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10-0483 (PLBG)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-06000483, Property Address: 52280 AVENIDA VELASCO APN: 773-265-002- - - Application description: PLUMBING Property Zoning: COVE RESIDENTIAL Application valuation: 2300 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT . BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date:. 6/07/10 Owner: LA QUINTA REDEVELOPMENT AGENCY P O BOX 1504 LA QUINTA, CA 92247 Contractor: SO CAL & ASSOCIATES PLM11 I N C , P.O: BOX 955YUCC_ (760A369L4104 CA 92286 )'�.. y O 2010 . Lic. No. 793482 7I CITY F L9%iq t 'sdYro V LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION. I hereby affirm under. penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one'of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Licerpe Class: A B C36 C4 icense o.: - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ifissued. �n r: 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 - OW ON - insurance carrier and policy number are: I hereby'affirm.under penalty of perjury that I am exempt from the Contractor's State icense aw for the Carrier STATE FUND Policy Number 1820769-2010 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of. the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to e.sdb' S. compensation laws of California, - ' permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State nd agree that, if ecome subject to the workers' compen isions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 700 of a or Code, I sh S. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by 6°' - - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): bate: . 1 1 1, 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 WARNING:FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL ' Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ' and who does the work himself or herself through his -or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS.PROVIDED FOR IN - improvements are not intended.or offered for sale. If, however, the building or'improvement is sold within SECTION 3706 OF THE LABOR CODE,_ INTEREST, AND ATTORNEY'S FEES. ' 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.). APPLICANT ACKNOWLEDGEMENT 1 _ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for . pursuant to the Contractors' State License Law.).- _ whose benefit work is performed under or pursuant to any permit issued as a result of this application, ( 1 I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City Dater 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: LQPERMIT 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 constr hereby authorize representatives of this county to enter upon the above-mentioned pr 'nature IA r A e Application Number 10-•00000483 Permit PLUMBING SEWER Additional desc . Permit Fee . . . . 30.00 . Plan Check Fee .00.. Issue Date . . . . Valuation . . . 2300 Expiration Date 12/04:/10 Qty Unit Charge Per Extension BASE FEE 30.00 Special Notes.and Comments SEPTIC ABANDON;'SEWER.CONNECT. 2007 CODES. -------------------_-----------------------------.------ 'Other Fees BLDG STDS ADMIN (SB1473) ". 1..00 Fee summary Charged Paid ----------- ---------- -- Credited ----------- I Due ---------------.-- -- Permit Fee Total 30.00 Permit .00 00 30.00 Plan Check Total .00 .00 :00 .00 _ Other Fee Total 1.00 .00 .00 1.00 Grand Total 31.00 .00 .00 31.00 Jun 03 1012:42p ASAP_Pumping, Inc.. 7603654118 p.1 dFASSOCIATES Specializing in " • Sewer •WaterWorks• StormDrains State License A/B,'C36/C42 #793482 Proposal June 3, 2010 City Of La Quinta Tel: 760-777-7016 Fax: 760-777-7019 Att: Kirk Subject: Sewer Connection 52280 Avenida Velasco La Quinta, CA 92253 Scope of Work: :`> Abandon Septic System `> Connect Property To City Sewer System .`> Price Includes City Permits, Pumping, And Fill. Dirt Does Not Include Coachella Valley Water District, Fees Cost of Work Provided: 12,300.00 Respectfully Submitted, Michael S. Hildebrand SoCal & Associates Plumbing, Inc. License: A / B/C36 I C42 #793482 ACCEPTANCE OF PROPOSAL Accepted Signature Date Q Bin # City of La Quints Building 8% Safety Dh*lon P.O. Box 1504, 78-495 Calle Tampico La Qwhta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: �5 oZ - a Q'S Owner's Name: L QR A A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: o C v Telephone: Address: Project Description: City, ST, Zip: Telephone: City Lie. #: State Lic. # : Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. #: Name of Contact Person: 1 d Construction Type: Occupancy,: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.:--:t- 9 Stories: !� Us: Telephone # of Contact Person: 3 _ O Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACIOTIG PERMff FEES Plan Seta Pian Check submitted Item Amount Structural Cala. Reviewed, ready for corrections Plan Check Deposit Iyuas Calcs. Called Contact Person Plan Check Balance Tlde 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21' Review, ready for corrections/issue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plana picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE: Review, ready for eorrectionstissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fen �NpTER�' COACHELLA VALLEY WATER DISTRICT `•,O�ST'R� P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 8/6/2010 SUBJECT: 52280 AVENIDA VELASCO, SCC FEES, LA QUINTA CITY OF LA QUINTA Project: 10-2472 78495 CALLE TAMPICO Project Date: 8/6/2010 Amourit Due: $4,231.00 LA QUINTA, CA 92253. GEO: 06-06-12-1 Planner: DAVID MCGEE TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK ---------------------------------'=-------------------------..--..------------..-..-..-------------------------------------------------------------- _----- ---------------- -------------- ......... ------ 1.00 SCC -COLLECTION, $1,836.00 $1,836.00 1.00 SCC -TREATMENT $2,395.00 $2,395.00 PAIS $4,231.00 . AUG 0 9 2010 COACHELLA VALLEY WATER DISTRICT, BY SUBJECT: 52280 AVENIDA VELASCO, SCC FEES, LA QUINTA COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel