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BPLB2016-005378-495 CALLE TAMPICO O. i C 0 D LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2016-0053 I I"II' II'll Property Address: 52800 AVENIDA RAMIREZ 22 APN: 773323003 Application Description: RAMOS RESIDENCE / SEWER CONNECT Property Zoning: Application Valuation: $2,000.00 Applicant: RICK EDWARD EGGAN 17325 JOHNSON ROAD #31 DESERT HOT SPRINGS, CA 92241 INSPEC,T,10 1.9 oLiIntz CARLOS RRfO(�0 11450 GLADSTONEOq SILMAR, CA 92253 F� Contractor: RICK EDWARD EGGAN 17325 JOHNSON ROAD #31 DESERT HOT SPRINGS, CA 92241 (760)404-6325 LIC. No.: 950244 777-7125 016 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I hereby affirm under penalty of perjury one of the following declarations: 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my license is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: C42 License No.: 950244 n of the work for which this permit is issued. Date: Contractor: 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 /1141 is issued. My workers' compensation insurance carrier and policy number are: OWNER -BUILDER DECLARATION Carrie : Policy Number: _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State —1 -certify that in the performance of the work.for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of,California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. 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 Date: 3- 2-27 "JT= Applicant: 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO 171131IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ( ) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose ( ) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and.the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractors) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (� I am exempt under Sec. • . B.&P.C. for this reason 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. 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 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. . A Date: -�� Signature (Applicant or Agent) FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY 'AMOUNT `. PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 3/23/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY S & G PUMPING CHECK MR285 3738 MFA Total Paid for BUILDING STANDARDS -ADMINISTRATION BSA:. $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT. PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/23/16 PAID,BY METHOD. RECEIPT # CHECK # CLTD BY S &G PUMPING CHECK MR285 3738 MFA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 DESCRIPTION ACCOUNTQTY: AMOUNT,:. PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 3/23/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY S & G PUMPING CHECK MR285 3738 MFA DESCRIPTION ACCOUNT QTY AMOUNT; PAID PAID DATE BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 3/23/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY. S & G PUMPING CHECK MR285 3738 MFA Total Paid for PLUMBING FEES: $24.18 $24.18 Description: RAMOS RESIDENCE / SEWER CONNECT CONDITIONS Type: PLUMBING Subtype: Status: ISSUED Applied: 3/23/2016 MFA Approved: 3/23/2016 MFA Parcel No: 773323003 Site Address: 52800 AVENIDA RAMIREZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 158 Lot: 24 Issued: 3/23/2016 MFA UNIT 16 NAME TYPE NAME Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $2,000.00 Occupancy Type: Construction Type: Expired: 9/19/2016 MFA No. Buildings: 0 No. Stories: 0 No. Unites: 0 RICK EDWARD EGGAN Details: CONNECT SEWER AND ABANDON SEPTIC TANK PER 2013 CALFORNIA BUILDING CODE DESERT HOT SPRINGS F_..,J Applied to Approved CM Approved to Issued. CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT RICK EDWARD EGGAN 17325 JOHNSON ROAD #31 DESERT HOT SPRINGS CA 92241 CONTRACTOR RICK EDWARD EGGAN 17325 JOHNSON ROAD #31 DESERT HOT SPRINGS CA 92241 OWNER CARLOS RAMOS 11450 GLADSTONE AVE SILMAR I CA I 92253 Printed: Wednesday, March 23, 2016 4:34:57. PM 1 of 2 Cff? SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK ## METHOD PAID BY CLTD. BY BSAS 581473 FEE 101-0000-20306 0 $1.00 $1.00 3/23/16 MR285 3738 CHECK S & G PUMPING MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/23/16 MR285 3738 CHECK S & G PUMPING MFA Total Paid for PERMIT ISSUANCE: $91.85 $91.85 BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 3/23/16 MR285 3738 CHECK S & G PUMPING MFA BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 3/23/16 MR285 3738 CHECK S & G PUMPING MFA Total Paid for PLUMBING FEES: $24.18 $24.18 TOTALS: �117.03 $117,03 Printed: Wednesday, March 23, 2016 4:34:57 PM 2 of 2 - pSYS7EiviS let me if you received. From: Carlos Ramos <ramosc1112@gmail.com> . To: egganr <egganr@cs.com> Subject: let me if you received. Date: Wed, Mar 16, 2016 4:49 pm z COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398=2651 INVOICE -Date: 31W2016 SUBJECT:. SANTA CARMELITA. 52800 AVENIDA RAMIREZ. LA OUINTA, LID. 665292. "SCC FEE ONLY" CARLOS RAMOS Project: 11450 GLADSTONE AVENUE Project Date: Amount Due: SYLMAR, CA 91342 GEO: Planner: >0INSVIRE PROPER CREDIT. PLEASE RETURN THIS PORTIONIVATH RE)AMA'.hCE A>d0 INCLur E I HE PROJECT ON YOUR CHECK Page.1 of 2 16-7065 3116/2016 $4:851.00 06-06-12-1 SANDRA VILLALOBOS SUBJECT: SANTA CARIAELITA. 52800 AVENIDA RAIAIREZ. LA OUINTA. LID 685292. -SCC FEE ONLY" COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Paget https:Hmail.aol.com/webmail-std/en-us/PrintMessage 3/17/2016 Bin # City of La Quinta. Building &r Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contra t o• c r. S P � Tele hone: P ...................................... Address: 73' 6 �f0 ��((9ljA-t� r s� ��3 Project Description: City, ST, Zip: vL1 GA eh nc Tel o p D Loyz 6 State Lic. # : Z-A4LY City tic. M.. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: e h = ............................................. Occupancy: Construction Te: O Y: Type: ic. #• State New Add'n Alter Repair air Demo PrP �cir I ne •Ne Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: Zpz9t APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan CheckBalance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees r