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04-3716 (PLBG)T 272004 WO n;=D lA CE BUILDING & SAFETY DEPARTMENT nFD�• . P.O. BOX 1504 (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . .04-00003716 Date 4/27/04 Property Address . . . . . . 51295 AVENIDA DIAZ APN: 773-043-030-4-000000- Appl.ication description PLUMBING Property Zoning MEDIUM DENSITY RES Application valuation . . . . 3000 Owner ------------------------- KIM ERIN H 51295 AVENIDA DIAZ LA QUINTA CA 92253 Contractor ------------------------ ALMS UNDERGROUND CONST, INC. 38703 VISTA DRIVE CATHEDRAL CITY CA 92234 WCC: VIRGINIA INC WC: 00500016007 01/01/05 CSLB: 482180 11/30/05 CCC: C42-C21.- ----------------------------------------------------------------------------- Permit . . . . . . PLUMBING SEWER Additional desc . . Permit Fee 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 3000 Qty Unit Charge Per BASE FEE Fee summary Charged Paid Credited Permit Fee Total- 30.00 .00 .00 Plan Check Total .00 .00 .00 Grand Total 30.00 .00 .00 Extension 30.00• Due 30.00 .00 30.00 P.O. Box 1504 9W4 VOICE (160) 777-7012 78-495 CALLS TAMPIt O FAX (760) 777-701 1 LA QUINTA. CALIFORNIA 92253 4 4 a INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: - 7 (� Applicant: CC Applicant's Malting Address: ' Date: ' �7 -v Architect or Engineer. Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under Persaltr of perjury rat i am licensed under ptwi wm of ChWW 9 (0omm0n=V vdfh secbw 7000) of Division 3 of fro Bu=wn and Rdeumak �'-0d■. iLld lny tlOdlfd 4 lit �OfIC� /rYd CirtdCL Lkenve Class_r'• f Z _C -ZJ License No. Odle a 7� o r. �t�7`I CAnhac'Evr �' / M s �.�1"r . c�� r✓ �, ,�� C c� r S / � i OWNER$ULDER DECLARATION 1 treraby affmm etrder penally a[ perjury Murat l err► ElCarf�f kum ft C.ordrar q - SUAe Lkw" Law kr the fott---eq saszan (Serf 7 -5. 3;s; :rid Professions Cads: Any City orstalant Mural he m f +used 10 cores fnma Eller, irnprwe. 6wr*EW a repair any st ucturea prgr to Its issuance, also requires the appliccanf kw Mme Pemrit b lie a signed Purim to the pmvisions of the Car baalors' Slate Liaertse Low (Chapier 0 (corrnmriCinq wiCr Section 7000) of Divislnn 3 of the Buaireas and PrOlem1�0m Cdde) or Meal Ire a she i; EaoeRtpl 9rarolram and We basis brew alegPd rxwp6on, Arty violation of Section 7031.5 6] army applicant bra Pam serbjeata the N* aard t0 a airs penalty 0f not mare than five hundred dolans ($5W).); ( j 11 as owner of the property- err my employees with vragcs Its Wick sale compensabM will do a* ► o k, End the Struck" is nut intended or offered for sale (Sae- 7044. Business and ew or storms Code: The Carrtr mpio' stale Llcertse Law does not apply 10 an owner of property who builds or Ynpm%fts themM end who dons Mee work himself on Ivarseff a thrrxrghm his or loan Dino ernpY�ree;, provided that the improvements are not irdende�d or cfksred Im sale. K, however, the Imurldarp or knproverrrerd is add wit- one year of 0ompletion, the Goren -builder will Brave the burden of wing that he or she did ON Iwiid or improve tar the purpose of sale.). t j I. as owner a se Laprow does am excIuapply s i an op°th�g opWfthfear, tonbadors b WnWh cY the project (Sec. 70a4. Busmess and Profeukwm Cade: The Corkbckxz' State �� ' does not t La ,) an rarvrmer of propeRy who builds or improves thereon, and who c0ntraces for the Pm)ects whh a o0ntiachx[s) %Caused pursuant 10 Itee Carmdaclors' Slate Licer>ye Lary.). U I am exempt under Sec. , 8.d P.C. for this reason Date Owner 1 hereby affirm under WARS' COMPENSATION DECLARATION PAY d Perjury one Gf fha kAowkq declarations: T I hays and wN maintain a cerMicate. or cnlr s nt to self -insure for workers' cvrtrperaatiort, as provided for by Section 3700 of the Labor Code. for the pedorrnancs of the work for which ttis Pero is leaned_ i h a ve aand will maintain ►votkers' aompensaticrm irmsuran[ae, as required by Section 37M of the Labor Cote. for the performance of deb work for which pis Pei.. is Cams J workerorks•�tumbw end numberamL �raertify 11 rah in. Per( work for which ttis permit is issued. t shall not ernpby any Person M any manner to as to beomle subject to the workers' Conn Coulon fawn 0f Cafrlamia,"agree trail. It I should become subject brie workers' 0orrmpsnsation provisions of Seckn 3700 of fha Labor Code. I sires iodh kh wrnpty with those provisions, Date Applicant WARNING: FAILURE TO SECURE WORI{EFL COMPENSATION COVERAGE M UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIL*NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (3100.0001 IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR 1N SECTION 3706 OF THE LABOR CODE M+ITEFF$T. AND AT'TORJEY'S FEES. I hereby affirm under CONSTRUCTION LENDING AGENCY DAY of. M1at Myers is ■ car>struction lending agency for Mma PeAGrmance of the work for which this permit Is issued (Sec. 3097. Civ. C.). Lenders Name Lenders Address IMPORTANT Application Is her APPLICANT ACKNOmiLEDGEMENT fly mode to the Application Director of Bustling and Safety Ivr a Permit subjad to the candrtions and restrictions set forth on ttis applicakm 1. �pas a rsa result � pplbalica mdis apprrcahon is nmade, each person at W wse rr_quest and kx %tmose benefit work is Wom-ed under or pursuant IQ any PamrN offraerc, agents end PP atian, the owner, and Mee applicant, each agrees 10, and sha4, defend. indemnity and hold harmless the City Of LE Oulrrla. Rs employees fix any act or omission retated to the work being Performed under or foaaMng Issuance of Mils pertrilL 2 Any Pamd issued as a result of tells appkmtion berxrrrrs; null End void if worn is not tOMmenced within idti days from date of issuance of such perttW, or cessation of work krr 1$0 days will subject per'. 1 10 cancenation. I raertify Meat I have read this appiica lon and slate that the above kdorrnation is correct I construction, and hereby ■ullxxize representatives of nis agree w t0rrmply with an sty aril county ordir+ances and stale laws reta4ng 10 ourd,ng enter doom the abave•(fM► burped Property for knspection purposes. . n Date n �-M- Signature (Appkcard or Agent): D% ,� t APR-4-2004 02:44P FROM: TO:3249541 P:2/2 GOACHELtA VALLEY WATER DISTRICT CASH RECEIPT DETAIL N� 101244 Received From: C�k- IV /7/ , J � / -Dale; Address; em ] Lot(u),'"�� `� Tract % ' i �# I•, l {_ J fY lam_ r- GA. Code Service Address-C - L Meter(s) 7,� Service(s).�— LJ— ,, House Lateral(s) — De(Ktor Checks) __ . r Meter Surcharoe — Sanitation Capacity Charge _ 1 W.S.B.F.C. _ r.. Temporary Construction Meter- 1_7 Turn on Charge J Uncollected Account - Name -- If+Spection Fee- Tract - Fee - Plan Check Fees W1I0r r Sewer - Tract - L Bona Payment - A.D. - . -Bond Assmt. Cu9tomerDeposit_, - 1 Other - TOTAL r�r / Remarks: 1-f %� u 92 ` %i �l/ ---- Copy to; Cash Check Money Order S . J Water Service CAshiar_ CM1D-438(11189) _ • W APR-21-2004 WED 07:20RM ID: PAGE:2 M HAMMER PUMPING INC. JOB INVOICE P.O. Box 2448 CATHEDRAL CITY, CALIFORNIA 92235-2448 Mn► �r%n-7AA$t (760) 321- 7448 CUSTOMER'S ORDER NO-e RED DATE -7 ` ORDER YAKEN BY DATE PRMISED ❑ A.M- ❑ P, M. BILL TO PHONE ADDRESS ME H! Ir CITY HELPER JOB NA A LDCRnnN f�� �y-1 Ez i ❑DAY WORK SG R4PTIDN OF WORK ❑ CONTRACT ❑ EXTRA JayLLo In LIANT- DESCRIPTION OF MATERIAL USED V PRICE AMOUNT �! Gallons Pumping Fee per 1000 gal. IOo © - —j Dumping Fee per 1000 gal, Out of Area Fee Locating / Opening Fee (per hour) Size System: -� � /rr 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. HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS Q HELPERS @ TOTAL LABOR I hereby acknowledge the satisfactory completion of the above described work: TOTAL LABOR TAX SIGNATURE DATE COMPLETED L ' TOTAL