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0311-200 (PLBG)CD l— N rn W p = .C7 CY Lf)W oZr� coo O' o 1=CD Ha. Z LICENSED CONTRACTOR 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 # Lic. Class Exp. Date 422..155 C36 042 P ,A 01/3 :!2( Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt.from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( t1J I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). O I am exempt un er Section B&P.C. for this reason Date oo"A v Signature of Owner;,-" 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 & policy no. are: Cartier S'rATB pU)gD Policy No. 1643342-13;1 (This section need not be completed if, the permit valuation is for $100.00 or less). (+) 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, fortith comply with diose provisigRC ,1,109i:e.,r : -4 , APPlicant" Warning: Failure to secure Workers' Compensation coy ge-is unlawful and shall subject an employer to criminal' penalties and civil fines up to $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. IMPORTANT Application is hereby made to the.Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection,purposes. Signature (Owner/Agent) " <----••_� �u••'..�X_ Date - BUILDING PERMIT PERMIT�#��� DATE � � � VALUATION � ' LOT% TRACT JOB SITE ADDRESS APN OWNER CONTRACTOR / DESIGNER / ENGINEER WMA & CHEOROF, MOM)Y Y' R1r_ T 0 R0CqYX HRMFT CA 92543 (909)658-8541 C!B1.10 1.060 USE OF PERMIT PLUMBING ABANDON SEPTIC; tCOAtl*.WT SiWFA VALUATION 21000.00 Ls .Emmxrym con OF cmrdSi'1"zl<iC'x:do 2,OOi AX) PEIMUT PRE "MARY PLUMBINO FEE • SEWER 101-000-419-000 B Say"d 19-2-003 L' -J CI1 1 CF LA "Q,X1 31A FINANCE D,. 7 - RM -TOTAL CON. 'f1tU : C11a ANIS PLAk1`�1C $30.00 .LF.33 PRR-PAMF MW $0,00 TOTAL PERM" M N DUF -KUW RECEIPT DATE13Y YMPFINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final SLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Unde round Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final ' Plumbing Top Out Equipment Enclosure Shower Pans O:K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances - - Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS:, - - WACHELLA VALLEY WATER DISTRICT. ► ASH RECEIPT DETAIL Received From. %% �Ot `�J \ -tAXS,,, `+ _ " ',�► , ` r Address- 'Y' Account N,.( ��, Lot(g) ❑ Meter(s) O Service(s) ❑ Backflow(s) ❑ House Lateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge pe'�IanitationCapacity Charge 1_�P' ZY71 ❑ W.S.B.F.C. '❑ Temporary Construction Meter ❑ Tum on Charge ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water / Sewer - Tract - ❑ Bond Payment - A.D. - Bond Asamt ❑ Customer Deposit ❑ Other Remarks: J !tet �^t .'T 7. L{. qk� 9 � 1 u dopy to: h. sh sa Check_ - r Money Order i T N9 988945 r,eJ ! — t G.A: Code s TOTAL $ WaterService:~`- '" Cashier TOTAL $ WaterService:~`- '" Cashier OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements.specified. For your protectionyou,should be aware that as "Owner/ Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed bypropertyownerswnless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on, all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, -and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be anempl'oyer. If you are an employer, you must register with the State and Federal Governmenm.arl employerand you aresubject to several obligations including State and Federal income tax withholding, federal soti' security taxes, worker's compensaiion:insurance, disability, insurancecosts and:unemploymentxgmpensation contributions. There may be, financial risks for you if you do not carry out: these obligations, and these ri* are especially serious with respect to worker's compensation insurance. For more specific information about your obligations.under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). Formore specificinformation about your obligations under State Law, contact the Department of Benefit Payments and the Division.of Industrial':Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information. about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California.95814. Please complete and return the enclosed owner-buildeuverification form so that we can confirm that you are aware of these matters. The building permit will not issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle:Tampico Is Quina,, CA 92253 (760) 777-70 FAX (7 -7011 OWNER'S' SIGNATURE/DATE`/ S/ - N.5 L.1 .0 05/ s5 PROPER ADD SS x.311- X98- 03)/- a01Q PERMIT NUMBER(s) 80TOEl HEMET (909) 658-8541 El LAKE ELSINORE (909) 674-2312 ❑ BANNING (909) 922-9491 ❑ RANCHO/TEMECULA (909) 699-0555 WORK ORDER NO. 251191 J100 TER® 0 BEAUMONT j909) 845-3338 ❑ REDLANDS/YUCAIPA((90,) 797-8697 ❑ PERRIS 909 657-9852 ❑ PALM SPRINGS/DHS 760 322-2622 Plumb1 /' yy� /� 0 SUN CITY (909) 679-8919 ❑ INDIO/PALM DESERT (760) 346-1736 DATE �p ��-�. JOB # - - PL1�1�„ ers 796 N. STATE ST. • HEMET, CA 92543 of RotoCo., Inc. Tall Free: (800) 491-7686 Fax: (909) 652-9515 TECH #1 %.� 5 TECH #2 _ 1400 GET ROTO (438-7686) License Number: 422155_ • Federal ID Number: 33-0475032 FIXTURE MAIN LINE: FT ❑ BATH SINK -------- 0 FLOOR DRAIN - - - - -❑ JOB NAME I PURCHASE ORDER # CLEANED: TOILET ----------- ❑ KITCHEN SINK ----- 0 FLOOR SINK - - - - - - -0 ® J BATHTUB ---------❑ LAUNDRY --------- El AREA DRAIN -------0 JOB -A DRESS f' JC SHOWER ------- 11 URINAL --=----=---❑ OTHER ❑ CITY STATE ZIP ❑ YES GUARANTEE a NO r 8 A.M. - 5P.M. MON. THRU FRI. TIME IN TIME OUT CCOURTESY INSPECTION Q ACCESSED VIA CAUSE OF STOPPAGE DRAIN CLEANING $ ❑ DRAIN ❑ CLEAN OUT I]. ROOTS ❑ GREASE -= ❑ VENT ❑ OTHER ❑ UNKNOWN ADD'L FOOTAGE FIXTURE OK ,SRD' $ IAUTH. QTY. PART NO. DESCRIPTION / REMARKS / REPAIRS NEEDED PRICE ADD'L FIXTURES MAINLINE. " PLUMBING LABOR TOILET PARTS ® - 1u.N � �T BATH TUBl PRODUCTS/TREATMENT _ .� - ps SHOWER VJDEOINSPECTCON BATH_ SINK - _ - -�� , HYDRO-JETTER - - L - KITCHEN SINK ff MINI JETTER DISPOSAL « LINE/ LEAK LOCATION LAUNDRY PUMP SEPTIC/GREASE .. •• _ _ _ _ -- - _ _ - - - - - _ URINAL .OTHER= FLOOR DRAIN - FLOOR SINK: TAX AREA DRAIN -- . TOTAL _ WATER HEATER PAYMENT RECEIVED C/O REQ J L BALANCE DUE _ - PLEASE INITIAL THE FOLLOWING: ❑ CASH ❑ BILL ❑ CK # <] CREDIT CARD/TYPE A. The serviceman discussed Roto -Rooter products with me. B. I have. been advised additional lines cleaned at this time are half priced CC EXRDATE, APPROV # C. I have been advised that running my main line from a 3' roof vent Is I hereby authorize Rotoco, Inc. to charge my Credit Card for the above charges: i understand that by signing below I Improper access and can only be given a 10 day guarantee, a 2" main line has a am agreeing to all charges incurred on this Invoice and that the work was completed to my satisfaction. zero guarantee. In order to get a 90 day guarantee a cleanout must be installed, WAIVER OF RIGI•IT TO CANCEL; Cardholder Signature X Pursuant to Section 1680.13 of the,californio Civil Code. I acknowledge and hereby waive my right to cancel the sale withih three days and acknowledge that the products and services rendered hereunder are emergency repairs. Signature ` ADDITIONAL TERMS AND CONDIPONS CONTAINED ON THE REVERSE SIDE HEREOF Acknowledgement Completion CUSTOMER COPY CONDITIONS AND EXCLUSIONS Roto -Rooter Service & Plumbing Co. guarantees the services performed as set forth in this invoice to be free from defect in materials or workmanship for the applicable time period stated above. If within the Guarantee Period a drain stoppage or other defect in the repair of plumbing fixtures or plumbing parts installed by Roto -Rooter Service & Plumbing Co. occurs, Roto -Rooter Service & Plumbuig Co. will clear the drain stoppage or, repair or replace (at Roto -Rooter Service & Plumbing Co: s option) the plumbing fixture or plumbing part previously installed at no cost to customer. subject to the following exclusions and limitations: 1. This Guarantee applies only to the specific sewer lines cleaned. or plumbing fixtures or plumbing parts supplied and installed by Roto -Rooter Service & Plumbing Co: 2. Roto -Rooter Service & Plumbing Co. must receive notice of the. defect within the Guarantee Period. 3. This Guarantee does not apply to.- a. o: a. Multi Unit Dwellings sewer and drain lines, plumbing fixtures or plumbing parts. b. Materials furnished or work performed by other than. Roto -Rooter Service & Plumbing Co. c. Drains, sewer lines, plumbing fixtures and plumbing parts which have been misused. abused, damaged or modified by others; d. Draut or sewer line -stoppages caused by foreign. objects, including but not limited to sanitary articles, paper towels, toys, etc.; or e. Sewer lines which are settled, broken, offset deteriorated, damaged or improperly or illegally installed. L Drains, sewer lines, plumbing fixtures on septic systdnts. g. Commercial accounts. 4. The Guarantee Period commences on the date or original service and shall not be extended by subsequent services or repairs made pursuant to the terms of die Guarantee. The Guarantee hereunder extends to the customer im oiced for the services and is not transferable. 5. Roto -Rooter Service & Plumbing Co.'s liability hereunder shall be limited to recleaning of drain or sewer stoppage (Max. two repeat visits) or the repair or replacement of defective plumbing fixtures or plumbing parts: Roto -Rooter Service & Plumbing Co. shall not be liable for (1) Incidental or consequential damages; (2) Water or other damage; (3) Loss of use; or (4) Loss of anticipated benefits or profits.. any of which result from. the furnishing of services or products, or from the breach of the Guarantee, even if Roto -Rooter Service & Plumbing Co. knew of the likelihood of such damages. 6. Any implied warranty of merchantability, or fitness for a particular purpose of use, shall be limited to the duration of the foregoing written guarantee. The foregoing written guarantee is the customer's sole and exclusive remedy .and in lieu of all other guaranties and warranties, express or implied, written or oH, . This guarantee may only be modified in writing,.signed by an officer of Roto -Rooter Service & Plumbing Co. 7. 'This .guarantee does not apply in the event customer breaches any of the Terms and Conditions of service. including but not limited to timely payment of all charges. TERMS: NET 10 DAYS. A FINANCE CHARGE will be computed on the unpaid balance by a single period rate of 1-1/2% per month, which is an ANNUAL PERCENTAGE RATE OF 18%. "State law requires tory one who contracts to do construction work to be licensed by the Contractors State License Board in the license category in which the contractor is going to be working - if the total price of the job is $300 or more (including labor and materials). Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license. The Contractors State License Board may be unable to assist you with a complain. Your only remedy against an unlicensed contractor may be in civil court., and you may 4c liable for damages arising out of any injuries to the contractor or his or her employees, You may contract the Contractors State License Board to find out if this contractor has a valid license. The board has complete information on the history of licensed contractors including any possible suspensions: revocations, judgements and citations. The board has offices throughout California. Please check the government pages of the white pages for the office nearest you or call (800) 331-CSLB for more information." -.no r�_n��rn�r:��nr�1�t�pr��RIn21- rt��rr��nr.nr�t_n�r��nr�rsr�r�r� o 5 5Aesibleal ' i106 axon u t 5 5 5 5 (Single) Family Owner Occupied 5 1. Basin, Tub, Shower, Kitchen Sink, Laundry and Sewer in Good Condition with Clean Out ....90 days 5 5 5 2. Sewer From Roof Vent (2" Roof Vent$ Guarantee)..................................10 days 3. Toilet Stoppage and Area Draindays 5 .................................................10 4. Single Family Rental (Single Unit Only)...........................................30 days 5 C� 5. All Plumbing, Repairs and Replacements...............................1 Year Parts & Labor L� o ts� nr�rsrnrsr�r��nrrrst_nr rr�rsr rr.nrsr.nr, rr�r�tst_nsr�r:.rr1 nrrt l'Etr�tst n�r�r�r�r�r�r�t nr_r-t:l�r��r�r. rrnr��r.nrs�nr� 10 CONDITIONS AND EXCLUSIONS Roto -Rooter Service & Plumbing Co. guarantees the services performed as set forth in this invoice to be free from defect in materials or workmanship for the applicable time period stated above. If within the Guarantee Period a drain stoppage or other defect in the repair of plumbing fixtures or plumbing parts installed by Roto -Rooter Service & Plumbing Co. occurs, Roto -Rooter Service & Plumbuig Co. will clear the drain stoppage or, repair or replace (at Roto -Rooter Service & Plumbing Co: s option) the plumbing fixture or plumbing part previously installed at no cost to customer. subject to the following exclusions and limitations: 1. This Guarantee applies only to the specific sewer lines cleaned. or plumbing fixtures or plumbing parts supplied and installed by Roto -Rooter Service & Plumbing Co: 2. Roto -Rooter Service & Plumbing Co. must receive notice of the. defect within the Guarantee Period. 3. This Guarantee does not apply to.- a. o: a. Multi Unit Dwellings sewer and drain lines, plumbing fixtures or plumbing parts. b. Materials furnished or work performed by other than. Roto -Rooter Service & Plumbing Co. c. Drains, sewer lines, plumbing fixtures and plumbing parts which have been misused. abused, damaged or modified by others; d. Draut or sewer line -stoppages caused by foreign. objects, including but not limited to sanitary articles, paper towels, toys, etc.; or e. Sewer lines which are settled, broken, offset deteriorated, damaged or improperly or illegally installed. L Drains, sewer lines, plumbing fixtures on septic systdnts. g. Commercial accounts. 4. The Guarantee Period commences on the date or original service and shall not be extended by subsequent services or repairs made pursuant to the terms of die Guarantee. The Guarantee hereunder extends to the customer im oiced for the services and is not transferable. 5. Roto -Rooter Service & Plumbing Co.'s liability hereunder shall be limited to recleaning of drain or sewer stoppage (Max. two repeat visits) or the repair or replacement of defective plumbing fixtures or plumbing parts: Roto -Rooter Service & Plumbing Co. shall not be liable for (1) Incidental or consequential damages; (2) Water or other damage; (3) Loss of use; or (4) Loss of anticipated benefits or profits.. any of which result from. the furnishing of services or products, or from the breach of the Guarantee, even if Roto -Rooter Service & Plumbing Co. knew of the likelihood of such damages. 6. Any implied warranty of merchantability, or fitness for a particular purpose of use, shall be limited to the duration of the foregoing written guarantee. The foregoing written guarantee is the customer's sole and exclusive remedy .and in lieu of all other guaranties and warranties, express or implied, written or oH, . This guarantee may only be modified in writing,.signed by an officer of Roto -Rooter Service & Plumbing Co. 7. 'This .guarantee does not apply in the event customer breaches any of the Terms and Conditions of service. including but not limited to timely payment of all charges. TERMS: NET 10 DAYS. A FINANCE CHARGE will be computed on the unpaid balance by a single period rate of 1-1/2% per month, which is an ANNUAL PERCENTAGE RATE OF 18%. "State law requires tory one who contracts to do construction work to be licensed by the Contractors State License Board in the license category in which the contractor is going to be working - if the total price of the job is $300 or more (including labor and materials). Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license. The Contractors State License Board may be unable to assist you with a complain. Your only remedy against an unlicensed contractor may be in civil court., and you may 4c liable for damages arising out of any injuries to the contractor or his or her employees, You may contract the Contractors State License Board to find out if this contractor has a valid license. The board has complete information on the history of licensed contractors including any possible suspensions: revocations, judgements and citations. The board has offices throughout California. Please check the government pages of the white pages for the office nearest you or call (800) 331-CSLB for more information."