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BPLB2019-006578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description_ Property Zoning: Application Valuation: Applicant: HUITRON CONSTRUCTION CO 50427 RIGO CT COACHELLA, CA 92236 T4t�p 4 4u Qu4& DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT PLUMBING/ BPLB2019-0065 54470 AVENIDA JUAREZ 774233027 KEATING / SEPTIC ABANDONMENT AND SEWER CONNECT VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/29/2019 Owner: BRETTM. & MELANIE K. KEATING 54470 AVENIDAJUAREZ LA QUINTA, CA 92253 $1,500.00 _ Contractor: HUITRON CONSTRUCTION CO APR 2 9 2019 50427 RIGO CT COACHELLA, CA 92236 CITY OF .1� CIi�II Dr (760)457-9960 DESIGN & DEVELOPMENT �'�RP EN ! Llc. No.: 1030332 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 1030332 � 1 f Date: ZA r 19 ' &ntrartnr se /'l A_i❑ 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, 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 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 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 t�w rk for which this permit is issued. 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: BENCHMARK INSURANCE COMPANY Policy Number: CST5015396 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 11folthwith comply with those provisions. �h Ua t.. — Applicant: Vv 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 ab ve' form tion is t I agree to comply with all city and county ordinances and st e I s rel ting to b construction, and hereby authorize representatives of this c' y t me pon the above-mentioned property for inspection purposes. Date: — Signature (Applicant or Age Application Number: BPLB2019-0065 Property Address: 54470 AVENIDA JUAREZ APN: 774233027 Application Description: KEATING / SEPTIC ABANDONMENT AND SEWER CONNECT Property Zoning: Application Valuation: $1,500.00 Applicant: HUITRON CONSTRUCTION CO 50427 RIGO CT COACHELLA, CA 92236 Date: 4/.29/2019 Owner: BRETT M. & MELANIE K. KEATING 54470 AVENIDA JUAREZ LA QUINTA, CA 92253 Contractor: HUITRON CONSTRUCTION CO 50427 RIGO CT COACHELLA, CA 92236 (760)457-9960 Llc. No.: 1030332 Detail: PLUMBING - ABANDON SEPTIC AND CONNECT TO SEWER SYSTEM. CONTRACTOR TO INSTALL BACKFLOW PROTECTION VALVE PER PLAN AND MARK ALL CLEANOUTS. PER 2016 CALIFORNIA BUILDING CODES DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT ACCOUNT AMOUNT QTY 101-0000-42416 AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 Total Paid for PLUMBING FEES: $64.04 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 eca Qw�ta PERMIT# aPL32011 ^aOCoS Project Address: Project Description: APN #: C) t ff-. �4 Applicant Name: ` ,h, Address: ® . City, ST, Zip: o -- Telephone: b� Email: ��T yA4 fl,z"ra. Vnn Valuation of Project $--LL- Architect/ Engineer / L Architect/Engineer Name: Construction Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Required Received Pian Sets Structural Calcs Truss Calcs Title 24 Calcs Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval + Public Works aooroval Fire approval City Business License COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 4129/2019 SUBJECT: SANTA CARMELITA, 54470 AVENIDA JUAREZ, LA QUINTA, LOT 13, LID 690368, "SCC FEE ONLY" MELANIE KEATING Project: 19-9912 22112 BROKEN BOW DR. Project Date: 4/29/2019 LAKE FOREST, CA 92630 Amount Due: $4,851.00GEO: 06-06-13-2 Planner: SANDRA VILLALOBOS TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK SUBJECT: SANTA CARMELITA, 54470 AVENIDA JUAREZ, LA QUINTA, LOT 13, LID 690368, "SCC FEE ONLY" COACHELLA VALLEY WATER DISTRICT P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Page 1 z i gow- 60 5 0 W. LL oclim> :3c m LU Q �n 3 9! AX L� � r e� y AX