BWFE2015-0097 (BWFE)IIIIIIIIVIIIIIIVIIIIIII
65
IE
78-495 CALLE TAMPICO 0 D XP Qum&
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BWFE2015-0097 Owner:
Property Address: 81751 ANDALUSIA T D DESERT DEV
APN: 764670040 81570 CARBONERAS
Application Description: ANDALUSIA TM 31681-3 LOT 70 / BLOCK WALL 180 LF LA QUINTA, CA 0
Property Zoning:
Application Valuation: $4,500.00
Applicant:
T.D. DESERT DEVELOPMENT, L.P.
81-570 CARBONERAS
LA QUINTA, CA 92253
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 Cla s: License No.: AEC212
Date r C Contracto . //
v
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 31'
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.).
(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 contractors) 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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
T.D. DESERT DEVELOPMENT, L.P.
81-570 CARBONERAS
LA QUINTA, CA 92253
Llc. No.: AEC212
Date: 5/14/2015
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'
com eAaaprovided for by Section 3700 of the Labor Code, for the performance
o h ich this permit is issued.
and will maintain workers' compensation insurance, as required by
Sec ione Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: _ Polity Number.
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' co pensa ,on provisions of Section 3700 oft Labor Code, 1 shall forthwith
comply wi) t�hos rovisions.
Applican.
r/
WARNING: FAILURE TO SECURE WORKERS MPENSATION COVERAGE IS UNLA FUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST O
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LAB% 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 t n the above
mentioned 'yroopp�e /"for inspection purposes.
Date:' y Signature (Applicant or gent)::'
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00
PAID BY METHOD RECEIPT # CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION _
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$29.00
$0.00
PAID BY
METHOD
RECEIPT#
CHECK#.
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY =
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forFENCE OR FREESTANDING WALL $137.77 $0.00
TOTALS:00
Description: ANDALUSIA TM 31681-3 LOT 70 / BLOCK WALL 180 LF
Type: WALL/FENCE, Subtype:. Status: UNDER REVIEW
Applied: 5/12/2015 MFA
Approved:
Parcel No: 764670040 Site Address: 81751 ANDALUSIA LA QUINTA,CA 92253
Subdivision: TR 31681-3 Block: Lot: 70
Issued:
Lot Scl Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $4,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 180 LF GARDEN WALL [ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
Printed: Thursday, May 14, 2015 6:36:17 PM 1 of 2
SYSTEMS
T DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY r
CLTD
•
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
WALL/FENCE - EA
101-0000-42404
0
$29.00
$0.00
ADDITIONAL 50 LF
WALL/FENCE -FIRST
101-0000-42404
0.
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
101-0000-42600
0
$60.91
$0.00
100 LF PC
Total Paid forFENCE OR FREESTANDING WALL $137.77 $0.00
TOTALS:$0.00
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
ATTACHMENTS
Printed: Thursday, May 14, 2015 6:36:17 PM 2 of 2
CMIfflYSTEMS