BPLB2015-0020 + RR (12218)54220 Avenida Madero
BPLB2015-0020
12218
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DI
BUILDING PERMIT
Application Number:
BPLB2015-0020
Property Address:
54220 AVENIDA MADERO
APN:
774193011
Application Description:
SEWER / SEPTIC ABANDONMENT
Property Zoning:
Application Valuation:
$2,800.00
Applicant:
HAMMER PUMPING INC
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
FEB 0 9 2015
VV
VOICE(760) 760 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/9/2015
Owner:
KRISTEN AASTED
5075 SAN JOAQUIN DR
SAN DIEGO, CA 92253
Contractor:
HAMMER PUMPING INC
0 OUTSIDE CITY LIMITS
_II II LA QUINTA, CA 92253
(760)321-7450
Llc. No.: :LIC -0001138
I Crry OF LA QUINTA
-----------------------taht ijMTYBEVELGPNIGE91;EA 9?.MFt•1T--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licens)undprovisions of Chapter
9 (commencing ith Section 7000) of Division a Bnd Professions Code,
and my Lic nse is in full force and effect/
License CI s: License No.: :LIC
Date: Contra or:
OWNER -BU DECLARATION
I hereby affirm nder 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
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
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 Addre<
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 agr if I should b come ct to the
workers' co pensation provisions of ction 370 o the L or Co I s all forthwith
comply with hos provisions.
te: Ir App icant: .
WARNING: FAIL RE 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 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 t ove infor ationi t.
I agree to comply with all city and county ordinanc . ndstat aws re ting buiIdi g
construction, nd hereby authorize representativ of this city en t upon th o e•
mentioned op rty for inspection purposes.
DDte: 1 / Signature (Applicant r A
Is I N
PAID PAID DATE
INFORMATIONFINANCIAL
DESCRIPTION: ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
$0.00
PAID BY METHOD RECEIPT #
CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT # `
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BUILDING SEWER
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
'PAID DATE
BUILDING SEWER PC
101-0000-42600
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $24.18 $0.00
TOTALS:•0
Description: SEWER / SEPTIC ABANDONMENT
Type: PLUMBING Subtype:
Status: UNDER REVIEW
Applied: 2/9/2015 PJU
Approved:
Parcel No: 774193011 Site Address: 54220 AVENIDA MADERO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 257
Lot: 14
Issued:
UNIT 24
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $2,800.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
CITY
Details: SEWER CONNECTION SEPTIC ABANDONMENT 2013 CALIFORNIA PLUMBING CODES.
ZIP
ADDITIONAL SITES
CHRONOLOGY
DESCRIPTION I ACCOUNT I QTY I AMOUNT I PAID I PAID DATE I RECEIPT # I CHECK # I METHOD I PAID BY I CBYD
BSAS SB1473 FEE 1 101-0000-20306 1 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
Printed: Monday, February 09, 2015 1:54:08 PM 1 of 2
CRWYSTEMS
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT
HAMMER PUMPING INC
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(858)483-2100
CONTRACTOR
HAMMER PUMPING INC
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(858)483-2100
OWNER
KRISTEN AASTED
5075 SAN JOAQUIN DR
SAN DIEGO
CA
92253
(858)483-2100
DESCRIPTION I ACCOUNT I QTY I AMOUNT I PAID I PAID DATE I RECEIPT # I CHECK # I METHOD I PAID BY I CBYD
BSAS SB1473 FEE 1 101-0000-20306 1 0 $1.00 $0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
Printed: Monday, February 09, 2015 1:54:08 PM 1 of 2
CRWYSTEMS
Permit Details PERMIT NUMBER
City of La Quirita BPLB2015=000 r
DESCRIPTION
ACCOUNT
-
QTY
,
AMOUNT
...rte-....,r- ...-_ .
PAID
-
PAID DATE
....- -.
RECEIPT #
CHECK #
-..
