BPLB2016-002478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tit!t 4 44"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BPLB2016-0024
Property Address:
52790 AVENIDA NAVARRO
APN:
773335002
Application Description:
BAGLEY / ABANDON SEPTIC/SEWER CONNECTION
Property Zoning:
Application Valuation:
$2,400.00
Applicant:
SEWER & SEPTIC PROS INC
16315 AVENIDA RAMADA
DESERT HOT SPRINGS, CA
92240
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: C42 License No.: 986954 /
Date: Z 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 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 Name:
Lender's
Owner:
-SHARON BAGLEY
P 0 BOX 232103
ENCINITAS, C y
Contractor:
SEWER & SEI
16315 AVEN
DESERT HOT
(760)329-7600
Llc. No.: 986954
1111111111111111
44
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/2/2016
FEB 0 2 2016
tA0ll WA
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 polity 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 Labor Code, I shall forthwith
comply with those provisions.
Date: —0--l-CZApplicant
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth.on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and.
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
r
Date: Signature (Applicant or Agent):
:.$."-i':.,..wL 4,ac�.�"Py: ,i: :!..
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DESCRIPTION.x��ACCOUNT-R`� �`i�,�se+QTY>x�
�AMOUNT,� ,rPAID�,,t �,PAID.DATE.:
BSAS SB1473 FEE 101-0000-20306 0 . $1.00 - $1.00 2/2/16
.�r ''p,''
Y E PAID BYt, 4. rCFiECK�# CLTD BY
f, f) x#I'METHOD :>s ar tf. �RECEIPTs#
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SEWER & SEPTIC PROS INC DEBIT 1112515 RSE
Total' Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00' $1.00'
DESCRIPTION
. i
f ACCO a
F
TY
1'
y AMOUNT
r{. 4 - y:,32. y ik"
`' iiv
PAID
AI
kK Z S
PAID DATE
+
aQ
r ;.
r:., zr
`PERMIT ISSUANCE
101-0000-42404
0
$91.85
$91.85
2/2/16'
PAID BY
{ # ix
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of # y£_
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_ CHECK #�
x
CLTD�BY
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,RECEIPT
4_
SEWER & SEPTIC PROS INC,
DEBIT'.
R12515' `
RSE
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
sxr3.`o ?1
ACCOUNT.
e ±�'i=
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s xrSla,�s�.w £F<', '1
VAMOUNT
z sus: _ ttE `� rete. Fa�;.
t
PAID
;:.
R� ,PAID
DATE
BUILDING SEWER
101-0000-42401; .
0
$12.09
$12.09
2/2/16
PAID BY x:&
METIIUD�
RECEIPT # a
CHECK #
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SEWER & SEPTIC PROS INC,
DEBIT
R12S15
RSE
n 4r ''2fr f ,+z
Y DESCRIPTION'ACCOUNT
k fr r`ikt�,.i xX`"Y,,4
QTYA
--stir'
1'a�' T4's
rPAID
DATE
..y . ..i.,,, .. ✓s r
K -r,
a r�
MOUNT ,
,'PAID
BUILDING SEWER PC
101-0000-42600
0
$12.09
$12.09.
212/16
4
z PAID BY',
'" $C @'. 91.ai, Y✓'. -. ft f f)iy:
METHOD
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FS % ��?i- i�l PY > Ss 'htq`£51
RECEIPT #�
f:
CHECK #
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CLTD BYy.
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1Az'`,+o€.:.'•'s v.,»! v.6:.
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SEWER &'SEPTIC PROS INC
DEBIT
1112515
RSE
Total Paid for PLUMBING FEES: ., $24.18 $24.18
•
Permit Details = PERMIT NUMBER
Cit of La Quinta BPLB2016=0024
Y
Description: BAGLEY / ABANDON SEPTIC/SEWER CONNECTION •
CHRONOLOGY
CONDITIONS
Type: PLUMBING Subtype:
Status: UNDER REVIEW
Applied: 2/2/2016 RSE
Approved:
Parcel N6: 773335002 Site Address: 52790 AVENIDA NAVARRO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 149
Lot: 25
Issued:
UNIT 15
EMAIL
APPLICANT
Lot Sq Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $2,400.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
CONTRACTOR
[Details: SEWER CONNECTION AND ABANDON SEPTIC. 2013 CALIFORNIA BUILDING CODES.
16315 AVENIDA
RAMADA
t 1 • .
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
SEWER & SEPTIC PROS INC
16315 AVENIDA
RAMADA
DESERT HOT
SPRINGS
CA
92240
CONTRACTOR
SEWER & SEPTIC PROS INC
16315 AVENIDA
RAMADA
DESERT HOT
SPRINGS
CA
92240
OWNER
SHARON BAGLEY
P 0 BOX 232103
ENCINITAS
CA
92253
Printed: Tuesday, February 02, 2016 11:46:21 AM 1 of 2
SYSTEMS
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLD
BY.
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
2/2/16
R12515
DEBIT
SEWER & PROS
RSE
IN
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $1.00
BSA:
PERMIT ISSUANCE
101-0000-424040
$91.85
$91.85
2/2/16
R12515
DEBIT
SEWER & SEPTIC PROS
RSE
INC
Total Paid for PERMIT ISSUANCE: $91.85 $91.85
BUILDING SEWER
101-0000-42401
0
$12.09
$12.09
2/2/16
R12515
DEBIT
SEWER& PROS
RSE
IN
BUILDING SEWER PC
101-0000-42600
0
$12.09
$12.09
2/2/16
R12515
DEBIT
SEWER &NCTIC PROS
RSE
Total Paid for PLUMBING FEES: $24.18 $24.18
TOTALS:
INSPECTIONS
PARENT PROJECTS
ATTACHMENTS
Printed: Tuesday, February 02, 2016 11:46:21 AM 2 of 2 r
SYSTEMS
Qin #
.City of La Quinta
Building &• Safety Division
. . . 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit ff
ULF)
Project Address: 5 2 - 9 O AVG Y1t D q A/A vA nQp
Owner's Name: S i., a r o r G'cL
A. P. Number:
Address: S 2- `� tk d -r., /VA v R Q 2 O
Legal Description:
City, ST, Zip: \,_A Q V hk G eA 2 Z-�3
zr SeP��C
Telephone: l 3 1 q
i.0 2Contractor:Sew
Address: (o - 3 S A•v'e Q Ann A, ZA
Project Description:
City, ST, Zip: Q ESE r -'r N O i- S r\c.\.S
S 2 W c r C o nric(✓ G n
Telephone( o 3 2
G � �- 6 0 O
-� e v\r�
s a
s .�
S e 6
T L A ►J v e
�'l
State Lic. c1 S Ll
City Lic. #;
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
5: d -e n
1Cn tructi n Type:
Occupancy: FG S :a
State Lic. #.
Repairair Demo
Project �cile one): Ne w Altert
Sq. Ft.: # Stories: # Units:
Name of Contact Person: D SCc-r z c.r 4A, -e
Telephone # of Contact Person:( C. v 1 Z } 2 3e—k%0
Estimated Value of Project: Z L1 d 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance,
Title 24 Cafes.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Pcrson
Plumbing
Grant Deed
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN I10USE:-
'rd Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees,
Total Permit Tees
I9<',
�AT�R COACHELLA VALLEY WATER DISTRICT
O�Sr�ttL'C P.O. BOX 1058, COACHELLA, CALIFORNIA' 92236 (760) 398-2651
INVOICE Date: 1/27/2016
SUBJECT: SANTA CARMELITA, 52790 AVENIDA NAVARRO, LA QUINTA, LID 685688, SCC ONLY
SHARON L. BAGLEY Project:
52-790 AVENIDA NAVARO Project Date:
Amount Due:
LA QUINTA, CA 92253 GEO:
Planner:
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
16-6935
1/27/2016
$4,851.00
06-06-12-1
SARA LOPEZ
Cal
1.00 FF SCC -COLLECTION $2,415.00 $2,415.00
1.00 FJ SCC -TREATMENT $2,436. 0 $2,436.00
I j $4,851.00
PAID $ � v a ' 'd
Development Services Department C 67 % 0
JAN 2"8 2016 U
Coachella Valley Water District
75-515 Hovley Lane East
Palm Desert, CA 92211
SUBJECT:SANTA CARMELITA, 52790 AVENIDA NAVARRO, LA QUINTA, LID 685688, SCC ONLY
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel