13-0780 (BLCK)t P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000780
Property Address:
51715 AVENIDA OBREGON
APN:
773-123-028-8 -000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
525
Applicant: Architect or Engineer:
if-ce- diatss�ulf2. I.l
LICENSED CONTRACTOR'S DECLARATION
c
4•
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/24/13
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 Professionals Code, and my License is in full force and effect.
License Class: B License No.: 926128
Date: �% I� I Contractor: V L11vIQZ C �+�.f C G
OWNER -BUILDER DECLARATION
I hereby affirm* under penalty of perjury that I am exempt from the Contractor's State License Law for they
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 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 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.)
(_ 1 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 Address:
LQPERMIT
Owner:
FOREMOST HOMES LLC
70600 COUNTRY CLUB DR
RANCHO MIRAGE, CA 92270
ED
Contractor: LI JUN 2 4 2093
DANTOR MARTINEZ CONSTRUCTION
81057 AVENIDA ROMERO CITY OF LAQUINW
INDIO, CA 92201 FINANCE DEPT.
(760)702-6209
LiC. No.: 926128
-------------------
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
�7 Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND 'INS Policy Number 1960997
-1 certify that, in the performanceof 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 ICI��o\de, I shall forthwith comply ith those provisions.
r Date: b "z�- 17pplicant: : "--t t91, e__ � P�
�2
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 Director of Building and Safety 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 build' construction, an hereby authorize represent tives
of this county to enter upon the above-mentioned pope ' fc inspection purp es.
,Date: �17Signature (Applicant or Agent):
Application Number . . . . . 13-00000780
Permit . . . . . WALL/FENCE PERMIT 2013
Additional desc . .
Permit Fee . . . . 47.19 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 525
Expiration Date . . 12/21/13
Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
----------------------------------------------------------------------------
Special Notes and Comments
13LF OF 6' GARDEN WALL WITH 5' WIDE GATE
AT SOUTH SIDE YARD AND 8LF 6' GARDEN
WALL AT NORTH SIDE YARD [ORCO
SPECIFICATIONS) PRECISION CONCRETE BLOCK
SHALL BE COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING WHERE VISIBLE FROM
OUTSIDE THE PROPERTY. 2010 CALIFORNIA
BUILDING CODES.
June 24, 2013 2:37:06 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.06
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 47.19 .00 .00
47.19
Plan Check Total .00 .00 .00
.00
,Other -Fee Total 61.06 .00 .00
61.06
Grand Total 108.25 .00 .00
108.25
LQPERMIT
Bin #
City, of La Qulnta
Building &r Safety_ Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project,Address:13011�j G
Owner's Name:
A. P. Number:
Address:
Legal Description:
City; ST, Zip:
Contractor: ` D
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Telephone: {'..,'�x�_•'`$.�;<:�:x'<r,�g 3�><k?;�:
Project'Description:
Address:
City, ST, Zip: C 1
%;o$:y': ',S$r$$Ri?:?q:;::•":"x<:;;>:?;•:?'.c
Telephone: 76.0
�� In
State Lic. # : Gi-Z (o i 2 City Lic.'#;
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Arch., Engr., Designer:
Address:
City., ST, Zip:
:f$: 4'iC. l L$L'••$$:.1':$Iv\..v.:i: n'b'$\:F7;M:+;�:}M
Telephone:
State Lic. #•: <;;;;?<:>:. `.zf;.r.$:.:;;:>::•;:<>.
Name of Contact Person:
Construction Type: Occupancy:
Project type'(circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
#Units:
Telephone #. of Contact Person:
Estimated Value of Project: 4'
APPLICANT: DO'NOT .WRITE;BELOW-THIS LINE
#
Submittal
R.eq'd
Recd
TRdCKING
T PERMIT FEES
Plan Sets
. Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plao`Gheck Deposit
Truss Calcs.
Called Contact Person
'Plan Check Balance
Tide 24 Calcs.
Plans picked•up
'Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2oa Review, ready for corrections/issue-
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant'Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
i A.I.P.P.
Pub. Wks. Appr
'Date of per issue
School Fees
Total Permit Fees
1
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BG & SAFETY DEPT.
�AAEM APPROVED
kFOR CONSTRUCTION
51-715 AVENIDA OBREGON DATE b?�l B
SCOPE OF WORK
13LF OF 6' HIGH PRECISION BLOCK WALL (ORCO SPECIFICATIONS) WITH 5' WIDE GATE AT SOUTH SIDE YARD
i
'Q� 81-F OF 6' HIGH PRECISION BLOCK WALL (ORCO SPECIFICATIONS) AT NORTH SIDE YARD