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BPLB2015-011378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: BPLB2015-0113 51805 AVENIDA MADERO Twit 4 4'v Qu&z COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT 773153015 GONZALEZ / ABANDONMENT SEPTIC CONNECT SEWER $1,500.00 Applicant: TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO, CA 92201 gCpNNED D Q � OCT 15 2015 CITY OF LAQUINTA COMMUNITY DEVELOPMENTOEPARTMENT 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: C36 License No.: 930133 Date: /D—/F— /S Contractor 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, 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 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: 23 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/15/2015 Owner: SUSAN GONZALEZ 59493 HOP PATCH SPGS RD MOUNTAIN CENTER, CA 92253 Contractor: TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO, CA 92201 (760)574-4444 Llc. No.: 930133 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' com ensation, 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 Sectio'n'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: _ . certify that in the performance of the work for which this permit is issued, 1 sh 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 forthwith comply with those provisions. Date: Applicant: L% WARNING: FAILURE 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 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 city to enter upon the above-mentioned property for inspection purposes. Date: fg2%S Ir Signature (Applicant or Agent) i� w a DESCRIPTION " : ` . FINANCIAL INFORMATION :ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD, RECEIPT #. CHECK p CLTD BY Total Paid for BUILDING 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 DESCRIPTIONACCOUNT 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: TOTALS:• $24.18 $0.00 00 Description: GONZALEZ / ABANDONMENT SEPTIC CONNECT SEWER Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 10/15/2015 SGU Approved: Parcel No: 773153015 Site Address: 51805 AVENIDA MADERO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 30 Lot: 3 Issued: UNIT 2 ZIP PHONE FAX EMAIL' APPLICANT Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 " TOMMY ROOTER PLUMBING INC Details: SEPTIC ABANDONMENT SEWER HOOK UP PER 2013 CALIFORNIA BUILDING CODES INDIO Printed: Thursday, October 15, 2015 4:20:38 PM 1 of 2 Cr SYS7Eh1S CHRONOLOGY NAME TYPE NAME ADDRESSI • NDI TI • CONTACTS CITY STATE ZIP PHONE FAX EMAIL' APPLICANT TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO CA 92201 CONTRACTOR TOMMY ROOTER PLUMBING INC 80975 INDIO BLVD #C3 INDIO CA 92201 OWNER SUSAN GONZALEZ 59493 HOP PATCH SPGSRD MOUNTAIN CENTER CA 92253 Printed: Thursday, October 15, 2015 4:20:38 PM 1 of 2 Cr SYS7Eh1S 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 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 Printed: Thursday, October 15, 2015 4:20:38 PM 2 of 2 SYSTEMS Bin # Permit # 1 `3 R;, 26 5 Project Address: Sl _ �j Cit} of La Quinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet �� v Owner's Name: zo A. P. Number: Address: Legal Description: r City, ST, Zip: Contractor: T h ne Telephone: P . Address:d G Project Description: City, ST, Zip: ne• Telephone: 0 d t�S G o � 3 ................................. ...........::::::::::::::. State Lie. # :. 30 13 City Lc. O S�Grti/ Arch., Engr., Designer: Address: City, ST, Zip: Telephone'. Occupancy: Con tructi n Type: ane Construction YP Y• State tc Lie #• Project type (circle ne)• Neww Add'n Alter Repairair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: lJ�1 . APPLICANT: DO NOT WRITE BELOW THIS LINE U Submittal Req'd Rec'd 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 correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.1. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" 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 WwD 10/15/15 03:58PM HP LASERJET FAX P.02 COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Dat®: 1011/2015 SUBJECT: SANTA CARMELITA, 51805 AVENIDA MADERO, LA QUINTA, LID 682008, "SCC FEE ONLY" GONZ.ALEZ, SUSAN Project: 15-6667 51-805 AVENIDA MADERO Project Date: 9/29/2015 Amount Clue: $A,851.U0 LA QUINTA, CA 92253 GEO: 06-06-01-3 Planner: SARA LOPEZ + TO 1NSuRF PROPER CREDIT, PL.f:ASE RETURN M.S PORTION WI'TI.1 REMITTANCE AND INCLUOf; THE PROJECT ON YOUR CHECK SUBJECT:SANTA CARMELITA, 51805 AVENIDA MAnERO, LA QUINTA, LIP 682008, "SCC FEE ONLY" COACHELLA VALLEY WATER n1S'11"R.ICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92136 (760) 398-2651 Page 1 10/15/15 03:58PH HP LASERJET FAX P.01 4, , q 0 -ft . -777-70/( ���� ; Ly ��� u r poki � � Semr ave.�,;dw Mad ,(,g y Lynda.M.urra Propcqy Movqonwin I,ik,. 1410M)148 dki (.cj/i 760.275-32:59 Desert. f=alls Really ?60. 346.3314 bll F,Cc! 003,03903 77- 54 Jon: '760.404.1428 Country Ch%b Drive BW g. A, Suite 101 Pal.., CA 9M I