10-1422 (BLCK)46995 Adams Street
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00001422
Property Address:
46995 ADAMS ST
APN:
643-090-019- -000000-
Application description:
WALL/FENCE
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
240
Titvl 4 4& Q"
Applicant:
Architect
or Engineer:
C/ ' 1✓ V
-----------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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: C/29 icense No.: 809220
Date/ `/ )TIO Contractor: C
OWNER -81 IL;AiDECLARATION
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 0500)•:
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 1, 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 _ 1 1 am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING
I hereby affirm under penalty of perjury that there is a construction lertdi
work for which this permit is issued (Sec. 3097, Civ. C.). _
Lender's Name:
Lender's Address:
LQPERMIT
or erforma a of the
3 2010
„" aF u►au►H A
1111111111111111111111111 76
IE VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/30/10
Owner:
CVCWD
P 0 BOX 1058
COACHELLA, CA 92236
Contractor:
ORTEGA MASONRY
P.O. BOX 2772
INDIO, CA 92201
(760)342-1726
Lic. No.: 809220
----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ 1 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 STATE FUND Policy Number 1948662
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
37,010 of the Labor Co e, I shall f thwi comply with those provisions.
1VDate: 12-3o Applicant: L
WARNING: FAILURE TO SECURE WORKERS' COMPENSAT N 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 Quints, 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
ofthis county to enter upon the above-mentioned property f inspecti 13 oses.
Date: 2— /OSignature (Applicant or Agent):
Application Number . . . . . 10-00001422
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00 Plan Check Fee
.00
Issue Date . . . Valuation
_ 240
Expiration Date . . 6/28/11
Qty Unit Charge Per
Extension
BASE FEE
----------------------------------------------------------------------------
15.00
Special Notes and Comments
15LF @ 3' HIGH RETAINING WALL TO ENCLOSE
COMMUNICATIONS EQUIPMENT - CONSTRUCTION
TO MATCH EXISTING BLOCK WALLS [CITY
STANDARD] 2007 CALIFORNIA BUILDING
CODES.
December 30, 2010 10:31:12 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
-----------------
Due
----------------------------------------
Permit Fee Total 15.00 .00 .00
15.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 16.00 .00 .00
16.00
LQPERMIT
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CITY OF LA CSU I N TA
BUILDING & SAFETY DEPT
APPROVED
FOR CONSTRUCTION
DATE
BY,
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http://maps.google.com/ 12/29/2010
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1, /7 ten- V
01
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
,APPROVE
FOR CONSTRUCTION
DATE I Z i A A '� BY,
Bin #
City of La Quinta
Building & Safety Dlvtslon
P.O. Box 1504, 78-495 Calle Tampico
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: qct-5,
Owner's Name: C
A. P. Number:
Address: _ . (D
'C
Legal Description:
ST, Zip'
Telephone:,
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Contractor:
.Address:–.
0
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Project Description
City, ST, Zip:O
Telephone:
–
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State Lic. #:
Arch., Engr., Designer.
City Lie. C
Address:
City, ST, Zip:
Telephone:
State Lia #:
Name of Contact Person: t°
D
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq.Ft ;
#Stories: #Units:
Telephone # of Contact Person:lon
�Eifi- ed Value of Project:
l�'ir7
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACiCI1VG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check De t�t
►--
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Coastruetion
i5� �►
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
V Review, ready for corrections/issue
Electrical
Subcoutactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Pians resubmitted
Grading
IN HOUSE:-
''' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P..
Pub. Wks. Appr
Date of permit issue
Sm
School Fees
1-7
Total Permit Fees
23