BPLB2019-015578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
PLUMBING/
BPLB2019-0155
79825 FIESTA DR
c&ht 4 4P Q9&Z
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
600052006
CHANG / SEPTIC ABANDON AND SEWER CONNECT
Applicant:
SEWER & SEPTIC PROS INC
16315 AVENIDA RAMADA
DESERT HOT SPRINGS, CA 92240
PD Z% 0
DEC 10 2019
CITY OF LAQUINTA
DESIGN & 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: License No.: 986954
Date: / Z—/y 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).:
() 1, 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 Name:
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/10/2019
Owner:
ANGIE CHANG
79825 FIESTA DR
LA QUINTA, CA 92253
Contractor:
SEWER & SEPTIC PROS INC
16315 AVENIDA RAMADA
DESERT HOT SPRINGS, CA 92240
(760)329-7600
Llc. No.: 986954
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:
Carrier: ACE AMERiCA_N_INSURANCE COMPANY Policy Number: C66367836
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.
Date:
its--( C.)
Applicant:
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.
Date: Signature (Applicant or Agent): '
Date: 12/10/2019
Application Number:
BPLB2019-0155
Owner:
Property Address:
79825 FIESTA DR
ANGIE CHANG
APN:
600052006
79825 FIESTA DR
Application Description:
CHANG / SEPTIC ABANDON AND SEWER CONNECT
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
Applicant: Contractor:
SEWER & SEPTIC PROS INC SEWER & SEPTIC PROS INC
16315 AVENIDA RAMADA 16315 AVENIDA RAMADA
DESERT HOT SPRINGS, CA 92240 DESERT HOT SPRINGS, CA 92240
(760)329.7600
Llc. No.: 986954
------------------------------------------------------ ==---------------------------------------
Detaii: PLUMBING - ABANDON SEPTIC AND CONNECT TO SEWER SYSTEM. CONTRACTOR TO INSTALL BACKFLOW PROTECTION VALVE AND MARK ALL
CLEANOUTS IF NEEDED- INSPECTOR TO VERIFY. PER 2016 CALIFORNIA BUIW(I46'606ES'-
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
PERMIT ISSUANCE
101-0000-42404 0 $101.97
Total Paid for PERMIT ISSUANCE: $101.97
DESCRIPTION
ACCOUNT
CITY
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
QTY 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:
ta Qaigra
— ;EM of Jr DESERT —
PERMIT # 8PLA�JotJ-0(
PLAN LOCATION:
Project Address:
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #:
S e V' sz ;' o ,X e c, 1- t G
Applicant Name: OS C Gr
Address: 16 � (3 f p qc
City, ST, Zip: c1 2 (.tiO
Telephone: t, Z `, C p O
Email:
Valuation of Project S C'R0C]
Contractor Name: S v f i ` ,vg
New SFD Construction:
Address: l� _ 3 1S- AUS `
Conditioned Space SF
City, St, Zip �\ S 2 rL L (]
Garage SF
Telephone: GO 2 �1 C) D
Patio/Porch SF
Email: ` q
S u->�%
Fire Sprinklers SF
State Lic: Gi � 6 ct 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: ` VV
New Commercial / Tenant Improvements:
Address: �c.� 5i
Total Building SF
City, ST, Zip �L
Construction Type: Occupancy:
Telephone:
Email:
CALLE TAMPICO
LA C!UINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Req'd
Rec'd
i
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
i
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
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COACHELLA VALLEY WATER DISTRICT
i�rRtiG4 P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date:11/14/2019
SUBJECT: TRACT NO. 2180, 79825 FIESTA TRL, LA QUINTA, LID 305162, (SCC FEE & LATERAL FEE
ANGIE CHANG Project: 19-10555
79825 FIESTA DR, Project Date: 11113/2019
Amount Due: $6,951.00
LA QUINTA, CA 92253 GEO: 05-07-29-1
Planner: SANDRA VILLALOBOS
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PQRTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT: TRACT NO. 2180. 79825 FIESTA TRL, LA QUINTA, LID 305162, (SCC FEE & LATERAL FEE)
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
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