BPLB2015-004878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2015-0048
Property Address: 53255 AVENIDA DIAZ
APN: 774071013
Application Description: DEANDREA ABANDONSEPTIIECT TO SEWER
Property Zoning:
Application Valuation: $4,500.00 IS
Applicant:
MICHAEL DEANDREA
53255 AVENIDA DIAZ
LA QUINTA, CA 92253
APP 4 2 2015
CITY OF LA QUINTA
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.
XDate:
License Class: A License No.: 988742
` ,/ s" I os- Contractor:
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 Divisio 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:
C`k-� .
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/2/2015 •
Owner:
MICHAEL DEANDREA
53255 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
VALLEY PIPELINE SERVICES INC
42-240 GREEN WAY STE I
PALM DESERT, CA 92211
(760)340-3715
Llc. No.: 988742
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:
Carrier:_ Policy Number: _
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 tabor Code, I shall forthwith
comply with those provisions.
Date: ^1:p— 11 s Applicant
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 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 on the above-
mentioned property for inspection purposes.
#) 1( iS
ate: Signature (Applicant or Agent): �J
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Data: 3/25/2015
SUBJECT: SCC ONLY - 53255 AVENIDA DIAZ, LA QUINTA, LID 887298
MIKE DEANDREA Project: 15-6218
53-255 AVENIDA DIAZ Project Dom: 3/25/2015
Amount Due: $4,851.00
LA QUINTA, CA 92253 GEO: 08-08-12-3
Planner. SARA LOPEZ
TO MSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
$4,851.00
PAIQ$ 'f, 85/.po '
Develr:pment Services Departmentr,�,
MAR 2 7 2015 ,�iy Cc�/s
Coachella Valley Water District dC%C
75-515 Hovley Lane East
Palm Desert, CA 92211 /t,C,.419J�S
SUBJECT: SCC ONLY - 53255 AVENIDA DIAZ, LA QUINTA, LID 887298
COACHELLA 'VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Page 1
Bin #
Qty of La Qulnta
Building ST Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777.7012.
Building Permit. Application and Tracking Sheet
Permit #
'VL,?7pIS
Project Address:S3 95 5 v��
Owner's Name:
A. P. Number:
Address: . j 3 a,�55
Legal Description:
City, ST, Zip: eco �
Contractor: r
T eleP hone:
Address:
Project Description: S2 G—�c7�SPu120�` Cfl4VAr ,
City, ST, Zip:
�� G,*Lq0C--
e
ele .
Telephone:
P
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
i
Construction aneY•
Type: Occupancy:
State Lic
Project P (circle one): New Add'n Alter Repair Demo
Name of Contact Person: `�
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
cb
Estimated Value of Project:S�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2". Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' 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
o•
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RAIDFAIDDATE
�DES�CRIPTION�rv,xAC000NT 4 W rQ NiEAMOUNTa �§
BSAS 361473 FEE
101-0000-20306 0.. ,
<` $1.00 $0.00,
.¢CAF'$k,`Lt3Ria:
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PAID BYE+
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IVIET:FIOD F
Ci �i�SIY
RECEIPT #CWECK BY
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Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00,
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DESCRIPTION
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PAID
sPAIUyDATE
PERMIT ISSUANCE
101-0000-42404
`0
$91:85
$0.00
:,-r° .z':,<-,`•'rtX '.`b',so'�•:
- z`�,,-.' *%<.srsY3,.:aA rxY -01
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RECEIPT #.'�
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X
CHECK
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Total Paid forPERMIT ISSUANCE: $91.85 $0.00
y'°P° �<' -., Ei - :' 'Y"SY
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antis
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PAID,><
i DESCRIPTIONSA000UNTE
a ..P,�..
AMOl1NT i._..>.
.,
„PAIDyDATE
BUILDING SEWER
101-0000-42401
0,-
$12.09,
$0.00
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METIiOD
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RECEIPT #,;
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DESCRIPTION;
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`•ir `K.
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F
AMOUNT
f X:.... Ir,{g i n
k " ° $PAIDr
PAID. DATE.
>§ 90..AC.000NT
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EQTY
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BUILDING
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Total Paid for PLUMBING FEES- $24.18 $0.00' ,
• M
n,
4
Permit Details PERMIT NUMBER
City of La Quinta BPLB201s 004$
ti t
Description: DEANDREA ABANDON SEPTIC CONNECT TO SEWER
ADDITIONAL
Type: PLUMBING Subtype:
Status: ON HOLD
Applied: 3/27/2015 SKH
Approved:
Parcel No: 774071013 Site Address: 53255 AVENIDA DIAZ LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 183
Lot: 1
Issued:
UNIT 18
OWNER HAS NOT SELECTED A CONTRACTOR.
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $4,500.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
CONTACTS
Details: PLUMBING -ABANDON SEPTIC AND CONNECT TO SEWER. 2013 CALIFORNIA BUILDING CODES.
Printed: Thursday, April 02, 2015 12:23:33 PM 1 of 2 CR
SYS7ENIS
ADDITIONAL
CHRONOLOGY TYPE STAFF NAME
ACTION DATE
CHRONOLOGY
COMPLETION DATE
NOTES
PLAN CHECK SUBMITTAL STEPHANIE KHATAMI
RECEIVED
3/27/2015
3/30/2015
OWNER HAS NOT SELECTED A CONTRACTOR.
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
MICHAEL DEANDREA
53255 AVENIDA DIAZ
LA QUINTA
CA
92253
(
Printed: Thursday, April 02, 2015 12:23:33 PM 1 of 2 CR
SYS7ENIS
DESCRIPTION7-
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK#
METHOD
PAID BY
I-4TD,I
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
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
• 00
INSPECTIONS
SEQID` INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS' NOTES
PLUMBING FINAL" BLD
REVIEWS
p
REVIEW TYPE REVIEWER . SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
Printed: Thursday, April 02, 2015 12:23:33 PM 2 of 2 .
srsrerns