13-0851 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000851
Property Address:
79940 HORSESHOE RD
APN:
649-071-028-27 -2180 -
Application description:
PLUMBING
Property Zoning: ,A
LOW DENSITY RESIDENTIAL
Application valuation:
3000
Applicant: Architect or Engineer:
0
•44S
�W
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HORSESHOE TRUST
LA QUINTA, CA 92253
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty o�ecju t I am licen ed(nals
der p ovisions of Chapter 9 (commencing with
Section 0001 cf Division 3,of the Z iness
'in Prof si Cod , and my License is in full force and effect.
License lass C42 (.eT6 icen No.: 661018
Date Contracto
OWNER -BUILDER DE RATION
I hereb affifm under penalty of perjury that'I am exempt from the ontractor'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 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 Name:
Lender's Address: _
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/10/13
- t35QC'7yyyi0FLAqU1
Contractor:jHAMMER PUMPING INC d0 2013
P.O. BOX 2448
CATHEDRAL CITY, CA 92NTi4
(760)321-7448 -- F!NANCED_EPT.
Lic. No.: 661018
-----------------------------------------------
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 I_abnr Code, for the performance of the work for which this permit is
ssued.
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:
Carrier NATIONAL UNION Policy Number 910606
_ I certify that, in t or ce of the work for which this permit is issued, I shall not employ any
p son inkmanner so a to become ubject the. orkers' compensation laws of California,
a d agree that, if I should eco su ct to th arks s' compensation provisions of Section
FIUO
of the Labor C de, shall o with comply wit se provisions.
Date: A
WARNING: PAO TO hEC RE 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 Director of Building and Safety 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 wnrk is nvrfnrmed 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 certi*thatlread this application and state that the abo infor ation i correct. agree to comply with all
city anances and state laws relating to building c nstr tion, and thorize representatives
of thister upon the above-mm/eentioned property'f in ction purposesDate:Signature (Applicant or
r
Application Number . . . . . 13-00000851
Permit ... PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 1/06/14
Qty Unit Charge Per
Extension
1.00 11.9200 EA PLBG BUILDING SEWER
11.92
----------------------------------------------------------------------------
Special Notes and Comments
SEPTIC ABANDONMENT/CONNECT TO SEWER.
2010 CALIFORNIA BUILDING CODES.
----------'-----------------------------------------------------------------
Other Fees, . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PERMIT ISSUANCE M/P/E
90.57
PLAN CHECK, PLUMBING
11.92
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 11.92 .00 .00
11.92
Plan Check Total .00 .00 .00
.00
Other Fee Total 103.49 .00 .00
103.49
Grand Total 115.41 .00 .00
115.41
LQPERMIT
Bin #
Qty Of La Quinta
Building 8T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 711ctO 77#b
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: LN QV° p Cor �'Z-ZSR
Contractor:M \ UW I (S
Address:'P 2 L4 L �L
Telephone:
Project Description:IC—
City, ST, Zip: L� �J f�
Telephone: � � o � GO -7
State Lic. # :
City Lic.
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
on
struction Type: Occupancy:State
Lic. #:
tYPa �citcle one • w Altor Repair Demo
Name of Contact Person:
Sq. Ft.:#U
#Stories:
nits:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
4
Submittal
Req'd
Recd
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 Calcs.
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
�1ATER COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 719/2013
SUBJECT: 79940 HORSHOE RD, LA QUINTA, LID 305238, "SCC FEE ONLY"
HORSESHOE TRUST Project: 13-4688
79940 HORSESHOE ROAD Project Date: 7/912013
Amount Due: $4,851.00
LA QUINTA; CA• 92253 GEO: 05-07-29-1
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT: 79940 HORSHOE RD, LA QUINTA, LID 305238, "SCC FEE ONLY" I . .
COACHELLA VALLEY WATER DISTRICT
P.o. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Page 1