13-0051 (PLBG)P.O: BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1 -00000051
Property Address: 52130 EISENHOWER DR
APN: 773-231-007-16 -000000-
Application description: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 4000
T4hf 4 4 a"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
LA QUINTA PROPERTY MANAGI
52130 EISENHOWER DR r
LA QUINTA, CA 92253 IID
Contractor:
HAMMER PUMPING INC
P.O. BOX 2448
CATHEDRAL CITY, CA 92235
(760)360-7448
Lic. No.: 661018
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/16/13
------------------------------------------------
U TRACTOR'S DECLARATION
--
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
hereby affirm under6penplt-perjury hat licensed nder provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 70001 of Divthe Busi e s a Pro sc' n Is Code, and my License is in full force and effect.
I have and will maintain a certificate of consent to self -insure for workers' compensation,.as provided
License lass:, C42 1 a. No.: 661018
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: (-
_ 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
oNER-BUILDFJi.BEC RATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
Carrier NATIONAL UNION Policy Number 91
:,ss
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, ' e performance the work for which t ermit is ed, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person' 'any manner so as to b come subject to worke ' comp nsation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
a ree that, if sho bec,'o a subject to th orkers' compe tion provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
0
of the Labor Code, I forthwith co ply with those ision .
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).:
"-"Date: 1 (__
AFAILURE
pplicanr /V -
1, 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
WARN( GTO E WORKERS' 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 TO CRIMINAL 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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the .
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 cessati n of work for 180 days will subject
permit to cancellation. -
I certify that I have read this applicati and state that the ab ve informatio is correct agree to comply with all
city and oun ordinances and stat?laws relating to building 'onstructio , and hereby thoriz representatives
of this / u/nt to enter upon the above-mentioned property f inspecti purposes.
Date: / �V L.Signature (Aplticant or Aqa_ _
Application Number
Permit
Additional,desc .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
. . . . 13-00000051
PLUMBING SEWER
30.00 Plan Check Fee 00
Valuation 4000
7/15/13
Qty Unit Charge
Per
Extension
BASE FEE
15.00,
1.00 15.0000
EA PLB BUILDING
SEWER
15.00
-----------------------------------
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
1.00
Grand Total
31.00
.00
.00
31.00
LQPERMIT
Bin.�
Permit f
ProjectAddtess JAZ ��jU
CityOf ici QUIhta
Bulidttlt & Safety Ditdsion
P.O. Box 1504,78-495 Cane Tampico
fa.Quinta, CA 92253 -:(760) 777-7012
Building Permit "Application and Tracking Sheet
'���j �v l�v— Owner's Name:. LAQ.; , r s A izeC
A P. Number
Address:
Legal Description:
City, ST, Zip:
Contractor. �n,t (L
J,M l ti 1
Telephone:
Project Description:
Address:
City, ST, Zip:
' . Ara 0 OwJ M- ."
Telephone %O ate 61 �{ L(,
`j
State Lia #:
City Lic. 0,
Ard.. Fag., Designer:
Address
City, ST, Zip.
Telephone:
State Lia #:
Name of Coatact person:
Construction Type:. Occupancy:
Pmject type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories # Units:
Telephone i of Contact Person:
Estimated Value of Project: D C) v
/ Submittal Req'd
Plan Set
APPLICANT. DO NOT WRITE BELOW THIS LINE
Recd TRAC MG PERMrr FEES"
Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit.
Truss Cates.
Called Contact Person Plan Check Balance •
Tide 24 Calve.
Plans picked up Construction"
Flood plain plan
Plans resubmitted Mecharilcal
Gilding plan
2" Review, ready for correctionsrissue Electrical
Subeostaetor List
Called Contact Person Plumbing "
Grant peed
Plans picked up ' S.M-L
H.O.A. Approval
Plans resubmitted Grading
[K 110USE:1
''' Review; ready for correctioaslissue Developer [millet Fee
Pbhnoing Approval
Called Contact Person Ad.P.P.
Pub. Wks. Appr
Dau of permit issue
Sebooi Fees
Total Permit Fees
COACHELLA VALLEY WATER DISTRICT
TSC� P.O. BOX 1058,-COACHELLA, CALIFORNIA '92236 (760) 398-2651
INVOICE Date: 1/15/2013
SUBJECT: SANTA CARMELITA, 52130 EISENHOWER DR, LA QUINTA, LID 683320, "SCC FEE ONLY"
FLORENTINO VARGAS Project: 13-4338
52130 EISENHOWER DRIVE Project Date: 1/15/2013
Amount Due: $4,231.00
LA QUINTA, CA 92253 GEO: 06-06-12-1
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
Em __Eee Type Description
1.00 FF SCC -COLLECTION
$1,836.00 $1,836.00
1
1.00 FJ SCC -TREATMENT
$2,395.001 $2,395.00
g
� e 00
$4,231.00
✓�- /&7q
JAN' 15 202
COACHELLA VALLE)'
WATER DISTRICT
SUBJECT:SANTA CARMELITA, 52130 EISENHOWER DR, LA QUINTA, LID 683320, "SCC FEE.ONLY"
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Pagel
_A
P.O. BOX 2448 - Cathedral City, CA 92235-2448 • LIC# 6.61018 JOB INVOICE
L�ATE: TIME.
TIME IN: OUT. TECHNICIAN N2 HELPER(S)
ORDERED BY: P.O. N START DATE; END DATE:
www.hammerpumping.com
760/360-7448 7601321-7448 FAX 760/324-6434
Custdmer Name
14v kor4rk'
Address t
city
r'i
Phil_
Additional Service -_1 Required ❑Recommended
Description/ Remarks/ Drawings
Jog LOCATION
REASON FOR
SERVICE
❑ BACK UP
❑CONTRACT
MAINTENANCE
❑ REPAIR
❑ MAINTENANCE
❑
ESTIMATE
®"CONSTRUCTION
❑ OTHER
Credit Card -- MC / VISA # EXP.DATE
I hereby authorize Hammer Pumping, Inc. to charge my credit card for the above charges.
I understand that by signing below I am agreeing to all charges incurred on this ticket and
that the work was completed to my satisfactlon.' y
J i
COMMENTS
❑ Leach System Failing ❑ Roots ❑ Excessive sludge/grease
SERVICES COMPLETED
PUMPING
PLUMBING
SEPTIC
E]
Water Line
-
®,SEEPAGE PIT
❑
Sewer Line
El
Gas Line
[_]GREASE
❑
Toilet
❑ DRYWELL
❑
Water Heater
❑ CATCH BASIN
❑
Hose Bib
❑ OTHER
❑
Fixture
CONSTRUCTION SERVICE
❑ Leach Line ❑ Snake / Rooter
❑ Seepage Pit ❑ Hydro Jet
❑ Sewer Hook -Up
❑ Video Inspectior%
❑ Tank Install ❑ C-42 j
❑ Landscape Drains r
E] Other ❑ Products /Parts
❑ Leak Detection
QTY SERVICE AMOUNT TOTAL NEXT SERVICE
DUE ON
❑ Billing
TOTAL AMOUNT DUE _ ❑Check#��
A service charge of $20 will be due on all returned checks, 18% per year will be charged on past due our
1� MAI=m
Problem Solved!