BPLB2017-000778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPLB2017-0007
Property Address: 53360 AVENIDA DIAZ
APN: 774072005
Application Description: LEYVA/ABANDON SEPTIC/CONNECT TO SEWER
Property Zoning:
Application Valuation: $3,000.00
Applicant:
ALMS UNDERGROUND CONSTRUCTION INC
38703 VISTA DRIVE
CATHEDRAL 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.: 4a2180
Date:47 J:Ln , 2-a 17 Contractor:
OWNER -BUILDER DECLA TION
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.).
(� 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 ) 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 Na
Lender's Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/17/2017
Owner:
AMALIA LEYVA
P 0 BOX 324
LA QUINTA, CA 92253
Contractor:
ALMS UNDERGRO(JND CONSTRUCTION INC
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
(760)324-1911
Llc. No.: 482180
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one ofkhe following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700of the Labor Code, for the performance
of the work for which this permit is issued.
J_JK&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: ACE AMERICAN INSURANCE COMPANY Policy 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.
�J
Date: sr.2017 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COFAPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,00D). 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 owne and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the =ity 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 cancelbtion.
I certify that I have read this application and stzte that the above information is correct.
I agree to comply with all city and county ordirances and state laws relating to building
construction, and hereby authorize representa-ives of this ci to enter upon the
above-mentioned property for inspection purposes.
Date I7Ja». ZA17 Signature (Applicant :)r Agent):,/ ./"
Detail: PLUMBING -ABANDON SEPTIC AND CONNECT TO SEWER. 2013 CALIFORNIA BUILDING CODES
Date: 1/17/2017
Application Number: BPLB2017-0007
Owner:
Property Address: 53360 AVENIDA DIAZ
AMALIA LEYVA
. APN: 774072005
P 0 BOX 324
Application Description: LEYVA / ABANDON SEPTIC/CONNECT TO SEWER
LA QUINTA, CA 92253
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: PLUMBING -ABANDON SEPTIC AND CONNECT TO SEWER. 2013 CALIFORNIA BUILDING CODES
cm
DESCRIPTION
ACCOUNT I QTY I AMOUNT
BSAS S131473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
D.TY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
aTY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$2533
DESCRIPTION
ACCOUNT
-QTY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$17.73
TOTALS: _ $140.33
Bin
I'i ty of La Q U- in to
Building &r Safety Division
Permit #i 78-495 Calle Tampico
r o La Quinta, CA 922531- (760) 777-701,2
Building Permit Application and Tracking Sheet
Project Address: 53390. A tre J I Owner's Name:
A. P. Number.
Address: f? U) Sox = Z41
Legal Description:
City, ST, Zip: 9 -Z_-z.4 7
Contractor: or: Co
5
Je �
ne:
Telephone:
Address: 3 $ 7Q3 (A74 .i< -oma, U o-
Project Description: s� r CO %I VteG t O r_
City, ST, Zip�HCdr-1 �fi . 9ZZ3
Telephone: `7 ci 3 2.
State Lic. # : y g Z J g-0
City Lic.
Arch., Engr., Designer:
,
Address:
City, ST, Zip:
Telephone:Construction
Type: Occupancy:
State Lic. 9:
DemoProJeet type circle one): New Ad Alter Repair
'
Name of Contact Person: Do U-
! r,, s
Sq. Ft.:
#Stories:
# Units: .
Telephone # of Contact Person: 7
5791- / 510
Estimated Value of Project:
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
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 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical ,
SubcontactorList
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
bl-
'-l''M`R; COACHELLA VALLEY WATER DISTRICT
V P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 1111/2017
SUBJECT: SANTA CARMELITA, 53360 AVENIDA DIAZ, LA QUINTA, LID 687326, "SCC FEE ONLY"
AMALIA LEYVA Project: 17-7.727
PO BOX 324 Project Date: 1/11/2017
Amount Due: $4,851.00
LA QUINTA, CA 92247 GEO: 06-06-12-3
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
e•
1.00 FF SCC -COLLECTION $2,415.00 $2,415.00
1.00 FJ' SCC -TREATMENT $2,436.00 $2,436.00
$4,851.00
PAID $ T' 00. ✓`*' 44-0(0
Development Services Department c
JAN 11 2017
Coachella Valley Water District
75-515 Hovley Lane East
Palm Desert, CA 92211
SUBJECT:SANTA CARMELITA, 53360 AVENIDA DIAZ, LA QUINTA, LID 687326.'. "SCC FEE ONLY"
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel