BPLB2017-0054M O�i a� VOICE (760) 777-7125
78-495 CALLE TAMPICO D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/4/2017
Application Number: BPLB2017-0054 Owner:
Property Address: 51345 AVENIDA DIAZ LORIANE HUFF
APN: 773043023 51345 AVENIDA DIAZ
Application Description: HUFF/ SEWER CONNECT LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $2,800.00
Applicant: D Contractor:
CANYON BUILD & DESIGN APR 0 4 2017 CANYON BUILD & DESIGN
66539 6TH STREET 0 66539 6TH STREET
DESERT HOT SPRINGS, CA 92240 DESERT HOT SPRINGS, CA 92240
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT (760)275-7442
Llc. No.: 1020898
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under- provisions of Chapter 9
1 hereby affirm under penalty of perjury one of the following declarations:
(commencing with Section 7000) of Division 3 of the BusinZProfe'ns Code, and
_ I have and will maintain a certificate of consent to self -insure for workers'
my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance.
License Class: B License No.: 1020898
of thew k for which this permit is issued.
WI have and will maintain workers' compensation insurance, as required by
Date: Contractor:
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-BULDER DECLA ATION
Carrier: BENCHMARK INSURANCE COMPANY Policy Number: CST5009544
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
_ I certify that in the performance ofthe 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 any
compensation laws of California, and agree that, if I should become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
statement that he or she is licensed pursuant to the provisions of the Contractor's State
comply with those provisions.
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
Date: ! Applicant:
alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
009�
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
WARNIN : FAILURE TO SECURE WORK RS' COMPENSATION 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 he
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on this application.
(_J 1, as owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon,
as a result of this application , the owner, and the applicant, each agrees to, and shall
and who contracts for the projects with a contractor(s) licensed pursuant to the
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
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 work
Date: Owner:
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. C.).
Lender's Name:
Lender's
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):
l
f
Date: 4/4/2017
Application Number:
BPLB2017-0054
Owner:
Property Address:
51345 AVENIDA DIAZ
LORIANE HUFF
APN:
773043023
51345 AVENIDA DIAZ
Application Description:
HUFF / SEWER CONNECT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$2,800.00
'Applicant:
Contractor: .
CANYON BUILD & DESIGN
CANYON BUILD & DESIGN
66539 6TH STREET
66539 6TH STREET
DESERT HOT SPRINGS, CA
92240
DESERT HOT SPRINGS, CA 92240
(760)275-7442
---------=----------------------------------------------------------------------------------
Llc. No.: 1020898
Detail: ABANDON SEPTIC TANK AND FILL WITH SLURRY OR SAND, HOOK UP
TO CITY SEWER. PER 2016 CALIFORNIA PLUMBING CODE
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FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY
AMOUNT
BSAS SB1473 FEE 101-0000-20306 0
$1.00
a 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
f 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 ENHANCEM -NT FEE: $5.00 '
1 y
•
it 4
•
-
't
.
Bin #
Permit ;'
Project Address: Jov—
City of La Qbinta
Building &' Safety Division
78-495 Calte Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
Owner's Name: �1 c
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
nContract
TelePh
v _ y
Address: _ 3 £ It CZ
Project Description:
City, ST, Zip:"
_._
Z
L. it
S
Tele hone:
P 2
:.#:::.:::`,::::,::::::::::::::.
State Lic. # lc> 2.6-10
City Lic. 3
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone-
...........
Occupancy:
n Type: cy:
Constructiontructi P
State Lic. #.:.
Project type (circle one): New Add'n Alter Repair Demo.
Naive of Contact Person: v
Sq. Ft.:
# Stories: —T
—Units:
# of Contact erson:
2 2�
Estimated Value of Project: C2 vv—
hc'Telephone
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
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 Cates.
Called Contact Person
Plan Check Balasce.
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.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Revicw, ready for corrections/issue
Developer Impar Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date or permit issue
School Fees,
I
Total Permit Fee:
_ gP� 7- no�Y
_COACHELLA VALLEY WATER. DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (7.60) 398-2651
sTr+'
INVOICE Date: 3/27/2017
SUBJECT: 51345 AVENIDA DIAZ, LA QUINTA, LOT 9, LID 680368 "SCC ONLY
.LORRAINE HUFF Project: 17-7901
51-345 AVENIDA DIAZ - Project Date: 3/27/2017
- ry Amount Due: $4,851.00
LA QUINTA, .CA 92253 z GEO: 06-06-01-3
Planner: SARA LOPEZ
+' TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT -.'51345 AVENIDA DIAZ, LA QUINTA; LOT 9, LID 680368"SCC ONLY" '
_�
COACHELLA VALLEY -WATER DISTRICT - .
.' P.0.' BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 '
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1.00 FF SCC -COLLECTION
$2,415.00 $2,415.00
1.00 FJ SCC -TREATMENT
$2"436.00 $2,436`.00
y
,,
PAID �1 7 $4,851.00
i
Developm rit Services' Department ,
'
MAR 2 8.200
Coachella Valley Water District'
-'
75515 Ho Aey Lane East
'
Pain; Desert, CSL 9221 i
RECEIVED'
..
APR 01:4.2017'
_ -
CITY OF LA QUINTA
x -
COMMUNITY DEVELOPMENT
•
. may. �_
SUBJECT -.'51345 AVENIDA DIAZ, LA QUINTA; LOT 9, LID 680368"SCC ONLY" '
_�
COACHELLA VALLEY -WATER DISTRICT - .
.' P.0.' BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 '
Page 1.
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