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78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2016-0131
Property Address: 51365 AVENIDA VELASCO
APN: 773085018
Application Description: ROLL SPARROW LLC/SEWER HOOK UP
Property Zoning:
Application Valuation: $1,500.00
Applicant:
HUITRON CONSTRUCTION
50427 RIGO COURT
COACHELLA,CA 92236
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 rofessions Code,
and my License is in full force and effect.
License Class: B License No.: 926190
Date: b Contractor: I'
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).:
(_) 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 Add
i
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/28/2016
Owner:
ROLL SPARROW LLC
50981 WASHINGTON ST
LA QUINTA, CA 92253
Contractor:
HUITRON CONSTRUCTION
50427 RIGO COURT
COACHELLA, CA 92236
(760)457-9960
Llc. No.: 926190
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.
have and will maintain workers' compensation insurance, as required by
Secti n 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: EVEREST NATIONAL INSURANCE COMPANY Policy Number: 7600014538
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: b Applicant:r-
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 c
I agree to comply with all city and county ordinances and state laws relating to b
construction, and hereby authorize representatives of thisy(to e ter upon tFje
above-mentioned property for inspection purposes. nn Z
Date:? Y� Signature (Applicant or Agen
r
,
Dater 11/28/2016
Application Number:
BPLB2016-0131
Owner:
Property Address:
51365 AVENIDA VELASCO
ROLL SPARROW LLC
APN:
773085018
50981 WASHINGTON ST
Application Description:
ROLL SPARROW. LLC/ SEWER HOOK UP
LA QUINTA, CA 92253
Property Zoning:
Application'Valuation:
$1,500.00
Applicant:
Contractor:
HUITRON CONSTRUCTION
HUITRON CONSTRUCTION
50427 RIGO COURT
50427 RIGO COURT
COACHELLA, CA 92236
COACHELLA, CA 92236
(760)457-9960
---------------------------------------------------
-------------------------------------------
Llc. No.: 926190
Detail: SEWER CONNECTION AND SEPTIC ABANDONMENT. PER 2013 CALIFORNIA BUILDING CODE
DESCRIPTION
ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306 0
FINANCIAL
INFORMATION,
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
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
101-0000-42401
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$17.73
Total Paid for PLUMBING FEES:
TOTALS:
$43.06
$140.33
t
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Building 8f Safety Division '
Permit tf ' , 78-495 Calle Tampico
' La Quinta, CA 92253 - (760)1777-701,2. '
..Building Permit'Application and Tracking.Sheet '
Project Address:" . "
3 6 . SQA s , Owner's
A. P. Number:
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Address: 'b 4 -i S
Legal Description:( �p P
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Address: sc® ' 2�. e
Project Description: -
City,ST, Zi C*
Tele hone: `
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State Lic. #
City Lie. #c
Arch.,•Engr., Designer:
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Address:
City', ST, Zip:
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Tele hne:
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Construction YP Occupancy:,
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State teLc
P'ettYPe (circlele one): Ne � Add'nAlter Repair.air• De m
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Name of Contact Person:
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Sq. Ft.:
# Stories:
Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rcc'd + TRACKING - PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
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 corrections/issue
Electrical
Subconlaetor List
'
Called Contact Person-
Plumbing
Grant Deed
Plans picked up"
S.M.I.
11.O.A. Approval '
4Pl2ns resubmitted
Grading
IN I10USE:-
''d Review, ready for correctionstissuc
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. \3'ks. Appr
Date of permit issue'
SCI,061 Fees, .•
,
• .
w
Total Permit Fees
,
COACHELLA VALLEY WATER DISTRICT
P.'O. B6X 1058,' COACHELLA,, :CALIFORNIA, 92.2.'36 (760) 358-2651
INVOICE Date: -1,1/23/2016,
SUBJECT: SANTA
TA CARMEiITA, 51365.AVENIDA-VblLASCQ.,LA QUI*NTA, LID 68.1.008,' . !. SCC.FEE ONLY
GUSTAVO HUITRON Project; 16=761,6
5136*5 AVENIDA VELASCO
Proje6t:Daie: 11/23/2016
Amodfit Due- $4,851.00
LA-QUINTA, CA 92253: GEO-
Plan.ner.- SANDRA V.ILL.ALbBO'$
7b INSURE PROPER.CREDIT, PLEASE -RETURN THISPORTION WITH
REMTTAN , INPIQUQ.F. THE !PROJECT '0N YOUR CHECK
1.00 FF SCC -COLLECTION $2;4.15:00. '$2,4-1.5.10.0
.1.001FJ SCC -TREATMENT 9_0�
:$2*436.00:1 $2,436.00
1 $4,851z.-00
PAID
Devel6pment SerVICes'06po'llipent C/C f'p
vl'tr$ 2016
0 . Qpchella Valley Water District,
75515 Hovley Lam East
PaImPosert. CA 92211
SUBJECTi-SANTACARIVIELITA, 51'365,AVENbAV.ELASCQ, LAbUINTA, L106910.08,'!SCC FEE ONLY" NLY"
COACHELLA VALLEY WATER DISTRICT*
P.O. 9ox .1058f . C0ACkELLA,.',C4L!FQRNIA 92236 (760) 358=2651
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