BPLB2019-015478-495 CALLE TAMPICO T O D 4Qu&M VOICE (760) 777-7125 LA QUINTA, CALIFORNFAX (760) 777-7011IA 92253 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/4/2019
Permit Type/Subtype:
PLUMBING/
Owner:
Application Number:
BPLB2019-0154
THE AVENIDA JUAREZ TRUST U.D.T
Property Address:
52515 AVENIDA JUAREZ
52515 AVENIDA JUAREZ
APN:
773244010
LA QUINTA, CA 92253
Application Description:
AVE JUAREZ TRUST / SEWER CONNECTION & SEPTIC ABANDONMENT
Property Zoning:
Application Valuation:
$3,000.00
Applicant: Da Contractor:
GARDNER'S DESERT ENTERPRISES INC DBA S & GARDNER'S DESERT ENTERPRISES INC DBA S &
44489 TOWN CENTER WAY STE D481 DEC 0 4 2019 44489 TOWN CENTER WAY STE D481
PALM DESERT, CA 92260 P 0 PALM DESERT, CA 92260
CITY OF LA QUINTA (760)404-6325
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 950244
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: C42 License No.; 950244
Date: ! L• Y— / %9 Contractor
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
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
Oft wo which this permit is issued.
AEI 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: EARNET INSURANCE COMPANY Policy Number: BNUWC0145572
_ 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.
4
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPEN N VERAGE 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.
certify that I have read this application and state thatthe 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.
Date: bz"' 4z _Signature (Applicant or Agent):
Date: '12/4/2019
Application Number:
BPLB2019-0154
Property Address:
52515 AVENIDA JUAREZ
APN:
773244010
Application Description:
AVE JUAREZ TRUST / SEWER CONNECTION & SEPTIC ABANDONMENT
Property Zoning:
Application Valuation:
$3,000.00
Applicant:
GARDNER'S DESERT ENTERPRISES INC DBA S &
44489 TOWN CENTER WAY STE D481
PALM DESERT, CA 92260
Owner:
THE AVENIDA JUAREZ TRUST U.D.T
52515 AVE NIDA JUAREZ
LA QUINTA, CA 92253
Contractor:
GARDNER'S DESERT ENTERPRISES INC DBA S &
44489 TOWN CENTER WAY STE D481
PALM DESERT, CA 92260
(760)404-6325
Llc. No.: 950244
----------------------------------------------------------------------------------------------
Detail: ABANDON SEPTIC TANK AND FILL WITH SLURRY OR,SAND AND HOOK UP TO CITY SEWER.INSPECTOR TO VERIFY IF BACKWATER VALVE IS NEEDED
AT THE PROPERTY. PER 2016 CALIFORNIA PLUMBING CODE.
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.97
Total Paid for PERMIT ISSUANCE: $101.97
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BUILDING SEWER
101-0000-42401
0
$26.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BUILDING SEWER PC
101-0000-42600
0
$18.78
Total Paid for PLUMBING 2019: $45.61
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
taPERMIT
— cF•:,�t fair �,esr-..•Kir'�-1
#gp
2> �5
PLAN LOCATION:
Project Address f—Z
Project Description:
Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
i
���C✓�1 v
Applicant Name: �(> RIQ4
Address: q(l LC-19i.1?o
City, ST, Zip: ¢'`j--LA,
Telephone: 7 b s�
Email:
Valuation of Project
Contractor Name: i 1Uc, �) -
New SFD Construction:
Address:
Conditioned Space SF
City, St, Zip
Garage SF
Telephone:
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lic: 15d 21' f l City Bus Lic:
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: / J
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
1AT>E� COACHELLA VALLEY WATER DISTRICT
4jgTR�C,t P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date:12/3/2019
SUBJECT: SANTA CARMELITA, 52515 AVENIDA JUAREZ, LOT 1, LA QUINTA, LID 683628 ""SCC ONLY"
S & G PUMPING SERVICE Project: 19-10605
44489 TOWN CENTER WAY Project Date: 12/3/2019
SUITE D 481
Amount Due: $4,851.00
PALM DESERT, CA 92260 GEO: 06-06-12-2
Planner: RUBEN MONTIEL
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
1.00 FF SCC-COLLECTION $2,415.00 $2,415.00
1.00 FJ SCC-TREATMENT $2,436.00L $2,436.00
$4,851.00
PAID
Development Services Department
DEC 03 2019
Coachella Valley Water District
75-515 Hovley Lane East
Palm Desert, CA 922'11
SUBJECT: SANTA CARMELITA, 52515 AVENIDA JUAREZ, LOT 1, LA QUINTA, LID 683628 "'SCC ONLY"
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Pagel