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BPLB2015-013878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: 'edit 4 alefi CZ" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPLB2015-0138 • 54270 AVENIDA ALVARADO 774241026 AUSTIN / SEWER CONNECT ABANDON SEPTIC. $2,000.00 Applicant: PEREZCHICA CONSTRUCTION 68380 VERANO ROAD CATHEDRAL CITY, CA 92234 D 11 .� DEC 04 2015 J CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 11111111111111111111 40 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: •MAUREEN AUSTIN 54720 AVENIDA ALVARADO LA QUINTA, CA 92253 Contractor: PEREZCHICA CONSTRUCTION 68380 VERANO ROAD CATHEDRAL CITY, CA 92234 (760)328-9398 Llc. No.: 506475 Date: 12/4/2015 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 Professions Code, and my License is in full force and effect. License Class: B. C36 License No.: 50647 Date: /a_ T` r q Contr OWNER -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).: ( ) 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.). ( ) 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. 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: 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: Carrier: Policy Number: 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 370' . he or Code, I shall forthwith comply with those provisions. Date: l? 44—�� Applic WARNING: FAILURE TO SECURE WORKERS' ENSATION 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 Building Official 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 representatives of this ' t upon the above-mentioned property for inspection purposes Date:0-4—? Signature (Applicant o ' DESCRIPTION FINANCIAL INFORMATION , ACCOUNT QTY. ..' ` AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/4/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY PEREZCHICA CONSTRUCTION CHECK R11299 7578 SGU Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00' DESCRIPTION . ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 12/4/15 PAID BY ' METHOD • RECEIPT # • CHECK # - CLTD BY PEREZCHICA CONSTRUCTION CHECK R11299 7578 SGU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 DESCRIPTION ACCOUNT ; QTY AMOUNT ` ' PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 12/4/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY PEREZCHICA CONSTRUCTION CHECK R11299 7578 SGU DESCRIPTION ACCOUNT QTY AMOUNT PAID • :' PAID DATE BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 12/4/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY PEREZCHICA CONSTRUCTION CHECK R11299 7578 SGU Total Paid for PLUMBING FEES: $24.18 TOTALS: $117.03 $24.18 $117.03 Permit Details City of La Quinta Description: AUSTIN / SEWER CONNECT ABANDON SEPTIC . Type: PLUMBING Subtype: Status: APPROVED Applied: 12/4/2015 SGU Approved: 12/4/2015 SGU Issued: Finaled: Expired: Parcel No: 774241026 Site Address: 54270 AVENIDA ALVARADO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 265 Lot: 24 UNIT 24 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Valuation: $2,000.00 Occupancy Type: Construction Type: No. Buildings: 0 No. Stories: 0 • • No. Unites: 0 Details: SEWER CONNECT ABANDON SEPTIC SYSTEM. 2013 CALIFORNIA BUILDING CODE. Applied to Approved. ADDITIONAL SITES CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESS1 CONTACTS CITY • STATE ZIP PHONE • FAX EMAIL APPLICANT PEREZCHICA CONSTRUCTION 68380 VERANO ROAD CATHEDRAL CITY CA 92234 PEREZCHICACONST@A OL.COM CONTRACTOR PEREZCHICA CONSTRUCTION 68380 VERANO ROAD CATHEDRAL CITY CA 92234 PEREZCHICACONST@A OL.COM OWNER MAUREEN AUSTIN 54720 AVENIDA ALVARADO LA QUINTA CA 92253 FINANCIAL INFORMATION Printed: Friday, December 04, 2015 8:19:46 AM 1of2 CSYSTEiMS Permit Details City of La Quinta BPLB2015-0138 DESCRIPTION • ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/4/15 R11299 7578 CHECK PEREZCHICA CONSTRUCTION SGU Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: . PERMIT ISSUANCE 101-0000-42404 0 591.85 $91.85 12/4/15 R11299 7578 CHECK PEREZCHICA CONSTRUCTION SGU Total Paid for PERMIT ISSUANCE: $91.85 $91.85 BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 12/4/15 R11299 7578 CHECK PEREZCHICA CONSTRUCTION SGU BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 12/4/15 R11299 7578 CHECK PEREZCHICA CONSTRUCTION SGU Total Paid for PLUMBING FEES: $24.18 $24.18 TOTALS: $117.03 $117.03 INSPECTIONS PARENT PROJECTS REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE STATUS REMARKS NOTES BOND INFORMATION ATTACHMENTS Printed: Friday, December 04, 2015 8:19:46 AM 2 of 2 CPR/SYSTEMS Bin # City of La Q Odin to Building 8T Safety Division . 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 M3 La Permit Application and Tracking Sheet Permit 4f �$ 2-O l 5 Project Address: 5 —,g-70 !(E, diy4r •• 0 Owner's Name: • .' .AP- .!... SUS(/,v A. P. Number: ,‘41 Address: k)q�-.,)7Q 9i g7 ,g1 o Legal Description: City, ST, Zip: 0a74 i w a 3 • Contractor: E� �(6tigTelephone: hone: : .. Address: 65-3 go &27,7,1_,,,2, . 7». Project Description: 5--- CQ, G77O'v City, ST, Zip: (' 1C c Telephone 0' State Lic. # : �f/ Cti 7 �j City Lic. #; c)f0 M 0 Arch., Engr., Designer: . Address: City, ST, Zip: Telephone: one: e• Occupancy: Construction ion TYP an cY: State Lic. # Name of Contact Person: • (4i 3 / A • / z q,' , Project•ecte (circle one): . Ne w Add 'n Alter RepairDemo Sq. Ft: I # Stories: (# Unit: Telephone # of Contact Person:..----- �0-J10— 9c2 / Estimated Value of Project: ' (90674'� • APPLICANT: DO NOT WRITE BELOW THIS LINE • Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. 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:- 'fl! Review, ready for corrections/issue Developer Impact Fee ' Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr ' Date of permit issue School Fees, Total Permit Fees COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 12/1/2015 SUBJECT: SANTA CARMELITA, 54270 AVENIDA ALVARADO, LA QUINTA; LOT 24, LID 690490, "SCC ONLY*' MAUREEN AUSTIN 54270 AVENIDA ALVARADO LA QUINTA, CA 92253 Project: Project Date: Amount Due: GEO: Planner: TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 15-6809 12/1/2015 $4,851.00 06-06-13-2 RUBEN MONTIEL IMEK , awe .. d ....,:Fee TYJ'S�'C3escriptloin.=. .,, ..i�.: �,�N�'�- > 'Charge �-Amount ' Tatai-Amount � 1.00 FF SCC -COLLECTION $2,415.00 $2,415.00 1.00 FJ SCC -TREATMENT $2,436.00 $2,436.00 $4,851.00 PAID $ `7rCl - c—rte _� 2--(9 Development Services Department DEC 01 2015 Coachella Valley Water District 75-515 Hovley Lane East PnIm Desert, CA 92211 SUBJECT:SANTA CARMELITA, 54270 AVENIDA ALVARADO, LA QUINTA, LOT 24, LID 690490, "SCC ONLY** COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Page 1