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BPLB2015-001952620 Avenida Martinez BPLB2015-0019 78-495 CALLE TAN1i0ICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 c&ht 4 4 QuiKs COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPLB2015-0019 52620 AVENIDA MARTINEZ 773302005 SEWER CONNECT/SEPTIC ABANDONMENT $2,800.00 FEB 0 9 2015 CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licens uncle isions of Chapter 9 {commencing with Section 7000) of Division 3 of the B i ss and P fessions Code, and my License i in full force and a License Cla s: License No :LIC"Xate:Zontra // vv OWN DER DECLARATION I he 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 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. BAP.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: 'U r VL , VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/9/2015 Owner: ANNETTE MELENDEZ 52620 AVENIDA MARTINEZ LA QUINTA, CA 92253 Contractor: HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 (760)321-7450 Llc. No.: :LIC -0001138 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 subje " workers' compensation laws of California, and a e that, if I s uId I ubject o the workers' compensation provisions o ectio'3700 of th Labor ode, I I orthwith comply with t Ypse p visions. G.ntC— late:WARNING: I J Appl FAILU E 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 th a ab informal' n is co I agree to comply with all city and county ordinan sand state I s rela ' g to bui construction, Ind h eby authorize representa(rA ,f this city t enter po the menti*o nled p _pert for inspection purposes. pate: G 4 Signature (Applicant/ / f FINANCIAL • 1• DE`3CRIPTION .: ' ' ' ACCOUNT. QTY AMOUNT PAID PAID DATE 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 # Y 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 Permit Details PERMIT NUMBER -; City of La Qu i nta B P LB2015=0019 = '" Description: SEWER CONNECT/SEPTIC ABANDONMENT Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 2/9/2015 PJU Approved: . Parcel No: 773302005 Site Address: 52620 AVENIDA MARTINEZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 143 Lot: 19 Issued: UNIT 15 Lot Scl Ft: 0 Building Sci Ft: 0 Zoning: Finaled: Valuation: $2,800.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ADDRESSI Details: SEWER CONNETION SEPTIC ABANDONMENT 2013 CALIFORNIA PLUMBING CODES. STATE xUUI'fICPNAL SITES CHRONOLOGY CONTACTSCONDITIONS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 CONTRACTOR HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 OWNER ANNETTE MELENDEZ 52620 AVENIDA MARTINEZ LA QUINTA CA 92253 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 1 101-0000-20306 0 $1.00 $0.00 Total Paid forBU1LDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Monday, February 09, 2015 1:45:07 PM - 1 of 2 CRWYSTEMS Permit Details PERMIT NUMBER City of La Quinta BPLB2015-00.19 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY _.. CLTD BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERMIT 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 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 1:45:07 PM 2 of 2 CRWSrsrEMS Bin # . 0ty 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# Project Address: V OQ aIM) Owner's Namc: 00f E M L -C-W ()Er-- A. P. Number: Address: j Z ZQ AJ N100 Legal Description: City, ST, Zip: L Contractor:^ Telephone: :,:,,.;,::•;;::::>.:.:•;::::•;:;.;:.;:;'>; Address: Project.Description: City, ST, c D6 i @ •Tclephonc: Q 3 d V ? .:::::,.. ::City r— ,— r_ S tit .1 tL. Statc Lic. # : p (Dig Lic. #.::: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: v.:hY.J': iiyi is cY: Construction oYP Occupancy: State Lic. #: c (circle one): New Add'n Alter. Re air Demo Pro'cct 1 p J type Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE #! Submittal Rcq'd Rcc'd TRACMIG 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 Subcontaclor List Called Contact Person Plumbing Grant Decd Plans Pickcd up S.M.I. II.O.A. Approval Plans resubmitted Grading IN HOUSE:- ""Review, ready for eorrcctionsrissuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue SC11061 FCCS Total Permit Fees Jan 2115 11:46a Palm Desert Family Dental 7605685904 p.3 z COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 1/1912015 SUBJECT: SANTA CARMELITA, 52620 AVENIDA MARTINEZ, LA QUINTA, LOT 19, LID 684806 "SCC FEE ONLY" ANNETTE MELENDEZ Project: 15-6057 52620 AVENIDA MARTINEZ Project Date: 111 6f2015 Amount Due: $4,851.00 LA QUINTA, CA 92253 GEO: 06-06-12-1 Planner. RUSEN MONTIEL TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK SUBJECT: SANTA CARMELITA, 52620 AVENIDA MARTINEZ, LA QUINTA, LOT 19, UD 68430E "SCC FEE ONLY- COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel 1.00 FFSCC-COLLECTION . $2,415.00 $2,415.00 1.00 FJ SCC -TREATMENT S2.436.001 $2,436.00 $4,851.00 PAID $ Development Services Deparnent JAN 0 9 2015 Coachella Valley Water District jZ 75-5f5 Hovley Lane East Palm Desert, CA 92211 SUBJECT: SANTA CARMELITA, 52620 AVENIDA MARTINEZ, LA QUINTA, LOT 19, UD 68430E "SCC FEE ONLY- COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel