11-0609 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000609
Property Address:
51780 AVENIDA DIAZ
APN:
773-161-002-23 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3200
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MATA STEVE JAMES
1tY; A ,sstshl4tl�—�
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.).
(_ 1 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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
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 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 voi i ork is not c menced
within 180 days from date of issuenee of3oo ermit, or cessatio o work for 180 d s will subject
permit to cancellation.
1 certify that 1 ave read this application'and state that the abo informatio s correct. ee to omply with all
city and un ordinances and state laws relating to building c �structio , and hereby authori presentatives
of this cotnty o enter upon the above-mentioned property f rfspec ' purposes.
Signature (ApoUcant or
Contractor:
Applicant: Architect or Engineer:
HAMMER PUMPING INC
P O BOX 2448
CATHEDRAL CITY, CA 92235
(760)360-7448
Lic. No.: 661018
-------------------------------------------------
RATION
LICENSED C1�91
-----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
I hereby ffir under penalty of fury th am licenCh. pter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 000 of Division 3 the Business Profesicense is in full force and effect.
1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Licen lass C42 018-_
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
i
ate: - `U C tractor•
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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier SELF - INSURED Policy Number 2246
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
_ I certify that, in the per o ce of thew rk for�wKich-th's permit is issued, 1 shall not employ any
person in any a ner so as to becom subjefC oto the w kers' 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 _
and agree thaif I should b c me s ject to the wor. er compensation provisions of Section
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
1
3700 of the Labor Code, I h Ifo with comply with t isions.
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
ate:
Acant:
(_ 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
WARNIN
: F IL E TO ECURE RKER '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 INAL 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.).
(_ 1 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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
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 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 voi i ork is not c menced
within 180 days from date of issuenee of3oo ermit, or cessatio o work for 180 d s will subject
permit to cancellation.
1 certify that 1 ave read this application'and state that the abo informatio s correct. ee to omply with all
city and un ordinances and state laws relating to building c �structio , and hereby authori presentatives
of this cotnty o enter upon the above-mentioned property f rfspec ' purposes.
Signature (ApoUcant or
+J -
LQPERN1IT
Application Number . . . . . 11-00000609
Permit . .
. PLUMBING SEWER
Additional desc .
Permit Fee
30.00
Plan Check Fee
00
Issue Date. . . .
.
Valuation . . .
. 3200
Expiration Date
12/03/11
Qty Unit Charge Per
Extension
BASE FEE
30.00
----------------------------------------------------------------------------
Special Notes and
Comments
SEPTIC ABANDON, SEWER CONNECT: 2010 .
CODES.
----------------------------------------------------------------------------
Other Fees .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged Paid
--------------------
Credited
----------
Due
Permit Fee Total
30.00
----------
.00 .00
30.00
Plan Check Total
..00
.00 .00
.00
Other Fee Total
1.00
.00 .00
Grand Total
31.00
.00 .00
31.00
06/03/2011 09:05 7145693797 OC PROBATION SAO PAGE 03/03
gyp► COACHELLA VALLEY WATER DISTRICT
Cys P.o. Box 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 5/24/2011
�+ SUBJECT: 51780 AVENIDA DIAZ, LA 4UINTA
STEVE MATA Project: 11-2955
6444 E. RIDGE GLEN RD Project Date: 5/24/2011
Amount Due: $4,231.00
ANAHEIM, CA 92807 GEO: 06-06-01-3
Planner: REBECCA MILWARD
TO INSURE PROPER CREDIT. PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT: 51700 AVENIDA DIAZ. LA QUINTA
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Page
Bin #
City 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 # l
I
"
Project Address: a�l� ��
Owner's Name: v v \ v--,, , 1P�
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor.--
?�;s:wr
Address.'-�t/,a`-��04 `ZA4%
Project Description:
City, ST, ZipjC �,Qq n e C i T
Lif{•.'r s :!:::ijv;:.f�Lj;:•45�(>.:ii i::}ii::, `.
State Lic. # : City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
foiF :%•:;,;; :i y`5? > •', : mow:
? v F ' :::; :;::.>.X.:::::»:;: <<:c ;;»:..
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.: # Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: j �5
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.1.
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