BPLB2019-011578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
PLUMBING/
BPLB2019-0115
54385 AVENIDA HERRERA
774245019
SPRIGGEL / SEPTIC ABONDONMENT AND SEWER CONNECT
$2,000.00
Applicant:
NIXON PLUMBING CO
79411 SPALDING DRIVE
BERMUDA DUNES, CA 92203-1275
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/19/2019
Owner:
DANIEL & TERESA SPRIGGEL
54385 AVENIDA HERRERA
LA QUINTA, CA 92253
F
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Contractor:
AUG 19 2019 NIXON PLUMBING CO
0 79411 SPALDING DRIVE
CITY OF LA QUINTA BERMUDA DUNES, CA 92203-1275
DESIGN & DEVELOPMENT DEPARTMENT
(760)217-5222
Llc. No.: 599233
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: Crrjj36 License No.:
Date:` k�L' Contractor:
44
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the C ractor's State
License Law for the following reason (Sec. 7031.5, Business and Profe ions 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, as owner of the property, am exclusively contracting with licensed contractors to
constructthe 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 Address:
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.
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:
Ca911na.1
T Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shemploy 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 QNhe Labor Cod' I 11 forthwith
comply with those provisions.
Date: _ '1'— I q Applicant:
_0
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE E 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 ofthis 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 b ding
construction, and hereby authorize representatives of thjs ty t@ rater upo t ab ve
mentioned property for inspection purposes. n 1 y "\A
Date: _ t q l9 Signature (Applicant or Agent):
Date: 8/19/2019
Application Number:
BPLB2019-0115
Property Address:
54385 AVENIDA HERRERA
APN:
774245019
Application Description:
SPRIGGEL/SEPTIC ABONDONMENTAND SEWER CONNECT
Property Zoning:
Application Valuation:
$2,000.00
Applicant:
NIXON PLUMBING CO
79411 SPALDING DRIVE
BERMUDA DUNES, CA 92203-1275
Owner:
DANIEL & TERESA SPRIGGEL
54385 AVENIDA HERRERA
LA QUINTA, CA 92253
Contractor:
NIXON PLUMBING CO
79411 SPALDING DRIVE
BERMUDA DUNES, CA 92203-1275
(760)217-5222
Llc. No.: 599233
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.
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BACKFLOW DEVICE
101-0000-42401
0
$13.34
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BACKFLOW DEVICE PC
101-0000-42600
0
$5.34
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$18.68
Total Paid for PLUMBING FEES: $64.04
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
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Project Address: �.l _
PERMIT #
PLAN LOCATION:
Project Description:
APN
Applicant Name:
c
Address: -79 q t' Cj cA6 Can r
City, ST, Zip:
Telephone:760 217- C-LZQ
Email: 6Y-CJ V\t VUt,t
60
Project Valuation $ 0G(5
Contractor Name: CX G v
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: City Bus Lic:
Architect/Engineer Name:
Construction Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
�1
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone: -IM-
Email: -) ��l ) .
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Required
Received
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
CVWD Fire Flow Letter
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
Zof4 - olIS"
CITY OF LA QUINTA
BUILDING DIVISION
REVIEWED FOR
CODE
CO PLIANCE ?ot
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5438SAueNIUA 14etaet�4
•N�'T�R COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date:8115/2019
SUBJECT: SANTA CARMELITA, 54385 AVENIDA HERRERA, LOT 7, LA QUINTA, LID 690658 "" SCC ONLY"
SPRIGGEL, DAN Project: 19-10256
42102 WASHINGTON ST. Project Date: 8/15/2019
Amount Due: $4,851.00
INDIO, CA 92203 GEO: 06-06-13-1
Planner: RUBEN MONTIEL
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT: SANTA CARMELITA, 54385 AVENIDA HERRERA, LOT 7, LA QUINTA, LID 690658 "" SCC ONLY'"
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
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