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11-0261 (PLBG)Acct .4 401i&J4.551(. 45 -a t P.O. BOX 1504 4^' VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA,. CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 . BUILDING PERMIT Date: 3/17/11 Application Number: 11-00000261 Owner: Property Address: 52050 AVENIDA CARRANZA CITY OF LA QUINTA APN: 773-221-001- - - 78495 CALLE TAMPICO Application description: PLUMBING LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL Application valuation: 2100 !� Contractor: Applicant: Architect or Engineer: SO CAL & ASSOCIATES r BNpG INC P.O. BOX 955 fYi�� 1` 2�iqq 1 ` YUCCA VALLEY, CA 92 6' /� (760) 369-4104 a1P, LiC. NO.. 793482 U'YOF',,k4111N A -•-�.,.s Wit: u:.. ------------------------------------------------------------------------------------------------- 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. License Class: A B /C336 C4 482 Date: —4-1=egatra 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.). (_) 1, 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: LQPERMIT 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 STATE FUND Policy Number 1820769-2010 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 umduun pir. of Section 3700 of the Labor Code, I 1 comply with those provision Pete: a 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 (5100,000). 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 1 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 county to enter upon the ove•mentioned property for ins ec bat �� Si ure IM6'lip LQPERMIT Application Number . . . . . 11-00000261 Permit . . . PLUMBING SEWER Additional desc " Permit Fee . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2100. Expiration Date 9/13/11 Qty Unit.Charge Per Extension BASE FEE 30.00 Special Notes and Comments SEPTIC ABANDON; SEWER CONNECT. 2010 CODES.. ----------------------------- Other.Fees . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due - Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total 00 .00 .00 00 . Other Fee Total 1.00 .00 .00 1.00. Grand Total 31.00 .00 .00 31.00 LQPERMIT Mar 16 11 06:02p Socal & Associates Plumbi r and ° ASSOCIATES Ip�u ilium s o llrr s.��_ Speola!!iing !n Sewer-WatwWorks- StormDrains State License A/8/C36/C42 #793482 March 16, 2011 City Of La Quinta Tel: 760-777-7016. Fax: 760-777-7011 Att: Kirk Subject Sewer Connection 52050 Avenida Carranza La Quinta, CA 92253 7603286607 p.1 , Proposal / Contract Scope of Work: `> Abandon Septic System .' Connect Property To City Sewer System `? Price Includes Pumping And Fill Dirt `> Does Not Include Coachella Valley Water District Fees > Does Not Include City Permits Cost of Work Provided: Respectfully Submitted Rlichael S. Hildebrand SoCal & Associates Plumbing, Inc. License: A! 8/C36 / C42 #793482 2100.00 ACCEPTANCE OF PROPOSAL CONTRACT' Accepted 0 -1 Signature Date 1 (7` 0' 369-4104. ° ;800) 7 -4 � x 950, Yucca Valley, CA 92286 1Sign; �€��6 Fax �� ctae t,��r �: ®�aE 9aIIm�$�a�Ca�d.��s� �a�# X350; 323-6607 6 r1h COACHELLA VALLEY WATER DISTRICT 4/r2t P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 3/29/2011 SUBJECT: 52050 AVENIDA CARRANZA, APN 773-221-001, SCC ONLY, LA QUINTA CITY OF LA QUINTA Project: 11-2842 78495 CALLE TAMPICO Project Date: 3/24/2011 Amount Due: $4,231.00 LA QUINTA, CA 92253 GEO: 06-06-12-1 Planner: DAVID MCGEE TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 4A 1.00 FF SCC -COLLECTION $1,836.00 $1,836.00 1.00 FJ SCC -TREATMENT $2,395.00 $2,395.00 PA'® $4,231.00 f4 u 0 APR 13 2011 COACHELLA VALLEY WATER DISTRICT t BY SUBJECT: 52050 AVENIDA CARRANZA, APN 773-221-001, SCC ONLY, LA QUINTA COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel COACHELLA VALLEY NATER DISTRICT *** CUSTOMER RECEIPT *** Oper: CASHIER5 Type: OC Drawer: 1 Date: 4/13/11 03 Receipt no: 654304 Description Quantity Amount 2011 2842 PZ PLANNING X ENGINEERING 1.00 $4231.00 , Trans number: 860150 Tender detail CK CHECK 913341 $4231.00 Total tendered $4231.00 Total payment $4231.00 Trans date: 4/13/1.1 'Time: 13:56:42 *TRUE CONSERVATION USE NATER WISELY* X: (760) 398-2651 0 I COACHELLA VALLEY NATER DISTRICT *** CUSTOMER RECEIPT *** Oper: CASHIER5 Type: OC Drawer: 1 Date: 4/13/11 03 Receipt no: 654304 Description Quantity Amount 2011 2842 PZ PLANNING X ENGINEERING 1.00 $4231.00 , Trans number: 860150 Tender detail CK CHECK 913341 $4231.00 Total tendered $4231.00 Total payment $4231.00 Trans date: 4/13/1.1 'Time: 13:56:42 *TRUE CONSERVATION USE NATER WISELY* X: (760) 398-2651 0 I� i .A.P. PUMP/NG Lic #C42 855 851 IOU 3ZO- / as / • 1'aUU'334- / L.'15 CUSTOMER'S ORDER NO. E ORDERED FAX 760 328-6607 Z3 P.O. Box 2318 • Cathedral City, CA 92235 ORDER TAKEN BY DTE PROMISED ❑ A.M. Pumping Fee per 1000 gal. ❑ P.M. BILL TO / PHONE ADDRESS/ Al �. MECHANIC CITY HELPER vl JOB NAME AND LOCATION ❑ DAY WORK Out of Area Fee DESCRIPTION OF WORK ❑ CONTRACT ❑ EXTRA Locating / Opening Fee (per hour) QUANT DESCRIPTION OF MATERIAL USED PRICE AMOUNT Gallons Pumping Fee per 1000 gal. Dumping Fee per 1000 gal. Out of Area Fee Locating / Opening Fee (per hour) Size System: 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. TOTAL MATERIALS TOTAL LABOR WAIVER: Not responsible for secondary damage such as water damage, chipped concrete, mark on street or driveways or trees. SIGNATURE DATE COMPLETED TAX TOTAL