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05-3707 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00.0-0.3.7_07 Property Address: 80105 VISTA GRANDE APN: 649-143-003714 -3505 - Application description: PLUMBING Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2500 Applicant: Architect or Engineer: oll 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 5 Owner: MULLENEAUX JOSEPH W 80105 VISTA GRANDE LA QUINTA, CA 92253 Contractor: SO CAL PLUMBING & REPIPE CO P.O. BOX 955 YUCCA VALLEY, CA 92286 (760)369-4104 Lic. 'No.: 793482 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. LicenseClass: C36- 2.- LicenseNo.: 793482 ate: � � ntractor: R -BUILDER DECLARATION 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): 1 _ 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 offeredfor 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.). , (_) I am exempt under Sec. ' , B.&P.C.-forthis 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: LQPERMIT _ v VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760)777-7153 Date: 8/22/05 AUG 2 2 2005 CITY OP LA QUl"T" ` ------------------ WORKER'S COMPENSATION DECLARATION 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 ofthe work for which this permit is issued. - I have and will maintain workers' compensation insurance, as required by Section' 3706 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 EXEMPT 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 o�e Labor Code, I shall forthwith comply with those provisions. _ WARNING: FAILURE TO SECURE WORKERS' 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 followingissuance 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 �c/ounty to enter upon the above-mentioned pro e ate: 0 gnature (Applica Y Application Number ' 05=00003707 .. Permit .. PLUMBING SEWER Additional desc . Permit Fee 30.00 Plan Check Fee .00. Issue Date . . .'. Valuation . . . . 2500 Expiration Date 2/18/06 Qty Unit Charge- Per Extension BASE- FEE 30.00 ------- Special Notes and Comments ------------------- ------ -•-------------- SEPTIC ABANDON; 'SEWER CONNECT Fee summary Charged Paid Credited Due 7 ---- Permft Fee Total' 30.00 ---------- ---------- .00 ---------- .00 30-.00 - Plan 'Check Total .00 .00 ..00•''00 Grand Total 30.00 .00 .00 30.00 -LQPERMIT,_­ Bin # Permit # Project Address: A. P. Number: Contractor: x D C Address: City. ST. Zip: � Telephone: X State Lic. # : X• Arch., Engr.. Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Ret Plan Sets, Structural Calcs. Truss Calcs. Title 24 Calcs. " Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub, Wks. Appr School Fees City Of La Quill ta Building 8i Safety Division P.O. Box 1.504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: X �, U e Address: X City. ST, Zip: X (Jj Telephone: q Q Project Description: X ..........................::::::::::::: City Lic. #: R • I Total Permit Fees '. Construction Type: u �•• Occupancy: P Project e on type (circle rcl e). New A dd'n Alter Repair Demo Sq. Ft.: #Stories: Units: Estimated Value of Project: x �— APPLICANT: DO NOT WRITE -BELOW THIS tINE Rec'd TRACKING PERMIT FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans picked up Construction Plans resubmitted Mechanical 2"u Review, ready for corrections/issue Electrical Called Contact Person Plumbing Plans picked up S.M.I. Plans resubmitted Grading 1rd Review, ready for corrections/issue Developer Impact Fee Called Contact Person A.I.P P Date of permit issue R • I Total Permit Fees 09:46am 0 From-Local;12 Palm. Desert +7607791316 1-594 P-003/003 F-541 COACHELLA VALLEY, WATER DISTRICT CASH RECEII ? DETAIL N Q 109713 �_..-- f }� Received Fr7m' `-o```�- � �� 1" Date: Acldre�; [J s • Account No. qq��l_ ' Lags} Tractr.� Service Addresses ---..- GA. Code 0 Maier($)- � 5eryice(s) �® M 13acktlov,(e) .T a M House Lateral(a) f ❑ Dater -tar Chocks) M Met Surcharge .�... WSanitatlon Capacity Charge - - -. Q WS,B,FC. n Temporary Construction Meyer * Turn on Charge ❑ Uncollected Account- Name —_ :J inspection Fee - Tract - _. Fee --- U Plan Check Fees Water! Sewer - Tract - ❑ Sond Paymont - A.D. - _ Bond----- Assort— - Q Customer Deposit— r-1 eposit— Otho TOTAL $ y cm. Remarks: w - - - - -------- Cas t ' p Water Service - Chock rnonoy ` �\ J Cashiar Order CWrD-ase h/051 JOSEPHV., IVIULLEkk4UX I 01-ea4eta2a: 72.4 ao:yos:VISTA GRANDE: to tau1P1TA, CA. 02.aa PAY TC.TWe -ORDER DF-=- 64 'r AHS •:U ''ate.. La Jolla Bank n4. riOC�NSM'+JM'»>. NC WI wfiLB,Gviip 1eS1No` �'7<4e�x ot�___ — 28649.29. • .0-3 i 310 i.- 20811'0? 21C,