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