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12-0791 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12=001)00791 _. Property Address: 58300 ALMONTE APN: 764 -190 -001 - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 4175 Applicant: T-4u4t " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: �Ja LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect', 7000) of Division 3 of the Business andZPrfssionals Code, and my License is in full force and effect. Li se Class: B Lice 634755 Date:,�� ontractor: OWNER -BUILDER D CLARATION 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 _ 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 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(sl 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: JAMES BLANTON 58300 ALMONTE LA QUINTA, CA 92253 Contractor: BADGER CONSTRUCTION, 26965 MERIDIAN STREET HEMET, CA 92544 (951)306-4295 Lic. No.: 634755 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Dater 7/17/12 JUL 17 2011 CITY OF LA QUINTA 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 E EMPT Policy Number EXEMPT 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 beco a subject to the workers' compensation provisions of Section ,;:317-0, �� of the Labor Cod � sh orthwith mpl ith those provisions. at cant: WARNING: FAIL�ETOPISECURE 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 .ofsuch 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 c�anqdounty ordinances nd state laws relating to building cons ruct',an, and hereby authorize representatives onythe above-mentioned property for iection p pgnatura (Applicant or Agent): IIIIIII VIII III VIII IIII 36 IE Application Number 12'-00000791 Permit WALL/FENCE PERMIT. Additional desc . Permit Fee . . . . 72.00 Plan Check Fee 00 Issue Date . . . . Valuation 4175 Expiration Date 1/13/13 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 27.00 ------------------------------------------------------=--------------------- Special Notes and Comments 167 L.F. 6' GARDEN.WALL WITH (2) 6' COLUMNS AT FRONT YARD. 2010 CODES. -----------------------------------------7---------------------------------- Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ----- --------- Permit Fee Total 72.00 .00 .00 ------ 72.00 Plan Check Total .00 .00 .00 .00 Other'Fee Total 1:00 .00 .00 1.00 Grand.Total 73.00 00 .00. 73.00 LQPERMIT - uin ff City of La Quinta Building 8t Safety Division Permit # /> I P.O. Box 1504, 78-495 Calle Tampico "1 La Quinta, CA 92253 - (760) 777-7012 2 Building Permit Application and Tracking Sheet Project Address: 0 / d hfie d^ wner's Name : ry VQ i» p� 91R p7t0A A. P. Number: Address: -5-S ?Ol'1 A # Submittal Plan Sets Structural Cates. Truss Calcs. Title 24 Cates. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees APPLICANT: DO NOT WRf 'd I Recd Plan Check submitted Reviewed, ready for correct Called Contact Person Plans picked up Plans resubmitted 2nd Review, ready for correct Called Contact Person Plans picked up Plans resubmitted "' Review, ready for correcti Called Contact Person Date of permit issue :�ity, ST, Zip: Telephone: 3roject Description: . 0 a ral`v.,,7 l ve onstruction Type: Occupancy: roject type (circle one): New Add'n Alter Repair Demo 1. Ft.: # Stories: # Units: stimated Value of Project: FE BELOW THIS LINE ING PERMIT FEES Item Amount ons Plan Check Deposit Plan Check Balance Construction Mechanical ions/issue Electrical Plumbing S. M. 1. Grading - rns/issue Developer Impact Fee A.I.P. P. Total Permit Fees v a d to m b -� l monfE Or, CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVE® FOR CONSTRUCTION DAT j' II /