10-1179 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00001179
Property Address:.
52170 AVENIDA HERRERA
APN:
773-224-008-15 -000000-
Application description:
PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3500
Tiht
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
alp
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that Iam licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Lice se Class: A B C36 4 _
� n
�7 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 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 (5500).:
(_ 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
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.).
(_ 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) 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
Owner:
RICHARD DEW
52170 AVENIDA
LA QUINTA, CA
HERRERA
92253
Contractor:
SO CAL & ASSOCIATES
P.O. BOX 955
YUCCA VALLEY, CA 922
(760)369-4104
Lic. NO.: 793482
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760)777-7153
Date: 11/04/10
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 STATE FUND Policy Number 1820769-2010
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
/700 of the Labor Code, I shall forthwith com I with those provisions._
Date:—
WARNING: FAIL 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 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 Quina, 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 1 have read this application and state that the above information is correct. I a ree to comply with all
city and ounty ordinances an state laws relating to buildin , n ere y authorize representa tv
of jco ty ent ' up he above -mention y for inspection purposes.
ateJ ignature 1 can[ or Agentl:
Application Number . . . . . 10-00001179
Permit
PLUMBING SEWER
Additional desc .
Permit Fee
30.00
Plan Check Fee
00
Issue Date
Valuation
.7731
Expiration Date
5/03/11
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
--------------------
Due
Permit Fee Total
30:00
.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
LQPERMIT
PUMP/NG, Inc.
�cn nne InnA-401c Uc NC42855851
Fax 760 365-4118.1-800-334-7255
P.O. Box 2318 • Cathedral City, CA 92235
asappumping@aol.com
EscRowa
DATE
AMOUNT
BILL TO
PHONE
ADDR 7C 1 O _
FAX
CITY
TECHNICIAN
JOB NAME AND LOCATION '
DESCRIPTION OF WORK
Rooter Service
QUANT.
DESCRIPTION OF SERVICES
PRICE
AMOUNT
Pumping Fee per 1000 gal.
2
o d
Rooter Service
Camera
Labor
$75/HR
Septic Inspection
Locating / Opening Fee
$75/HR
Jetting Service
Out of Area Fee
After Hours Fee
Comments:
O ,(Z—
Z
od
SYSTEM FAILING' El YES D NO
A FAILING SYSTEM MAY FILL BACK UP WITHIN A FEW DAYS AND
CONTINUE TO HAVE PROBLEMS IF NOT RECTIFIED.
FUEL
CHARGE
$25 U U
TOTAL
MATERIALS
TOTAL
LABOR
WAIVER: Not responsible for secondary damage such as water
damage, chipped concrete, mark on street or driveways or trees.
SIGNATURE DATE COMPLETED
TAX
TOTAL
O
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 11/4/2010
SUBJECT: 52170 AVENIDA HERRERA, LA QUINTA
MICHAEL HILDEBRAND
58970 CARMELITA CIRCLE
YUCCA VALLEY, CA 92284
Project:
Project Date:
Amount Due:
GEO:
Planner:
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
10-2633
11/4/2010
$4,231.00
06-06-12-1
REBECCA MILWARD
SUBJECT: 52170 AVENIDA HERRERA, LA QUINTA
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Page 1
Nov 01 10 08:49a I. q, property manage
qtr sd
SpeoYa�sg,n
Senre�•i�taieer�lfo>rks.Stont�DU11lRS
State L;oen a AWOWR sr2 *A3482
Piro
R,
October 21, 2010
La Quints Property Management
PO Box 525
La Quints. CA 92247
Tel: 760-564-4218
Aft: Ken
Subject: Sewer Connection
52170 Avenida Herrera
La Quints, CA 92253
Scope of Woric
:> Abandon Septic System
'> Conned Property To City Sewer System
Price Includes City Permits, Pumping, And Fill Dirt
Coachella Valley Water District Fee Of $4231.00 Must Be Paid In Full Before The
Commencement of Work
Cost of Work Provided: $7,731.00
(Sewer Connection): ($3.500.00)
(Coachella Valley Water District Fee): ($4.231.00)
Note: We will schedule work to be completed ASAP when signed contract is returned.
Respectfully Submitted,
Michael S. Hildebrand
SoCal & Associates Plumbing, Inc.
License: A I BIC36 I C42 #793482
ACCEPTARM OF PROPOSAL i
/ oo�Rgc�
Aacepreo v sigiiia,re
��ss
Project Address: C:; oa —1-7
A- P. Number:
Contractor.
Address:
.City, ST, Zip:
Telephone:
Stale Lic. # • --7Q 3
Arch., Env., Designer;
Adis:
City. ST. Zip:
Telephone:
State Lid. #: .
Name of Contact person
Telephony # of Contact Person:
It Submittal
Plan Sets
Structural Cases.
Trus Cala.
We 24 Cales.
Flood plain plan
Grading plan
Subeoutsetor List
Grant Deed
H.O.A.Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of LaQuints
BuNng at Safety DMilon
P.O. Box 1 SO4, 78-495 Calle Tampico
La Qtdnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracidng Sheet
Lie. &
v®
APPLICANT: DO NOT VMW SHOW THIS UNE
Rev'd
Plan Cheek sub
Revlewed, rad
(ailed Contact
Plana picked of
Plana resubmit
2'! Review, ra
Called Contact
Plans picked ui
Plana resabmll
Review, real
Called Contael
Date of permit
TRACI{��IG
PERMfr FEES
nitted
Item Amount
F for corrections
Pun (heck Deposit
Person
Plan Cheek Balance
Construction
ed
Mechantal
ly for eortion:/issue
ree
Eleetntal
Person
Plumbing
.
S.M.I. .
*d
GM41ag
ly for eorrectionvIssue
Developer Impact Fee
Person
A.U.P.
Issue
Total Permit Fees