BPLB2017-0078r
78-495 CALLE TAMPICO `&t,, 4
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT:
Application Number: BPLB2017-0078
Property Address: 53845 AVENIDA.HERRERA
APN: 774163019
Application Description: DE LA TORRE / ADANDON SEPTIC - CONNECT TO SEWER
Property Zoning:
Application Valuation: , $3,800.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ELIZABETH DE LA TORRE
53845 AVENIDA HERRERA
LA QUINTA, CA 92253
Date: 6/2/2017
Applicant: Contractor:
HAMMER PLUMBING AND PUMPING INC ® HAMMER PLUMBING AND PUMPING INC
P 0 BOX 2448 P 0 BOX 2448
CATHEDRAL CITY, CA 92235 J.0 N U 2 2017 1 DD CATHEDRAL CITY, CA 92235
CITY OF LA QUINTA (760)360-7448
Llc. No.: 661018
DESIGN AND DEVELOPMENT DEPARTMENT
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, C36, D35 License No.:6J6�1018
Date: l, -L-17 W-Contr� cto //t-�
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.).
(_) I, as owner of the property, amexclusively 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
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.
1�:;I a 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 policy number are:
Carrier: ACE AMERICAN INSURANCE COMPANY Policy Number: RWCC48818456
_ 1 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.
Dat�P- t 'i± l—Applicaant_.'n
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit issued
as a result of this application , the owner, and the applicant, each agrees to, and shall
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not
commenced within 180 days from date of issuance of such permit, or cessation of work
for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Lender's Address:Signature (Applica$nYtro'� rAgent)
Date: 6/2/2017,
Application Number: BPLB2017-0078
Owner:
Property Address: 53845AVENIDA HERRERA
ELIZABETH DE LATORRE
APN: 774163019
53845 AVENIDA HERRERA
Application Description: DE LA TORRE / ADANDON SEPTIC - CONNECT TO SEWER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $3,800.00
Applicant:
Contractor:
HAMMER PLUMBING AND PUMPING INC
HAMMER PLUMBING AND PUMPING INC
P 0 BOX 2448
P 0 BOX 2448
CATHEDRAL CITY, CA 92235
CATHEDRAL CITY, CA 92235.
(760)360-7448
---------------------------------------- ---------------------------------------------------
Llc. No.: 661018
•
Detail: ABANDON SEPTIC TANK AND FILL WITH SLURRY OR SAND, HOOK UP TO CITY SEWER.
PER 2016 CALIFORNIA PLUMBING CODE.
FINANCIAL .• {•
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
B►� #
City of LaQ uinta
Building Br. Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit'Application and Tracking Sheet
Permit #
Project Address: Sr 3 O,Owner's
Name:.
A. P. Number:
_Address:,\ 2r4-Q
Legal Description:
- City; ST, Zi c�-L z
1
-Contract or:=� �
1�N^�rv`t�
�-.�
Te —
le P hone. t9 -2 1J
Address: r u 2 4",
ProjectDesc' iption:
City, ST, Zip:
Telephone: hv ^ 3 Z — Z 4 3
State Lic. # :T 'V t7
CityLic. #'-
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction s coon T an cY:
Type: Occupancy:
State Lic. #:
Project ct • New Add
type (circle one)'n Alter r Repair Demo
'Xa a ofContact Person: �Y'��
Sq. Ft.:
# Stories:
# Units:
Telephone # of ContactPPaso'n• -Z 1,U — '3 .-E
=Value of I'ro�- 3 8 O.IJ
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 Calcs..
Plans picked up
Construction
Flood plain plan
.Plans resubmitted
Mechanical
Grading plan
2"d 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 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
t`��.r.��• ck a2`153
� S1L
bb to
► .. SUBJECT: TRACT SANTA CARMELITA, 53845 AVENIDA:HERRERA, LA QUINTA, LOT 7; LID 689270 "SCC ONLY"
COACHELLA VALLEY WATER DISTRICT
P:O. BOX 1058, COACHELLA, CALIFORNIA 9223..6.,.(760).398.-2651
Page.1
' w j
4
.4'? I
1.00 FF SCC -COLLECTION
$2,415.00
$2 41,5.00
1.00 FJ SCC -TREATMENT
$2436:00 1
$2 436.00
PAID•$ Y
Development Services Department ;
COACHELLA VALLEY WATER DISTRICT'
JUN :1, 2017
P.O.: BOX
1058:,
. "r, •" '
75-515 Howley Lane East
COACHELLA,• CALIFORNIA 9223.6 (760)
398-2651-.
Palm Desert, CA 92211 �.
.,
INVOICE Date:'6/1/2017
SUBJECT: TRACT SANTA CARMELITA, 53845 AVENIDA HERRERA, LA QUINTA, LOT 7, LID 689210 "SCC.ONLY"
ELIZABETH DELAT.ORRE
Project:
17-.8053
53-845 AVENIDA HERRERA
Project Date:
6/112017
'
Amount Due: - .
$4,851.00 '
LA QUINTA, CA 92253
k GEO:
06-06-1.2-4
Planner: �'
SARA LOPEZ
,
TO
INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION.WITH '
•
REMITTANCE'AND INCLUDE THE.PROJECT ON YOUR CHECK
► .. SUBJECT: TRACT SANTA CARMELITA, 53845 AVENIDA:HERRERA, LA QUINTA, LOT 7; LID 689270 "SCC ONLY"
COACHELLA VALLEY WATER DISTRICT
P:O. BOX 1058, COACHELLA, CALIFORNIA 9223..6.,.(760).398.-2651
Page.1
' w j
4
.4'? I
1.00 FF SCC -COLLECTION
$2,415.00
$2 41,5.00
1.00 FJ SCC -TREATMENT
$2436:00 1
$2 436.00
PAID•$ Y
Development Services Department ;
JUN :1, 2017
Coachella Val9ey�Water'District
G
75-515 Howley Lane East
Palm Desert, CA 92211 �.
► .. SUBJECT: TRACT SANTA CARMELITA, 53845 AVENIDA:HERRERA, LA QUINTA, LOT 7; LID 689270 "SCC ONLY"
COACHELLA VALLEY WATER DISTRICT
P:O. BOX 1058, COACHELLA, CALIFORNIA 9223..6.,.(760).398.-2651
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4