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BPLB2016-004178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT I I"III "II' I'I I II'I i 09 VOICE (760)777-71 25 FAX (760) 777-7011 INSPECTIONS (760) 7774153 .Date: 3/9/2016 Application Number: BPLB2016-0041 Owner: Property. Address: 53671 AVENIDA VILLA HOME STRONG USA FUND 1 APN: 774133021 8711 MONROE CT STE A Application Description: STRATEGIC RENTAL FUND / CONNECT TO SEWER RANCHO CUCAMONGA, CA 92253 Property Zoning: Application Valuation: $2,500.00 Applicant: �Q� i�ji Contractor: — GARDNER SEPTIC SERVICE 21195 BOCCACCIO COURT 1 iii 09��D MORENO VALLEY, CA 92557 �{T'iGrl�iiIIVTP. (951)830-4840 CG'f (11u1:TY[?EVEtJt y+.ctv`UEPABfinE0,1T Llc. No.: 873639 1 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.: 87363399��/ 5'" Date:&3�/4. Contractor(•7VLC. 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.). (1 1, 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: 0309 / C.. - Owner: (`--)l 'e -y cl — - 0 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: 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: _ 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: ��!/Applicant:( 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. Date: !� Signature (Applicant or Agent): zih� r41 FINAWAL INFORMATIOW DE ..,.� is.4 "Mir IP, AMOUNT.f PAID PAID'DATE; ,.tx� BSAS SB1473 FEE 101-0000-20306 0 $1.00. ,_ . $1.00 3/9/16 :. �, "..A '.ls,§€` § N q'XE. 3+.g. .. 3 .. �vA "i73' :^Cw. ,c. Y x A <. .....: .":e _ �1 f f E i' `X PAID BY'� METHOD��?.E uiiy; fgtt°.. eei t:s'.?h 4 »"a 4. is`YE&-h5 iF .5 '''# ry :` � j' t z?? i+ 3p 't Y RECEIPT # 1�CEIECK # CLTD BYE '�'s .a'�i''.z`:es,;?�Fi� 'raS T BALLINGER DEVELOPMENTS LLC CHECK MR274 2089 RSE Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 : `$ aACCOIINTt QTY' �AMOUNTr i PAID 'tf PAID DATE; j„DESCRIPTION ; y � `� � _ ,� �c. _ _ -iv, PERMIT ISSUANCE 101-0000-424084 0 $91.85 $91.85 3/9/16 F�. Se �+. v� �"d y z PAID -BY ��k '� 'i'ix`5'b,''z,�*.,F'-'k "�`. •':?F`' f `�,s`4y?' ,�- METMOD s- t',. 3�. ��R n'.#'£"v "Y..,..fa �.a.c: E CEIPTF#ti . CHECK #CLTD BY 41 BALLINGER DEVELOPMENTS LLC CHECK MR274 2089 RSE Total Paid for PERMIT ISSUANCE: $91.85 $91.85 DESCRIPTION ; ' 6"s.n.xA000UNT N 'AMOUNT �:� § P{►ID f D PAS _DATE . x. fvr BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 3/9/16 PAID BY�EA METIiOD�'� CHECK #CLTD BY, .; 1; ..,., _RECEIPT#�< r -c BALLINGER DEVELOPMENTS LLC. CHECK MR274 .2089 RSE r DESCRIPTIONUl zkne ACCUUNT*TY Q �r�AMOUNT PAID a' AP ID:DATE'F �� n s��_ �z� .g- _ Pte. BUILDING SEWER PC 101-0000-42600 :0 $12.09 '$12.09 3/9/16 �PAIDkBY gm f (mMETHOD x i �c � § RECEIPT`#!5UR ” A �CNECK °4 BALLINGER, DEVELOPMENTS* LLC CHECK MR274 - 2089 RSE Total Paid for PLUMBING FEES: $24.18 $24.18 Description: STRATEGIC RENTAL FUND / CONNECT TO SEWER CONDITIONS Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 3/8/2016 SKH Approved: Parcel No: 774133021 Site Address: 53671 AVENIDA VILLA LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 242 Lot: 9 Issued: UNIT 23 Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 FAX Details: ABANDON SEPTIC/CONNECT TO SEWER. 2013 CALIFORNIA BUILDING CODES. CONTRACTOR CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY- STATE ZIP PHONE FAX EMAIL CONTRACTOR GARDNER SEPTIC SERVICE 21195 BOCCACCIO COURT MORENO VALLEY CA 92557 (951)830-4840 GARDENERSEPTIC@G MAIL.COM OWNER HOME STRONG USA FUND 1 8711 MONROE CT STE A RANCHO CUCAMONGA CA 92253 (951)830-4840 Printed: Wednesday, March 09, 2016 3:13:58 PM 1 of 2 SYSTL•'ti1S Printed Wednesday, March 09, 2016 3:13:58 PM 2 of 2 • � r1?SYSTEti1S CL DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 3/9/16 MR274 2089 CHECK BALLINGER RSE DEVELOPMENTS LLC Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 3/9/16 MR274 2089 CHECK BALLINGER RSE DEVELOPMENTS LLC Total Paid for PERMIT ISSUANCE: $91.85 $91.85 BUILDING SEWER 101-0000-42401 0 $12.09 $12.09 3/9/16 MR274 2089 CHECK BALLINGER RSE DEVELOPMENTS LLC BUILDING SEWER PC 101-0000-42600 0 $12.09 $12.09 3/9/16 MR274 2089 CHECK BALLINGER RSE DEVELOPMENTS LLC Total Paid for PLUMBING FEES: $24.18. $24.18 TOTALS: $117.03 $117.03 Printed Wednesday, March 09, 2016 3:13:58 PM 2 of 2 • � r1?SYSTEti1S .•K T. 13;n # City of La Quin to . Building 8t Safety Division 78=495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #f OKM IV Project Address:- 5 1N f� Owner's Name: A. P. Number: Address: jUyC S�� Legal Description: % / City, ST, Zips U e/-] 1 I c'n Contra t _ L c r: o _ / G f�v _ S_ Telephone: Address: Azv- 30ey • Project Description: 70 City, ST, Zip: IVAI(5, TeleP hon( T x S T Y C Uw � r r State Lic. 48;7-9 ! City Lie. #.: 70371.,/>;;:.: Z'qT, - Arch., Engr., Designer: Address: City, ST, Zip: Telephone: one: Construction TYP e• Occupancy: e Lic. #: oSta Project type cit le e):N w Addn AlterRe air Demo Name of Contact Person:' �� ( Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: ^' APPLICANT: DO NOT WRITE BELOW THIS LINE /i Submittal Req'd Rec'd 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 Check Balance Title 24 Cales. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2nd 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 IIOUSE:- jd 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 7 COACHELLA VALLEY WATER DISTRICT CASH -RECEIPT MAIL Address: ServiceAddress' AA;0_ 0 Meter(s) Cl tervic'e(e). . - .0 Backflow(i) 0. House Lateral(s) El DotoctorCheck(e) 0 motor Surcharge /1"riltation,dapaelty Charge El WS.B.F.d. 0. TeFnporaryCdnstructlon,meter 0 Turn on Charge 0 Unoollected.Account- Name 0 InspectlonFee - Tract - Fee - 0 Plsn'C:heck Fees Water I Sewer - Tract [3 Bond Payment - A.D_ ------.:Bond - Asemt. El Cuotamet 1)6poelt El Other ?%omarks: Copy to: Cash '0 653 Money, Order ?LJV 00 9;6854 G.A. Code 5 TnT-Al 41 WatarSefvloa 96954 caahl AVENIDA Wotm -.0 K Vv= IN ne M3 k CALLE COUMA VILLA f. 1' EfCRK%V, 01 T� T= ztvrq T� �s VA -M at You o"'. sm t^ tH 41 TIQ =+[�tKT= SANTA CARMELITA J - Ji 9-11MD I ,_em 19 3 24 f2or AVENIDA Wotm -.0 K Vv= IN ne M3 k CALLE COUMA VILLA f. 1' EfCRK%V, 01 T� T= ztvrq T� �s VA -M at You o"'. sm t^ tH 41 TIQ =+[�tKT= SANTA CARMELITA J - Ji 9-11MD I ,_em °•a 096 �6YJ-rl—&Ve rN 6NNd:5- ,Ta SFi✓ G.4ThoL vsiw (!oqQqc,-- /J��lox S �a Sv -, oa max d5�vzrl-jlvc ,A_/// w 7-H 54W ✓[L��-.G4 9UINTA 0 e5-50-4) ING S�i%c sysi'r� ✓c.�l s-evi e e.4J",eF&6 6NNS L�j 7D SFi✓ AT1,4 4L U,S/w iI 9 scall lqo i r °•a rug rN-<4*V 6NNet' ,T� SFi✓�52 G�►T�L us�iv y sub yv lass (: 0 9Qq6= V tj � L.pCA7�ati7o 067/ *JVEA)1W ✓, tL��_ (A- 4._ (� ./ -_._..._tea% ' N i 11A_G�D 2 6 � � �6F� Q' _. sew rz-