v� Telephone: Address: c(30 Project Description: City, ST, Zip: l H.O.A. Approval Telephone: . r. Plans resubmitted State Lic. # : City Lic. #: Arch., Engr., Designer: Address: 3'" Review, ready for corrections/issue City, ST, Zip: Developer Impact Fee Telephone: manning Approval Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: —T—Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE N 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. Total Permit Fees Called Contact Person Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2"' Review, ready (or corrections/issue Electrical M 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 manning Approval Called'Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees M