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BPLB2015-007478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4'4t 4•�wRu;.rw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2015-0074 Property Address: 52520 AVENIDA JUAREZ APN: 773281002 Application Description: VELEZ/ABANDON SEPTIC AND CONNECTTO SEWER Property Zoning: QUINTA, CA 92253 Application Valuation: $7,400.00 Applicant: PERRIS VALLEY SERVICE PLUMBING 49652 WAYNE STREET INDIO, CA 92201 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: _ License No.: 477854 2 Date:(, Contractor/ 1 J v 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.). (_) 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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: MARY VELEZ52520 AVENIDAJUAREZLA QUINTA, CA 92253 L10-1 Contractor: PERRIS VALLEY SERVICE PLUM 49652 WAYNE STREET INDIO, CA 92201 (760)485-9436 Llc. No.: 477854 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 Sectio 700 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: _ 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 the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions: / Date: Applicant: 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 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: Signature (Applicant or Age t . 1 FINANCIAL .!• DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING 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 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SEPTIC SYSTEM 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SEPTIC SYSTEM PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $16.92 $0.00 TOTALS:09 00 Description: VELEZ/ABANDON SEPTIC AND CONNECT TO SEWER Type: PLUMBING . Subtype: Status: UNDER REVIEW Applied: 5/26/2015 SKH Approved: Parcel No: 773281002 Site Address: 52520 AVENIDA JUAREZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 166 Lot: 22 Issued: UNIT 17 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $7,400.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: ABANDON SEPTIC AND CONNECT TO SEWER. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES CHRONOLOGY DESCRIPTION I ACCOUNT I QTY I AMOUNT PAID I PAID DATE I RECEIPT # I CHECK # I METHOD BSAS SB1473 FEE 1 101-0000-20306 1 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: PAID BY I CLTD BY Printed: Tuesday, May 26, 2015 8:54:13 AM 1 of 2 CRSY57EMS of - _ �Fo i,, `s f ^ +� 0 • • • • OF'I1'� - DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 BLD Total Paid forPERMIT ISSUANCE: $91.85 $0.00 SEPTIC SYSTEM 101-0000-42401 0 $12.09 $0.00 SEPTIC SYSTEM PC 101-0000-42600 0 $4.83 $0.00 Total Paid for PLUMBING FEES: $16.92 $0.00 ! c 5.cit �: k -Y �i y+.. � �� •:. , : ' ., ..'.' '. s ... 'v�w6';i:Y�,..e:'Ly�tx`3::•.�t°5�'.����iY�.B�L��di�h.n .-fc`��'. �rsssiF . .. T' _ _ .s: �� .�.. �.�^' iQ s�.�.� ti .t '�:. . � . ,-b=. e -.?t. t;:.. . v.. _.� - ,.. r.::z..: t - � - - aR -s: •'rix;�. rr..a,�N rr't +n!n : Lx��tt!a:� k. .{ e -,'yE'-.-rs�,.�� �,.. � BONDINFORMATIONWON OHM W- (: .3r ATTAC'HM N 5 Printed: Tuesday, May 26, 2015 8:54:13 AM 2 of 2 (COV V srsreMs x U_ SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE PLUMBING FINAL" BLD . � . ,-b=. e -.?t. t;:.. . v.. _.� - ,.. r.::z..: t - � - - aR -s: •'rix;�. rr..a,�N rr't +n!n : Lx��tt!a:� k. .{ e -,'yE'-.-rs�,.�� �,.. � BONDINFORMATIONWON OHM W- (: .3r ATTAC'HM N 5 Printed: Tuesday, May 26, 2015 8:54:13 AM 2 of 2 (COV V srsreMs lain # City of La Quinta Building 8l: Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # 3��r��'olS�o Project Address: sas Av eN t, ps Owner's Name:. (V` 1�•� L` C Z A. P. Number: Address: a S.1O, Legal Description: City, ST, Zip: CA. Contractor: 1 P 4 � L y Telephone: Address: 6 i3 C'0-'rC' V-,\ Q�-o Project Description:\ •2 4 " C' V - City, ST, Zip: 1 b a.'��� Gib r VIAew?t a CovAV\C- It Telephone ePhon e ................. State Lic. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone:. Con tr ucti n TY Pe• Occupancy: R • � L I �i Lic.# DStato Project type (circle one): New Add'emon ]ter Repair Ft.: i L Q # Stories: S L #Units: Name of Contact Person:Sq. Telephone # of Contact Person: Estimated Value of Project::3 L O to APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Ree'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 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for corrections/issue Electrical Subeontactor List Called Contact Person Plumbing. Grant Deed Plans picked up S.M.I. H.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 COACHELLA VALLEY WATER DISTRICT QrS Rte P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 4/21/2015 SUBJECT: SANTA CARMELITA, 52520 AVENIDA JUAREZ, LA QUINTA, LOT 22, LID 684276, "SCC FEE ONLY" MARY C. VELEZ 52520 AVENIDA JUAREZ LA QUINTA, CA 92253 Project: Project Date: Amount Due: GEO: Planner: TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 15-6292 4/16/2015 $4,851.00 06-06-12-2 SANDRA VILLALOBOS 1.00 FF SCC -COLLECTION $2,415.001$2,415.00 1.00 FJ SCC -TREATMENT $2,436.001 $2,436.00 $4,851.00 PAID $ Develop,_ ��L ent Services Department MAY IS 2015 Coachella Valley Water District, 75-515 Hovley Lane East Palm Desert, CA 92211 SUBJECT:SANTA CARMELITA, 52520 AVENIDA JUAREZ, LA QUINTA, LOT 22, LID 684276, "SCC FEE ONLY" COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel 4 I fi INVOICE # 0 ; o 'ke City of La Quinta INV -225 78-495 Calle Tampico a La Quinta,CA 92253 Date Due: 6/25/2015 � PERRIS VALLEY SERVICE PLUMBING 83613 SACRAMENTO STREET - Invoice Date: 5/26/2015 Record # Record Type Fee Group Fee Description' Quantity Amount . LIC -762813 CONTRACTOR C, ANNUALLY 0 $50.00 SB -1186 STATE FEE 0 $1.00 $51.00 Invoice Total: $51.00 f Please send your payment to this address: Printed: Tuesday, May 26, 2015 8:53 AM 1 of 1 CRw SYSTEMS ATTENTION CONTRACTOR 1 declare that the following items comprise a complete business license application packet for a new or renewal license for the City of La Quinta and are attached: A. Business License Application Form B. Check made payable to the City of La Quinta Contractor Business License Fees: A or B License Classification $100.00 per year. or $50.00 semi-annual C License Classification. $ 50.00 per .year -or $25.00 semi-annual SB -1186 State Fee $ 1.00 The submittal of a complete application packet will assist in the licensing process. Please return this .form with the information packet. Failure to include alf of the above may delay the application process. NOTE: If your business is not being run from a commercial location and you live in -the City of La Quinta, you will be required to obtain a Home Occupation Permit Approval prior to the submittal of your license paperwork. Thank you for your interest. Date: Applicant: - - On';Septembe� 19,.-201.2 .Governor.Brown sigried into law S:B-1186 which ;adds a state fee of.:51 on any applicant fora local businessiicense,permit,'orrenewal: The purpose:".--' comply wifh construction relked.accessibility requirements- for:businesses in'order.fo .facilitate :compliance with' federal:and stale:disability law; as specified.