BPLB2015-009878-495 CALLE:7 MPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Prope rty'Address:.
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
FLORES, MARCO
OUTSIDE CITY LIMITS
C&w�F.fwQ�rw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BPLB2015-0098
53106 AVENIDA VELASCO
774055004
HOME EXPO FINANCIAL SEWER HOOKUP
$7,500.00
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 Professions Code,
and my License is in full force and effect.
License Claps�s:J'. License No.: :LIC -762273 �A
Date: Contractors ��,"✓���
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/20/2015
Owner:
HOME EXPO FINANCIAL
23580 ALESSANDRO BLVD. #9818
MORENO VALLEY, CA 92253
Contractor:
FLORES, MARCO
OUTSIDE CITY LIMITS
Llc. No.: :LIC -762273
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 policy number are:
OWNER -BUILDER DECLARATION
Carrier: Policy Number: _
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
� I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of theomply
with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Divisio
�� ���
of the Business and Professions Code) or that he or she is exempt therefrom and the
• a4e: Applicant:
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant f a
permit subjects the applicant to a civil penalty of not more than five hundred doll rs
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
($500).: ,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR.CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES. .
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -.builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(� I, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to'any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'.
issued as a result of this application ,.the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under Sec. , B.&P.C. for this reason
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.
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 Na
Lender's
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: "5% Z/ / Signature (Applicant or Agent)/
T
r
Fl ANCIAL INFORMATION
`DESCRIPTION v% ACCOUNT F ' a QTY PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $1.00 $0.00
.' PAID�BY d t tt� '`METHOD'
i_t �
`'RECEIPT#ice f �iCHECK# " �"
`CLTD BY '
Total Paid for BUILDING'STANDARDS ADMINISTRATION. BSA $1.00 $0.00
r rt 11r'DESCRIPTION yR r't
� �� $` ACCOUNT k ?`•
QTYs,
=k h AMOUNT
PAID ;fid
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAI BYE :: e>
� ., METHODxCHECK
#
CLTD BYE''
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
r - 'JDESCRIP,TION`� �H`
ACCOUNT a��
QTY y:
#,�AIVIOUNTyz,
PAID y
'PAID DATE
BUILDING SEWER
101-0000-42401
0
$12.09
$0.00
PAID BY a>4
METHOD "'
riRECEIPT #kCLTD
BY
`DESCRIPTION., t�€ •
- ACCOUNT .
QTY;;
�';
AMOUNT .'
,r6s..
g .`.A.
r ,; _� PAID
d
PAIf)•DATE
-
BUILDING SEWER PC
101-0000-42600
0
$12.09
$0.00
w '� 'PAID BYt
e , *
-��
METHOD '4
� �
RECEIPT#
•
CHECK #
CLTD BY
'Total Paid forPLUMBING FEES:' $24.18 $0.00
TOTALS:$0.00
r
i
Description: HOME EXPO FINANCIAL SEWER HOOKUP
Type: PLUMBING Subtype:
Status: UNDER REVIEW
Applied: 8/20/2015 PJU
Approved:
Parcel No: 774055004 Site Address: 53106 AVENIDA VELASCO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 216
Lot: 4
Issued:
UNIT 21
ADDRESSI
CITY'
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $7,500.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
Details: SEWER CONNECTION SEPTIC ABANDONMENT PER 2013 CALIFORNIA PLUMBING CODES.
(951)515-1081
Printed: Thursday, August 20, 2015 1:29:10 PM 1 of 2
SYSTEMS
CONTACTS
NAIVIE.TYPE
NAME'.' '
ADDRESSI
CITY'
STATE-.
ZIP
PHONE FAX' -EMAIL=
APPLICANT
FLORES, MARCO
OUTSIDE CITY LIMITS
(951)515-1081
CONTRACTOR
FLORES, MARCO
OUTSIDE CITY LIMITS
(951)515-1081
OWNER
HOME EXPO FINANCIAL
23580 ALESSANDRO
MORENO
CA
92253
(951)515-1081
BLVD. #9818
VALLEY
FINANCIAL
.•
•
4.
"
,}•
A.' CLTDt
DESCRIPTION
.ACCOUNT
QTY ;;AMOUNT
"PAID
PAID DATE
RECEIPT. #. .CHECK.# METHOD PAID BY,
_ BY: _
BSAS 581473 FEE
101-0000-20306
0 $1.00
$0.00
Total Paid forBUILDING
STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
Printed: Thursday, August 20, 2015 1:29:10 PM 1 of 2
SYSTEMS
x-. - ,,
DESCRIPTION
�
ACCOUNT
QTY
._ ` .. _' :
AMOUNT
_
m .PAID , `
..q,.+r-+gay-,
PA1D DATE'
.%' —
RECEIPT #
..�►,�••.w,r'
CHECK #;
�
METHOD
'�_
PAID BY
>��' ,
:CLTD,
,.
�.
F
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE:
$91.85
$0.00
BUILDING SEWER
101-0000-42401
0
$12.09
$0.00
BUILDING SEWER PC
101-0000-42600
0
$12.09
$0.00
Total Paid for PLUMBING FEES:
$24.18
$0.00
T&
i 06
.
SEQID INSPECTION TYPE...: .'_ INSPECTOR
SCHEDULED CON1PlETED RESULT REMARKS NOTES
<_
.-
DATE'
DATE
PLUMBING FINAL" BLD
1
-
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, August 20, 2015 1:29:10 PM 2 of 2
' SYSTEMS
Bin #
City of La Quinta'
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
roject dress: 15'
am )Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: g., 41
Telephonezz:iL_5L_2�44
<
Address:ej
Project Description:
City, ST, Zip: 'rw q22'7'--
Telcphorie:7�.Q
. . . . . . . . . . . . . .
State Lie.
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Con onstruction TY pe: Occupancy:
State Lie.
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
timated Value of Project:
APPLICANT: DON T WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec1d
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.4
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
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.
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
SUBJECT: -SANTA CARMELITA, 53106 AVENIDA VELASCO, LA QUINITA; LOT 4, LID 687014 "SCC ONLY
COACHELLA VALLEY WATER DISTRICT) • ; !' t.
` 'P.O. BOX,1058,, COACHELLA, CALIFORNIA`92236 (760) 398-2651
t Page 1
»AT
1� COACHELLA VALLEY WATER -DISTRICT
ta
P.0.•,
` A,,
BOX,1058, COACHELLA,
CALIFORNIA. 92236• (760)
,
398-2651 �•. 'r .
°,
,.
INVOICE
Date: 8/20/2015
,;
SUBJECT: SANTA.CARMELITA, 53106 AVENIDA VELASCO,
LA'QUINITA, LOT 4 LID 687014"SCC ONLYl
HOME EXPO FINANCIAL
Project;
15-6562
23580 ALESSANDRO BLVD #9818
Project Date:
8/20/2015
Amount Due:
$4;851.00
MORENO VALLEY, CA ,92552
GEO: G -
06-06-12-4
Planner:
RUBEN MONTIEL
-
TO, INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
'.
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK--------------
SUBJECT: -SANTA CARMELITA, 53106 AVENIDA VELASCO, LA QUINITA; LOT 4, LID 687014 "SCC ONLY
COACHELLA VALLEY WATER DISTRICT) • ; !' t.
` 'P.O. BOX,1058,, COACHELLA, CALIFORNIA`92236 (760) 398-2651
t Page 1