METHOD
------•-
PAID BY
CL BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
BUILDING SEWER
101-0000-42401
0
$12.09
$0.00
BUILDING SEWER PC
101-0000-42600
0
$12.09
$0.00
Total Paid for PLUMBING FEES: $24.18 $0.00
TOTALS:00
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
Printed: Monday, February 09, 2015 1:54:08 PM 2 of 2 Cori"SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
PLUMBING FINAL"
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
Printed: Monday, February 09, 2015 1:54:08 PM 2 of 2 Cori"SYSTEMS
Bin # City of LQ Q u1 n to .
` -Building & Safety Division
Permit # P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: S i0Zd ICAOwner's Namc: / (�� 5—
A. P. Number:
Address: J 1 f3 �Q .
Legal Description:
City, ST, Zip: SSS e
t
Contractor:
Tcl h nc:
c o
P
Address: � �x 2q L4'7
Project Description: f� `lJ ✓pN
City, ST, Zi �
o •
Tele hone:
�s-
:::.:>:<•' «'%"
;.
State Lic. #:'(,. . (0 1
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
:z::•:•�:;<a::;<!:>: >::::.;:: ,;:. «.;;:;;:"
Construction Type: Occupancy:
cy:
State Lic. #:
Project type (circle one)•New Add'n Alter. Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
stimated Value of Project: 2 0�
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rcc'd TRACMIG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Revic-.ved, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'4 Review, ready for corrections/issue
Electrical
Subcon factor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"4 Rcpiew, ready for eorrections(ssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permft issue
School Fees
Total Permit Fees
T R• COACHELLA VALLEY WATER DISTRICT
r` P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Q t
INVOICE Date: 2/=015
SUBJECT: SANTA CARMELITA, 54220 AVENIDA MADERO. LA QUINTA, LOT 14, LID 6896180 SCC FEE ONLY'
KRISTIAN AASTED Project:
15-6093
5075 SAN JUAQUIN DRIVE Project Date:
1/29/2015
Amount Due:
$4,851.00
SAN DIEGO, CA 92109 GEO:
06-06-13-2
Planner:
RUBEN MONTIEL
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
PAID
Development Servioes Department
FEB 0 8 2015
Coachella Valley Water District
75-515 Hovley Lane East
Palm Desert, CA 92211
$4,851.001
SUBJECT: SANTA CARMELITA, 54220 AVENIDA MADERO, LA QUINTA, LOT 14, LID 689618' SCC FEE ONLY'
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Page 1
Building
Address 54-220 Madero
Owngaren Bennett
Mailing
Address Same
CityZip
La Quinta F CIX 92253
Contractor
Peterson Roofing
AddCfrep06 Enterprise
Cityl.
ZiMesa, 9 Te
926.26 (7I4)9749.
State Lic. City'
& Classif. C-39 607872 t Lic. # . )a5
4
P.O. BOX 1504 N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Arch., Engr.,
Designer
Address Tel.
12
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensetl under provisiens.gjphapter 9 (commencing with Section
]000) of Division 3 of the Business:ara dProfessions Vit"and my license is in full force and
_<fecL _R,.1
SIGNATURE - DATE
(/! OWNER -BUILDER DECLARATION
l hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit toconstruct, alter, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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).
O 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Company
opy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thq 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST. OCC. GRP.;
P. Number
Legal Description
Project Description Reroof
12218
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $2,500.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
30.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
30,00
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street SetbprJLfrom Center Line
Side Setback fr rop tl
n- -I t -
FINAL DATE
Issued by:_
Validated by:
Validation:
f
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
r`
BONDING
HEATING (ROUGH)
2ND FL. S0. FT.
FORMS
YARD SPKLR SYSTEM
POR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. S0. FT. ®
OTHER APP.IEOUIP.
DRAINAGE PIPING
WALL S0. FT.
TEMP. POLE
DRINKING FOUNTAIN.
SO. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
TI
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE FPLUMB.FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING /...(' La
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL