BPLB2017-0011i
VOICE (760) 777-7125
78-495 CALLE TAMPICO TAtyl D
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 1/19/2017
Application Number: BPLB2017-0011 Owner:
Property Address: 52185 AVENIDA CORTEZ CATHLEEN SULLIVAN
APN: 773201022 D �,�� ® 85 VENIDA C•JRTEZ
Application Description: SULLIVAN RESIDENCE / SEWER CONNECT '�/--1, A, CA 92253
Property Zoning:
Application Valuation: $3,000.00 JAN 19 2017
Applicant: CITY OF dor:
ALMS UNDERGROUND CONSTRUCTION INC QUINTA ALMS UNDERGROJND CONSTRUCTION INC
38703 VISTA DRIVE DESIGN AND DEVELOPMENT DEPA01WSTA DRIVE=
CATHEDRAL CITY, CA 92234 RAL CITY, CA 92234
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: C21, C42 License No.: 482180
Date: Contractor.�l--��2
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).:
(1 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 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:
(760)324-1911
Llc. No.: 482180
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of fie 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 =arrier and policy number are:
Carrier: ACE AMERICAN INSURANCE COMPANY Polity Number: RWCC48821078
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: Tlqo Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINA_ PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR ILI SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWIEDGEMENT
IMPORTANT: Application is hereby made to the Ituilding 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 applicaton becomes null and void if work is
not commenced within 180 days from date of iss jance of such permit, or cessation of
work for 180 days will subject permit to cancellaton.
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 ordinarces 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 4gen�f u
f
Date: 1/19/2017
Application Number: BPLB2017-0011
Owner:
Property Address: 52185 AVENIDA CORTEZ
CATHLEEN SULLIVAN
APN: 773201022
52185 AVENIDA CORTEZ
Application Description: SULLIVAN RESIDENCE/ SEWER CONNECT
LA QUINTA, CA 92:53
Property Zoning:
Application Valuation: $3,000.00
Applicant:
Contractor:
ALMS UNDERGROUND CONSTRUCTION INC
ALMS UNDERGROUND CONSTRUCTION INC
38703 VISTA DRIVE
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
CATHEDRAL CITY, CA 92234
(760)324-1911
---------------------------------------------------------------------------------------------
Llc. No.: 482180
Detail: ABANDON SEPTIC AND CONNECT TO SEWER. PER 2016 CALIFORNIA BUILDING CODE
DESCRIPTION ACCOUNT OTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
OTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
OTY
AMOUNT
BUILDING SEWER
101-0000-42401.
0
$25.33
DESCRIPTION
ACCOUNT
OTY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$17.73
Total Paid for PLUMBING FEES: $43.06
Iain #
Permit #
Project Address:
City of b Quin to
Building &r Safety Division
78-495 Calle Tampico
La Quinta; CA 92253 - (760) 777-701,2-
Building Permit Application and Tracking Sheet
✓ Owner's Name:
A. P. .Number: L
Address:I X,. 14CI
Legal Description:
City, ST, Zip: !� r
Ln M
ontra r:
C ct 0
6P
Tel h ne•
e o .
Address: (�
4-
Project Description:
City_ ST, Zip' r
,pv
TeleP h0 n
State Lica # :
City Lie. #;
Arch.,'Engr., Designer:
Address:
City, ST, Zip:.
Telephone:
Con tructi n Type: Occupancy:
'
State Lu. !,.
er Repair.air
Project type circle one): New Add'n �1]t Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value.of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
M
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item -
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Der--osit
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24. Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Revicw, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Gran( Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Reyierv, ready for correctionsrssue
Developer Imp=ct Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks- Appr
Date of permit issue
School Fees,
Total Permit Fees