14-0020 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
Application Number: -14-00000020
Property Address: 52645 .AVENIDA OBREGON
APN: 773-284-019-6 -000000-
Application description: WALL/FENCE:
Property Zoning: COVE RESIDENTIAL
Application Valuation: 1624
Applicant:
CK_9'^_'
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RW REAL ESTATE INC
52700 AVENIDA ALVARADO
LA QUINTA, CA 92253
,.
1 Contractor:
Architect or Engineer:
HUITRON CONSTRUCTION
50427 RIGO COURT
COACHELLA, CA 92236
(760)39,8-3227
�—
Lic. No.: 926190
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' LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury th t'I;am licensed under provisions of, Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus' a and ofessionals MandLicense is in full force anoeffectLicense•Class: B ic 6190
xDate: /'.7- �� Contractor.
. OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury that I am exempt'from the Contractor's StateLicense Law for the
.following reason (Sec. 7031.5, Business and Professions Code:+ Any. city: or. count y. 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 of the Business and Professions Code) or '
that lie or she .is,exempttherefrom;'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 hundreddollars ($500).:
1 _ 1 I, as owner of the property, -or my employees.with wages'as their sole compensation, will do.the work, and
thestructure,is not intendedor 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
improvementsare'not intended or offered for sale:' If, however, the building or improvement is sold within
one year ohcompletion, the owner -builder will`have, the burden of proving that he or she did not build or
improve'for the purpose of sale.). -
1 _ 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 fo,the Contractors' State License Law.).
I—) 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
I
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/07/14
JAN 0 7 2014
CITY OF LA QUINTA
r -----------
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.
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'l.Mywoikers' compensation
insurance carrier and policy number are:
Carrier STATE FUND. PolicyNumber. 0013718-2012
,'I certify that, in tne.perf- r ance of the.work for which this permit is issued, I shall not' -employ any
person, in any, manne s as to liecomesubject to thew�rkea s' compensation laws of California,
and agree that, if I s become subject to the wo *kcenation provisions of Section
3700 of the labortee, I shallf rthwrth comply' tios'` ovisions.
Date: T-1 '- 1 applicant:. ,.
WARNING: FAILURE TO SECUR .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 TONNE COST OF CONIPENSATION,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 Quinia; 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 suc .permit, or cessation of work for 180 days will subject
permit to cancellation. '
I certify that I have read this application and state that t e bove info r ation is correct I agree to comply with all
city and county ordinances and state laws relating to b it i g constr tion, and herb author: a representatives
of this county to enter upon the above-mentioned pro y for insp ion purposes
Date /-�'-I signature (Applicant or Agent
I
Application Number
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
. . . . 14-00000020
WALL/FENCE PERMIT 2013
47.19 Plan Check Fee . . .00
Valuation . . . . 1624
7/06/14
Qty Unit Charge Per Extension
1.00 47.1900 LS MISC WALL, FIRST 100 LF 47.19
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Special Notes and Comments
75LF OF 5' GARDEN AT FRONT YARD AND
EQUIPMENT AND PROPANE ENCLOSURES (ORCO
TRENCH FOOTING SPECIFICATIONS] PRECISION
CONCRETE BLOCK SHALL BE COVERED WITH
STUCCO, PAINT, OR TEXTURED COATING WHERE
VISIBLE FROM OUTSIDE THE PROPERTY. 2013
CALIFORNIA BUILDING CODES.
January 7, 2014 1:54:06 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
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Oty of La= ,Qdinta
Wk mg 8r Safety Division .
Permit .#
P.O. Box 1504; 78-49S:Caife Tampico•
La Quanta, CA 92253 =-{760} 7777012
Building Permit Applicationand Tracking Sheet
' Project Address: r, tuna s Name:. —
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A. P. Number.
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Address:
Legal Description:
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1 Q. Troject Description:
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i Telephone
State Lia #:
City Lic. #t
Arch, Engr, Designer
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i . Address:
City, ST, Zip:
Telephone:
Construction Type- • ..
occupancy:
' State Lia #: q�
Nect`typc (circle one):. Ncw Add'n Alter Repair Demo
Name of Contact Person � � J
� Sq. Ft-: #Stories # Unitx
Telephone # of Contact Penson
- Estimated Value of Project:.
;APPLICANT.- Do NOT WWTE BELOW
THIS:UNE
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Pian Cheek submitted Item Amount
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Sabcontaetor List
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Developer Impact Fee
Planning Apprpvel.
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A.I.P.P.
Pub. Wlcs. Appr
Date of permit issue
School Fen '
Total Permit Fees
CITY OFIE-A-OUINTA
BUILDING &, SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE1 1 UI BY
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