BPLB2020-001778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
PLUMBING/
BPLB2020-0017
53223 AVENIDA VILLA
T4ht 4 aCP Q"
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
774063023
FERRY / SEWER CONNECT & SEPTIC ABANDONMENT
$4,000.00
Applicant:
OSVALDO VALLES - ALMS UNDERGROUND CONSTRUCT CQ
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234 lip
0
CITY OF LAQUINTA
DESIGN & DEVELOPMENT DEPARTMENT
MAR 0 4 2020
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: C21, C42 License No.: 482180
Date: r L — LO 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/4/2020
Owner:
FIONA FERRY
53223 AVENIDA VILLA
LA QUINTA, CA 92253
Contractor:
ALMS UNDERGROUND CONSTRUCTION INC
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
(760)324-1911
Llc. No.: 482180
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 wo k for which this permit is issued.
WI 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 AMERICAN INSUBA(Q COMPANY Policy Number: C66363466
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.
�C
Date: Applicant: /ems. .L_
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: "' z/- O Signature (Applicant or Agent)
Date: 3/4/2020
Application Number:
BPLB2020-0017
Property Address:
53223 AVENIDA VILLA
APN:
774063023
Application Description:
FERRY / SEWER CONNECT & SEPTIC ABANDONMENT
Property Zoning:
Application Valuation:
$4,000.00
Applicant:
OSVALDO VALLES - ALMS UNDERGROUND CONSTRUCTION INC
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
Owner:
FIONA FERRY
53223 AVENIDA VILLA
LA QUINTA, CA 92253
Contractor:
ALMS UNDERGROUND CONSTRUCTION INC
38703 VISTA DRIVE
CATHEDRAL CITY, CA 92234
(760)324-1911
Llc. No.: 482180
Detail: COMPLETE REMOVAL OF SEPTIC TANK, OR ABANDON BY FILLING WITH SLURRY OR SAND AND HOOKING UP TO CVWD SEWER SYSTEM,
INSPECTOR TO VERIFY IF BACKWATER VALVE IS NEEDED AT THE PROPERTY PER 2019 CALIFORNIA PLUMBING CODE.
FINANCIAL INFORMATION
DESCRIPTION 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
$101.97
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
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: $163.58
W0"Cra PERMIT # IJ �Z.�Z►� — Do it
--CF\i•,,/ih, l) F1;FKf-
PLAN LOCATION:
Project Address: lJ� Zz3 AUt n Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
•f
Applicant Name: % 17
Address:
City, ST, Zip: (,Ci
Telephone: -M C) �* _
Email: Valuation of Project $ L D
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Email:
Bedrooms: Stories: # Units:
State Lic: City Bus Lic:
Property Owner's Name: 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
�P`TI�R
b15TR1G�
COACHELLA VALLEY WATER DISTRICT
*** CUSTOMER RECEIPT ***
Oper: PHOS80 Type: OC Drawer: 1
Date: 3/04/20 09 Receipt no: 632201
Year Number Amount
2020 10895
PZ PLANNING & ENGINEERING
$4851.00
Trans number: 8439595
SANTA CARMELITA
Tender detail
naK CHECK 16308 4851.00
Total tendered 4851.00
Total payment 4851.00
Trans date: 3/03/20 Time: 16:53:50
*TRUE CONSERVATION USE WATER WISELY*
COACHELLA VALLEY WATER DISTRICT
i8, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date:313/2020
'.23 AVENIDA VILLA, LOT 11, LA QUINTA, LID 687182 ** SCC ONLY *'
Project:
Project Date:
Amount Due:
GEO:
Planner:
E PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
TANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT: SANTA CARMELITA, 53223 AVENIDA VILLA, LOT 11, LA QUINTA, LID 687182 ** SCC ONLY'*
20-10895
3/3/2020
$4,851.00
06-06-12-4
RUBEN MONTIEL
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Pagel
A
COACHELLA VALLEY WATER DISTRICT
dfs�R,�'t P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date:3/3/2020
SUBJECT: SANTA CARMELITA, 53223 AVENIDA VILLA, LOT 11, LA QUINTA, LID 687182 ** SCC ONLY **
ALMS UNDERGROUND CONST. Project: 20-10895
38703 VISTA DRIVE Project Date: 3/3/2020
Amount Due: $4,851.00
CATHEDRAL CITY, CA 92234 GEO: 06-06-12-4
Planner: RUBEN MONTIEL
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
SUBJECT: SANTA CARMELITA, 53223 AVENIDA VILLA, LOT 11, LA QUINTA, LID 687182 ** SCC ONLY **
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Pagel
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TY OF LA QUINTA
BUILDING DIVISION
REVIEWED FOR
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