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BPLB2017-0044J' a 78-495 CALLE TAMPICO ` C` 0 44 IU� LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2017-0044 Property Address: 78451 PALM GARDEN PL APN: 643181001 Application Description: LANDRUM RESIDENCE /SEWER CONNECT Property Zoning: Application Valuation: $5,000.00 Applicant: HAMMER PLUMBING AND PUMPING INC P O BOX 2448 CATHEDRAL CITY, CA 92235 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 B d Professions Code, and my License is in full force and effect. -License C ss: C42 C36 D35 ense No.: 6 1018 ate: I %!C tractor. OWNERILDER 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 orimprovement 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 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 ) I am exempt under Sec. . B.&P.C. for this reason Date: Owner: A 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 Na Lender's rVOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 0 m mate: 3/1 2 OJSte: Owner: TIMOTHY LANDR-IM Z O n 78451 PALM GAFDEN PL D LA QUINTA, CA 9:2253 m O 3 CT c- ry mc - c c Contractor: Contractor:, rn n HAMMER PLUMEING AND PUMPAJL INC P O BOX 2448 CATHEDRAL CITY; CA 92235 m (760)360-7448 Llc: No.: 661018 WORKER'S COMPENSAMON DECLARATION I hereby affirm under penalty of perjury one or 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: ACE AMERICAN INSURANCE COMPAN- Policy Number: RWCC48818456 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 sub' e.workers' compensation laws of California, and ag �ree-th , " I should come subj ct to the workers' co pensaY n provisions o�ection �J00 f the �code" s all forthwith comply wit those. _ visions. 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 ($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 infor,gi'o�ni!I agree to comply with all city and county ordinances d state ws re construction, nd he eby authorize rel sentaive of this city enter above menti ned p operty for inspection purps s. D'a � ! T Signature�pplieant.o W g Date: 3/15/2017 Application Number: BPLB2017-0044 Owner: Property Address: 78451 PALM GARDEN PL TIMOTHY LANDR.JM APN: 643181001 78451 PALM GAFDEN PL, Application Description: , LANDRUM RESIDENCE / SEWER CONNECT LA QUINTA, CA 9?253 Property Zoning: . Application Valuation: $5,000.00 Applicant: Contractor: HAMMER PLUMBING AND PUMPING INC / HAMMER,PLUME•ING AND PUMPING INC P 0 BOX 2448 P 0 BOX 2448 CATHEDRAL CITY, CA 92235 CATHEDRAL CITY:"CA 92235 (760)360-7448 LIC. No.: 661018 Detail: ABANDON SEPTIC TANK AND CONNECT TO SEWER. PER 2016 CALIFORNIA BUILDING CODE 1 • l 1 . RMA. A DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-000042401. 0 $25.33 DESCRIPTION , ACCOUNT QTY AMOUNT BUILDING SEWER PC .101-0000-42600 0 $17.73 Total Paid fog PLUMBING FEES: $43.06 DESCRIPTION ACCOUNT QTY AMOUNT " TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 SUBJECT: TRACT NO. 2117,78451 PALM GARDEN PL, LA QUINTA, LID 455548, "SCC FEE ONLY COACHELLA VALLEY -WATER DISTRICT ' P:0 BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398=2651 .� p , 1.00 FF SCC -COLLECTION $2,41500 $2,415.00 1.00 FJ SCC-TREATMENT$2 43Cfi00 $2 436.00 •• • 11 +' $4,851.00 _• � ; ,`. - ,... 'gid .. - `- r ^ PAID $Ll i��' �. /•i/ %� �tJ� ai ✓L Z o 1 / , Development Services Department COACHELLA. VALLEY WATER. DISTRICT FEB 28-2017 • �' . �d/?y. 'P.O. BOX 1058, SiR1- COACHELLA, CALIFORNIA 92236 (760) 398-2651 ' a w INVOICE Date: 2/28/2017,'..,-• _'• . 4' ;� r- ., 4, - - � �•`,. ,.. � { `SUBJECT: TRACT NO. 2117,78451 PALM GARDEN PL, LA QUINTA, LID 455548, "SCC FEE ONLY" ,• CITY OF LA QUINTA TIM LANDRUM '� T• - • Project:16-7675; A - 78451 PALM GARDEN PLACE Project Date: ' 12/13/2016' ' k Amount Due: $4,851.00 LA QUINTA; CA 92253 ii GEO: , F 05-07-30-2' t. t .. Planner: EANDRA VILLALOBOS •• - Y � -4 7SIC .. - ••� - .. ' . n n• TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH r c - • - - Y . _ •. ._ J • • REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK y y+ SUBJECT: TRACT NO. 2117,78451 PALM GARDEN PL, LA QUINTA, LID 455548, "SCC FEE ONLY COACHELLA VALLEY -WATER DISTRICT ' P:0 BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398=2651 .� p , 1.00 FF SCC -COLLECTION $2,41500 $2,415.00 1.00 FJ SCC-TREATMENT$2 43Cfi00 $2 436.00 •• • 11 +' $4,851.00 _• � ; ,`. - ,... 'gid .. - ' r ^ PAID $Ll i��' �. /•i/ %� �tJ� ai ✓L Z o 1 / , Development Services Department FEB 28-2017 �•` - : Coachella Valley Water District _ t' 75-515 Hovley Lane East _ _'• . 4' ;� r- ,. Palm Desert, CA 92211- RECEIVE® +• - � �•`,. ,.. � . � • :•• � • , 4 - ; i� . , . - MAR '1 5.2017 - .;. ' ,• CITY OF LA QUINTA COMMUNITY DEVELOPMENT til r ., r .. ., - • 1• _ ^y ., t. t - f4 « - Y � SUBJECT: TRACT NO. 2117,78451 PALM GARDEN PL, LA QUINTA, LID 455548, "SCC FEE ONLY COACHELLA VALLEY -WATER DISTRICT ' P:0 BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398=2651 .� Bin # Permit # Address: ' City-6f La Quinta Building St- Safety Division 78-495 Calfe Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet EAProject Owner's Name: A wj CN IF— A. . P. Number: Address: Legal Description: City, ST, Zip: fiat Qu I i dp. ontra tr. C 0 c L u M 2 ad � 1 Tele hone: P � O i Address: Project Description: City, ST, Zip: CIS' i 4i♦'? �p►� Tele h ne P o . "Lic...# t. �--c� r bAJ o State Lic. # : ' t U` :::.:::.::.::::::::::::<.:::::. City Arch.,'Engr., Designer: Address: City, ST, Zip: Telephone: one: e P an c T Occupancy: Consfrac tion e: Y: Type: State a t ic. #- L ProJ eettYPe circle one • New Add'n Alter Repair. Demo Name of Contact Person: a6 Sq. Ft.: # ories: # Units: Telephone # of Contact Person: Estimated Value of Project. APPLICANT: DO NOT WRITE BELOW THIS LINE 9 Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Depsit ' Truss Calcs.. Called Contact Person Plan Check Balance. Title 24 Cates. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2" 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 I10USE:- 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, t Total Pcrmit Fccs