PLBG (14-0215)52170 Avenida Martinez
14-0215
F: O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
14-00000215
Property Address:
52170 AVENIDA MARTINEZ
APN:
773-232-009-14 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
4000
Applicant:
4A
Architect or Engineer:
/ V
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
Licenselass: C36 % Licen : 273088
Dat6 13 / Contractor: -41 1
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)•:
(_ 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 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.).
(_ 1 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—) 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:
LQPERMIT
t
Owner:
LELAND JOAN E
51001 EISENHOWER
LA QUINTA, CA 92253
(760) 564 -4 104
D
Contractor:
VALLEY PLUMBING CO
78886 AVENUE 41
BERMUDA DUNES, CA 92203
(760)347-3629
Lic. No.: 273088 --
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:
MAR Q _. 20%
OF
3/03/14
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 SELF-INSURED Policy Number 2246
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 forthwi comply ith those provisions.
Date: 3 Applicant:' "
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 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 auth 'ze representatives
of this cou ty to enter upon the above-mentioned property for inspection urp
Date: Signature (Applicant or Agent): 4 _v/ri—
Application Number . . . . . 14-00000215
Permit . . . PLUMBING 2013
Additional desc . .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration Date 8/30/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG SEPTIC SYSTEM
11.92
----------------------------------------------------------------------------
Special Notes and Comments
SEWER HOOK UP SEPTIC ABANDONMENT 2013
PLUMBING CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
4.77
Fee summary Charged Paid Credited
-----------------
Due
-------------,--------------------------
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 96.34 .00 .00
96.34
Grand Total 108.26 .00 .00
108.26
LQPERMIT
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
k ' ' U-1
Project Address: !a 1 '2 V (/q /V14-& r 1z__
Owner's Name:4 yJ Lrts.. .
A. P. Number:
Address: 0 L A Qu m
Legal Description:
,, l v
Contractor:,
City, ST, Zip: 5—loo
Telephone -.76 0
Address: f is 4%
Project Description:
City, ST, Zip: 6K K-4 q
7—
J'7"t5 AIV 0 W
Telephone. a { S ► I
S' (tel.) 1
12
State Lic. # : ' 1 3 O P
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
P
>•>:....:::.;•:.><.;;:.;:j.;:;;::..<;:;.;.;,:>:>..;:>::;::•:::
Construction Type: Occupancy:
State Lic.
S #:
Project type (circle ne • New
Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 0 o . CA7
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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.1.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
;%
02/20/201'""1 T,.14 7605640344 LA QUINTA PALMS PAGE 01/02
LM
COACHELLA VALLEY WATER DISTRICT
OR P.O. Box 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date, 2111012014
SUBJECT: SANTA CARMELMA, 52170 AVENIDA MARTINEZ, LA QUINTA, LID 683372, "SCC FEE ONLr
JOAN LELAND Project 14-5195
loo LA QUINTA PALMS REALTY project Dom: 1/24/2014
51001 EISENHOWER DR
Amount Due: $4,851,00
LA QUINTA, CA 92253 GEO: 06-06-12-1
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CRMXT, PLEASE RETURN THIS PORTION WITH
REMJTTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT:SANTA CARMEUTA, 52170 AVENIDA MARTINEZ, LA QUINTA, UD 683372. "SCC FEE ONLY"
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel