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BPLB2014-102678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 BPLB2014-1026 53780 EISENHOWER DR 774171002 . SEPTIC ABANDONM $3,200.00 "&tit 4 1aQumrw COMMUNITY DEVELOPMENT DEPARTMENT 1. BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed unde provisions of Chapter 9 (commencing with Section 7000) of Division 3 Business ns Code, and my License is in full force and effect. License Class: _114 cerise No.::LIC 001138 Date: ! `6 Contra 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 alleg 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/2014 Owner: COACHELLA VALLEY HOUSING COA 45701 MONROE ST STE G INDIO, CA 92253 Contractor: HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA, CA 92253 (760)321-7450 Llc. No.: :LIC -0001138 WORKER'S COMPENSATION DECLARATION 1 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 agre t if I should b come subject to the workers' compensation provisions ection 370 of the L e I shall forthwith comply with thosIt rovisions. Date: 6 A plicant: WARNING: FAILURE TO SECURE WORKERS' CMPENSATION 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 inform ti h c I agree to comply with all city and county ordinan law elati to construction, and hereby authorize represents es of this city ter n the mentioned p oper for inspection purposes. Date: /d Signature (Applican or A [ DESCRIPTION FINANCIAL •• 1. 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 forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-000042404 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 • 1 0• wet�ail.5 PERMITN 2_10"6 R r City of La Quinta BPL620�1 Description: SEPTIC ABANDONMENT /SEWER HOOK UP i • Type: PLUMBING Subtype: Status: APPROVED Applied: 10/14/2014 PJU Approved: Parcel No: 774171002 Site Address: 53780 EISENHOWER DR LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 247 Lot: 23 Issued: UNIT 23 PAID DATE RECEIPT # CHECK # METHOD PAID BY Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $3,200.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 $0.00 Details: SEPTIC ABANDONMENT SEWER HOOK UP 2013 CALIFORNIA PLUMBING CODES. Process bmmm_a_ry . , . 0. i't.k 4 i • 1 , is k „�5. T •'X,ij N ' CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 0 0 0 $1.00 $0.00 BSA: NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL APPLICANT HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 CONTRACTOR HAMMER PUMPING INC 0 OUTSIDE CITY LIMITS LA QUINTA CA 92253 OWNER COACHELLA VALLEY HOUSING COA 45701 MONROE ST STE G INDIO CA 92253 . , . 0. i't.k 4 i • 1 , is k „�5. T •'X,ij N ' CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Tuesday, October 14, 201412:36:45 PM 1 of 2 ��CVC TFMC DES ACCOUNT QTY AMOUNT. --T PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY 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 $0.0.0 TOTALS:00 - PA - RENT°PROJECTS RETURNED STATUS REMARKS REVIEW TYPE, ' REVIEWER SENT DATE DUE DATE DATE NOTES ' Printed: Tuesday, October 14, 201412:36:45 PM 2 of 2 CRC ".F C C� -,H— toSZ9 Bin # Submittal Oty of La QCuinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012.' Building Permit Application and Tracking Sheet Permit # Project Address: Scl3VJ Owner's Name: J_. 1JC A. P. Number: , 1� O Z — AA Address: W S� O M O t-v—d£ S Legal Descriptiop: City, ST, Zip: /-Ab i`t✓t ZZ6 j Contractor: Telephone: Address: a Zj'k 2 ( Project Description: City, ST, Zip: Citi 4&0 WA L C. 'CT Telephone --?6. Truss Cala. b State Lic. # : 0 1 C211 ed Contact Person City Lic. C Plan Check Balance • Arch., Engr., Designer. 1 Title 24 Cala. Address: Plans picked up City., ST, Zip: Construction Telephone: Flood plain plan `>h .. Construction Type: Occupancy:. Project type (circle nc : New Add'n Alter Repair Demo 'tate Lic. #: �" of Contact Person: q. #Stories: #Unlame :. Celcphone # of Contact Person -7 Uv ' Estimated Value of Project: ZU�-- APPLICANT: DO NOT WRITE BELOW THIS LINE ' # Submittal Rcq'd Rec'dTRACKING PERMIT FEES. Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cheek Deposit Truss Cala. C211 ed Contact Person Plan Check Balance • Title 24 Cala. Plans picked up Construction Flood plain plan Plans resubmitted Mcehanical Grading plan 2"' Review, ready for corrcctions/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I.' II.O.A. Approval Plans resubmitted Grading IN I10USE:- '`d Review, ready for correclionstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fccs Total Permit Fees c�kl�8zi 4 z COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 9/19/2014 SUBJECT: SCC ONLY -5.3780 EISENHOWER OR., LA QUINTA, LOT 23, LID 68314 CV HOUSING COALITION 45701 MONROE ST. UNIT G INDIO, CA 92201 Project: Project Date: Amount Due: GEO: Planner: TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 14-5826 9/19/2014 $4,851.00 06-06-12-4 SARA LOPEZ SUBJECT:SCC ONLY- 53780 EISENHOWER DR., LA QUINTA, LOT 23, LID 68314 COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel 1.00 FF SCC -COLLECTION $2,415.001$2,415.00 1.00 FJ SCC -TREATMENT 1 $2.436.001 $2.436.001 $4,851.00 PAID $ > Services Department Development Se p SEP 19 2014 Coachella Valley Water District 75-515 Hovley Lane East Palm Desert, CA 92211 SUBJECT:SCC ONLY- 53780 EISENHOWER DR., LA QUINTA, LOT 23, LID 68314 COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel