BPLB2014-1035f
D
78 495 CALLE TAMPICO .-` Qab& VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 11/6/2014
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
MR ROOTER PLUMBING
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
BPLB2014-1035
52600 AVENIDA HERRERA
773294005
SEWER CONNECT/SEPTIC ABADONMENT
$3,500.00
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 Class: License No.::LIC-0103
Date: Contractor:
OWNER-BUILDE ECLARATION
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
($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 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
Lender's
Owner:
RAYMOND CROWELL
, 92253
Contractor:
MR ROOTER PLUMBING
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
(760)779-0190
Llc. No.: :LIC -0103169
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 b ome subject to the workers'
compensation laws of California, and agree that, if I ould become subject to the
workers' compensatiori provisions of Section 3700 the Labor Code, I shall forthwith
comply with those provisions. f1
a
Date: Applicant:
WARNING:WAILRESECURE WORKER 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 upon the above-
mentioned property for inspection purposes.
Date: i1 ��6� i N Signature (Applicant or Agent): �
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
QTY " AMOUNT PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $1.00 $0.00
PAID BY
METHOD
RECEIPT # CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
.101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
DESCRIPTION
-ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BUILDING SEWER
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BUILDING SEWER PC
101-0000-42600
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $24.18 $0.00
TOTALS:00
Description: SEWER CONNECT/SEPTIC ABADONMENT
ADDITIONAL
Type: PLUMBING Subtype:
Status: SUBMITTED
Applied: 11/6/2014 PJU
Approved:
Parcel No: 773294005 Site Address: 52600 AVENIDA HERRERA LA QUINTA CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 151
Lot: 19
Issued:
UNIT 16
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $3,500.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
STATE ZIP PHONE FAX EMAIL'
Details: SEWER HOOKUP SEPTIC ABANDONMENT 2013 CBC.
MR ROOTER PLUMBING
0 OUTSIDE CITY LIMITS.
Printed: Thursday, November 06, 2014 11:00:37 AM 1 of 2
SYS TEMS
ADDITIONAL
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE ZIP PHONE FAX EMAIL'
APPLICANT
MR ROOTER PLUMBING
0 OUTSIDE CITY LIMITS.
LA QUINTA
CA 92253
CONTRACTOR
MR ROOTER PLUMBING
0 OUTSIDE CITY LIMITS
LA QUINTA
CA 92253
OWNER
RAYMOND CROWELL
92253
Printed: Thursday, November 06, 2014 11:00:37 AM 1 of 2
SYS TEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT`
PAID
PAID DATE
RECEIPT #
CHECK # r
~METHOD
F PAID BY _
CLTD
BY
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid forPERMIT 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 forPLUMBING FEES: $24.18 $0.00
TOTALS:•0
ATTACHMENTS
Printed: Thursday, November 06, 2014 11:00:37 AM 2 of 2
B? -W- SYSTEMS
COACHELLA VALLEY WATER DISTRICT
Q�S.7Rt P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 5/812014
SUBJECT: SCC ONLY- 52600 AVENIDA HERRERA, LA QUINTA, LID 684656
CROWELL , RAYMOND Project: . 14-5457
52600 AVENIDA HERRERA Project Date: 5/8/2014
Amount Due: $4,851.00
LA QUINTA, .CA 92253 GEO: 06-06-12-1
Planner: CAROL PFANNKUCHE
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
1.00 SCC -COLLECTION 1 $2,415.001 $2,415.00
1.00 SCC -TREATMENT 1 $2,436.001 $2,436.00
$4,851.00
PAID $ 1
95/.00 ✓3�k 1001
Development Services Department
NOV 0 5 2014
Coachella Valley Water DistdCt'
76-515 Hovley Lane East.
Palm Desert, CA 92211
SUBJECT:SCC ONLY- 52600 AVENIDA HERRERA, LA QUINTA, LID 684656
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel
Bin.#
C[y/ Of I.d Qiilllta
Btdl*g 8z Safety Division
P.O. Box 1504,78-495 Caife Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:i) y d ��r^
Owner's Name:. V1^ur� ' �(Q�✓
A. P. Number.
Address: 5 ca�boo v-J w. HeY'4e Cu."
Legal Description:
Contractor. MI/ . +�A bVMb(
City, ST, Zip:
Telephone:
y '
Address: S i) � S 1
' � 1;mss
Project Description: c5 �"� 1� eS
(Q
City, ST, zip:.PaCA,
GY�vP�✓-$vr--.
Telephone O — A ci 0-
State Lie. #: (5j(} 66 5� City Lie. 9-
State
;Arch,
Arch,Bngr., Designer
Address:
City., ST, Zip:
Telephone:.` . -
Y �
State Lic. #: - u , ,
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: #Stories: #Units:
Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project S 5-0 c'
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMNG
PERMUFEES
Plan Sets
PIan Check submitted
Item Amount
Structural Cafes.
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
Zad Review, ready for correctionsrLwue
Electrical
Subcontactorlrst
Called ContactPerson
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Gradlag
IN HOUSE:-
'^` Review', ready for correctionsfissae
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P. '
pub. Wks. Appr '
Date of permit Issue
School Fees
Total Permit Fees