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BPLB2017-012478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Permit Type/Subtype: PLUMBING/ Application Number: BPLB2017-0124 Property Address:, 53660 AVENIDA MONTEZUMA APN: 774101007 Application Description: MANQUERO / ABANDON SEPTIC CONNECT TO SEWER Property Zoning: Application Valuation: $4,000.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/25/2017 Owner: ANTHONY MANQUERO 53660 AVENICA MONTEZUMA LA QUINTA, Cry 92253 Applicant: Contractor: ANTHONY MANQUERO INc HAMMER PLUMBING AND PUMPING INC 53660 AVENIDA MONTEZUMA LgoclnTY 5 2017 P 0 BOX 2448 - LA QUINTA, CA 92253 CATHEDRAL CITY, CA 92235 QUINTAMENT DEPARTMENT (760)360-7448 Llc. No.: 661018 LICENSED CONTRACTOR'S DECLARATION' I hereby affirm under penalty of perjury that I am licensed nder rovisions of Chapter 9 (commencing with Section 7000) of Di ' ' of the Bus' s andJFfessions Code, and my License is in full force and e License Class: C42, C�36, D35 License No. 66 18 OWVEBAUILDER DECLARATION J 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.). (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 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 Addre! WORKER'S COMPENSATION DECLARATION . I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificr to of consent to self -insure for workers' compensation, as provided for by Section 3730 of the Labor Code, for the performance the�700 for which this permit is issued. have and will maintain workers'::ompensation insurance, as required by i 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 Polity Number: RWCC64391082 _ I certify that in the performance oF the work for which this permit is issued, I shall not employ any person in any manner fl as to become sub' ct to the workers' compensation laws of California, and e a ,'f 1 should be a sub to the workers' compensation provisions Sectio,, 370 f the La r Co I all forthwith comply wit those rovisions. Dafe: 0 i � Ap lican r WARNING: FAILURE TO SECURE R S' 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 -he Building Official for a permit subject to the conditions and restrictions set forth on tf is application. 1. Each person upon whose behalf this app ication 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 Citti 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 iss..jance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this'application and -tateth ve informati n is correct. I agree to comply with all city and county ordlnan sand state cos ela ' g to building construction, and her y authorize representativ s of this city e e Pon the above- mentioned pr ignt pection purposes. ate L71 ure(Applica t rAg s — . L Date: 10/25/2017 Application Number: BPL132017=0124 Owner: Prope�',Addtess:' '" 53660AVENIDA MONTEZUMA ANTHONY MANQUERO APN: 774101007. 53660 AVENIDA MONTEZUMA Application Description: MANQUERO / ABANDON SEPTIC CONNECT TO SEWER LA QUINTA, CA 92253 Property Zoning: Application Valuation: $4,000.00 Applicant: Contractor: ANTHONY MANQUERO HAMMER PLUMBING AND PUMPING INC 53660 AVENIDA MONTEZUMA P 0 BOX 2448 LA QUINTA, CA 92253 CATHEDRAL CITY, CA 92235 (760)360-7448 --------------- -------------------------------------- LIc. No.: 661018 ------------ -----------------.---------- Detail: ABANDON SEPTIC TANK AND FILL WITH SLURRY OR SAND, HOOK UP TO CITY SEWER. PER 2016 CALIFORNIA PLUMBING CODE Fj FINANCIAL INFORMATION *, : s•_;. :,.:DESCRIPTION ACCOUNT QTY AMOUNT ; BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION.BSA: $1.00 Total Paid for PER ISSUANCE: $96.27 DESCRIPTION ACCOUNT ! CITY AMOUNT BUILDING SEWER PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PER 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 ENHANCEM ENT FEE: $5.00 1.