BPLB2016-007178-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BPLB2016-0071
Property Address:
51245 AVENIDA RUBIO
AM:
773044036
Application Description:
QUILL RESIDENCE / SEWER CONNECT
Property Zoning:
Application Valuation:
$2,900.00
Applicant:
HAMMER PLUMBING AND
PUMPING INC
P 0 BOX 2448
CATHEDRAL CITY, CA 92235
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/19/2016
DLI.� 0 er: •
r1ILL
�19
4�ENIDA RUBIO
AYQUINT, CA92253
LCOMMum
CITY OFLAQUINTAITYDEVELOPMENTDErPA ENT
HAMMER PLUMBING AND PUMPING INC
P 0 BOX 2448
CATHEDRAL CITY, CA 92235
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under prov'sions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and P ofessions Code,
and my License is i full force and elle
License C� : C42 36 Lic e N 0 8
'Fate: Jr I ��D 4117-Cnt actor•
OWNE R 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.). .
I ) 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. . 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
Lender's Add
(760)360-7448,
Llc. No.: 661018
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 polity 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 subject to the workers'
compensation laws of California, and agree hat, if I should bec {ne Ject the
workers' compensation provisions ection 37of�he Lab Code, all f rthwith
comply with th�se pr¢visions.
DaDa�te',Applicant:
WARNING: FAILURE TO SECUR 'COMPENSATION COVERAGE 15 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 andlaws relating to building
construction, a d her y authorize representatives this city to me Don the
above -me eod,pr ert_y four inspection purpose .
Dat` Si( gnature (Applicant o. Age
N
+
FINANCIAL •• •
DESCRIPTION ` ACCOUNT 'QTY` AMOUNT, < I`4 PAID ,PAID DATE,
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$1.00
• 5/19/16
'PAID BY w ;: METHOD ' "" RECEIPT # t :
CHECK #
CLTD BY '
't
HAMMER PLUMBING AND PUMPING IN CHECK R15654
11937
MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
"DESCRIPTION
3 ACCOUNT '
°QTY
'AMOUNT
PAID P
PAID DATE;
r z,
f:'
A6,.a.
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
5/19/16
PAID BYw
METHOD
,� `RECEIPT #'>
F CHECK #
BY
n
w
$$CLTD
HAMMER PLUMBING AND PUMPING IN
CHECK
R15654
11937
MFA
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
$ x DESCRIPTION :`
'' "i ACCOUNT ;
;QTY -
AMOUNTd p F
; '.—PAID,PAIf)`DATE
_.
.
..
BUILDING SEWER
101-0000-42401
0
.$12.09
$12.09
5/19/16
v R
HO
RECEIPT#!
CHECK #
CLTD BY
`
,
L.,
HAMMER PLUMBING AND PUMPING IN
CHECK
R15654 • .
11937
MFA
DESCRIPTION
a �.
ACCOUNT 'j =QTY4
a
'` AMOUNT`«
-
,
• r
BUILDING SEWER PC
101-0000-42600
0
$12.09
$12.09
5/19/16
r ;PAID By
METHOD ,,.
#
, CHE4CK # «
CLTD BY
x`RECEIPT
HAMMER PLUMBING AND PUMPING IN
CHECK
R15654
11937
MFA
Total Paid for PLUMBING FEES: $24.18' $24.18
N
+
Description: QUILL RESIDENCE / SEWER CONNECT
Type: PLUMBING Subtype: Status: ISSUED
Applied: 5/19/2016 MFA
Approved: 5/19/2016 MFA
Parcel No: 773044036 Site Address: 51245 AVENIDA RUBIO LA QUINTA,CA 92253'
Subdivision: SANTA CARMELITA VALE LA QUINTA Block:. Lot: 22
Issued: 5/19/2016 MFA
UNIT 4
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,900.00 Occupancy Type: Construction Type:
Expired: 11/15/2016 MFA
No. Buildings: 0 No. Stories: 0 No. Unites: 0
CITY
Details: SEPTIC ABANDOMENT AND SEWER CONNECT PER 2013 CALIFORNIA BUILDING CODE
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE'
NAME . �
ADDRESSl
CITY
STATE
ZIP PHONE FAX'•' T `EMAIL
xi- , -
APPLICANT
HAMMER PLUMBING AND PUMPING
P 0 BOX 2448
CATHEDRAL
`CA
92235 (
FINANCIAL• • •
Printed: Thursday, May 19, 2016 4:10:40 PM 1 of 2
" SYSTEMS,
DESCRIPTION k
r ACCOUNT':
---- -�.-.
QTY .
--+.�::-_-•--
fir. AMOUNT
w+. PAID'
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=PAID DATE •
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RECEIPT,#
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METHOD
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PAID BYE
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.ry rr+ vs
r
A ...
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
5/19/16
R15654
11937
CHECK
HAMMER PLUMBING
MFA'
AND PUMPING IN
Total Paid for, BUILDING STANDARDS ADMINISTRATION.
$1.00 $1.00
BSA:
PERMIT ISSUANCE
• 101-0000-42404
0
$91.85
$91.85
5/19/16
R15654
11937
CHECK
HAMMER PLUMBING
MFA
AND PUMPING IN
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
BUILDING SEWER
101-0000-42401
0
$12.09
$12.09
5/19/16
R15654
11937
CHECK
HAMMER PLUMBING
MFA
AND PUMPING IN
BUILDING SEWER PC
101-0000-42600
0
$12.09
$12.09
5/19/16
R15654
11937
CHECK
HAMMER PLUMBING
MFA
AND PUMPING IN
Total Paid for PLUMBING FEES: $24.18 $24.18
PARENT PROJECTS
Printed: Thursday, May 19, 2016 4:10:40 PM 2 of 2
' SYSTEMS
Bin #
Permit #
Project Address:
City of La. Quinta
Building 8t Safety Division
78-495 Ca1Ie'Tampic6
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
.A. P. Number:
Address:
Legal Description:
City, ST, Zip: LQ. t 4 CA _ (-S
Contractor:
LA
u
T ele e•
P hon
� �BOOM
Address:w �X 2,`tProjectDescription:-
City, ST,Zi{C
Te le h ne•
P o . 0 1 -7k4 -6
G
ilk l
State Lic. #
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
- ..
CYon tructi n Type:
s o c
Occupancy:
P u P Y:
Lic. 4.
Project tyPa circle New A d'n
one): '
Alter Repair Demo
Name of Contact Person:
Sq. Ft.
Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Pr
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
2n° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A.'Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! 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
COacHEt.tA vat1E1! WATER blSTRICT
CASH 1RECEIPT DETAIL ® 96,500
J
Received From: ell
Received �%
• - - -
-
Address:
/
y
ACCOUnt No.
_
Lot(s)
Tract
Serdice Addrees - —�C
- G.A..Code
0 Meters)
- - -- - -
O Se-rvfce(s)
E7., Back!!ow(s).
0 House:Laterel(s)
4..
0 DetectorCheck(s)
0 Meter Surcharge -- • - -
- - -
OrSani tation Capaclty Charge
..
-
0 Temporary.Constructlon Meter
0 Tum on -Charge
O Uncollected Account- Name
- - -
0 Iriepeotlon.t?se -Tract -
'
Fee -
§f
O Plan .Chedk Fees I Sewer -
.Water
Tract - .. ...Bond
0-BondiPaymerit• A.D. -
Assmt.
-
O Customer Deposit
0 Other
bAta,— 7 _�—' .I
07
TOTAL 3
bsxpry�tio: /0
.Cash _ - Service
--- ; Water }. ~.
-Check , L !' "1
Money „ Cashier -
Order 48 ,ee)3i1