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BPLB2017-005978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tiht44Q": DESIGN & DEVELOPMENT DEPARTMENT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING PERMIT pp A lication Number: BPLB2017-0059 D��`� O er: Property Address: 53520 AVENIDA CORTEZ H L PIERCE MANFRA APN: 774102001 APR 2 4 2017 NAPOLEON DR Application Description: PIERCE RESIDENCE/ SEWER CONNE VEGAS, NV 92253 Property Zoning: Application Valuation: $4,000.00 CITY OF LA QUINTA i DESIGN AND DEVELOPMENT DEPARTMENT Applicant: ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 Date: 4/24/2017 Contractor: ALMS UNDERGROUND CONSTRUCTION INC 38703 VISTA DRIVE CATHEDRAL CITY, CA 92234 (760)324-1911 Llc. No.: 482180 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: C21, C42 License No.: 4812U0 of the work for which this permit is issued. tractor: I have and will maintain workers' compensation insurance, as required by e 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: OWNER -BUILDER DEC' ARA - N Carrier: ACE AMERICAN INSURANCE COMPANY Polity Number: RWCC48821078 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 I certify that in the performance of the work for which this permit is issued, I city or county that requires a permit to construct, alter, improve, demolish, or repair shall not employ any person in any manner so as to become subject to the workers' any structure, prior to its issuance, also requires the applicant for the permit to file a compensation laws of California, and agree that; if I should become subject to the signed statement that he or she is licensed pursuant to the provisions of the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division comply with those provisions. 3 of the Business and Professions Code) or that he or she is exempt therefrom and the %�-��/`tDi ��7 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a Date: Applicant: »� permit subjects the applicant to a civil penalty of not more than five hundred dollars 1 40m"-- ($500).: WARNING: FAILURE TO SECURE WORKERS' COMPEN ION COVERAGE IS UNLAWFUL, (1 I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO compensation, will do the work, and the structure is not intended or offered for sale. ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that IMPORTANT: Application is hereby made to the Building Official for a permit subject to he or she did not build or improve for the purpose of sale.). the conditions and restrictions set forth on this application. (� I, as owner of the property, am exclusively contracting with licensed contractors 1. Each person upon whose behalf this application is made, each person at whose to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' request and for whose benefit work is performed under or pursuant to any permit State License Law does not apply to an owner of property who builds or improves issued as a result of this application , the owner, and the applicant, each agrees to, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and the Contractors' State License Law.). employees for any act or omission related to the work being performed under or (� I am exempt under Sec. . B.&P.C. for this reason 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 Date: Owner: work for 180 days will subject permit to cancellation. 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. Q. Lender's N 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 oft'city to enter upon the above-mentioned property for inspection purposes. ,, Date? /� 2�, Signature-(Applicant—or Ageh ): r j ; Date: 4/24/2017 Application Number: BPLB2017-0059 Owner: Property Address: 53520 AVENIDA CORTEZ HAZEL PIERCE MANFRA APN: 774102001 1842 NAPOLEON DR Application Description: PIERCE RESIDENCE / SEWER CONNECT LAS VEGAS, NV 92253 Property Zoning: Application Valuation: $4,000.00 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: SEWER CONNECT AND ABANDON SEPTIC TANK. PER 2016 CALIFORNIA BUILDING CODE j ; SFINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT -,BUILDING SEWER 101-0000-42401 0 $25.33. DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $17.73 Total Paid for PLUMBING FEES: $43.06 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS: Bin.�f Permit Project Address: 15 3 .City of La Quin to Building 81- Safety. Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sheet Ave C,3,t,- Owner's Name: A. P. Number: Address: / F//2 Legal Description: City, ST, Zip: ZO-S Ve 2 S Ny$`/ /S6 contractor. irns idr � t CU ro ns Telephone: yl2:300 Address: 39203 Ui 5�� r Project Description: Se U-l2r C o n t1 e foro r City, ST, Zip:—,ea(/ret L t 223 Telephone: ne: 7Eo•3 _y 9 State Lie. # 2 / g'v City Lie. Arch.,-Engr., Designer: Address: City, ST, Zip: Telephone:ne: aneY : Construction Type: Occupancy: P State Lie. %. Project type (circle one): New Ad d 'n Alter Repair.air Demo Name of Contact Person:lbo K , n�S Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7,,o • .57$ I 510 Estimated Value of Project: 0, APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance: Title 24 Calcs. Plans picked up Construction ' Flood plain plan Plans resubmitted i Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontacl'or List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. 1I.O.A. Approval Plans resubmitted Grading IN IiOUSE:- Revie,v, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date orpermit issue School Fees, I Total Permit Fees ti _ • - COACHELLA VALLEY WATER,DISTRICT , F.O. BOX" 1058,' COACHELLA, CALIFORNIA 92236 (760) 398=2651 INVOICE Date: 3/8/2017 1 ..SUBJECT: SANTA CARIVIELITA, 53520 AVENIDA CORTEZ, LA QUINTA, LOT 24, LID 687984"SCC FEE ONLY" HAZEL PIERCE Project: 17-7866 X842 NAPOLEON DR: !Project Dater 3/8/2017 -/q2 - 3DO '51-77 Amount Due: $4,851.00 k -LAS VEGAS,, NV 89156 GEO: 06-06-12-3 t ! Planner: SANDRA VILLALOBOS TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH t REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK SUBJECT:SANTA CARMELITA, 53520 AVENIDA CORTEZ; LA QUINTA, LOT 24, LID 687984 "SCC FEE ONLY" S'y• COACHELLA VALLEY WATER DISTRICT ` PO..BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651. • F F Page 1 1.00 FF SCC -COLLECTION $2,415.001 $2,415.00 1.00 FJ SCC -TREATMENT $2,436.01711 $2 436.00 $4,851.00 -'PAID $ Development Services Departrhent - # MAR 3.0:2012 ` Coachelia' V3iley Water District 757515 Hovley Lane East .. Palm Deser., CA 92211 SUBJECT:SANTA CARMELITA, 53520 AVENIDA CORTEZ; LA QUINTA, LOT 24, LID 687984 "SCC FEE ONLY" S'y• COACHELLA VALLEY WATER DISTRICT ` PO..BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651. • F F Page 1