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07-0432 (BLCK)IIIIIIIIIIIIIIIIIIIIIIIII 79IE r P.O. r:�PX 1504. Tt t 4 44" 78-495 CALLE TAMPICO L!A QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description Property Zoning: Application Valuation: Applicant: X07 -06000i32 80175 AVENUE 772-410-018- WALL/FENCE HIGH DENSITY 30000 52 RESIDENTIAL Architect or Engineer: ata 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 Professionals Code, and my License is in full force and effect. License Class:B LicenseNo.: 774293 fDateZ f/%Contractor:lee r , 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 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 155001.: (_ 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 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.I. Lender's Name:�A Lender's Address:_ l LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/07/07 Owner: GREYSTONE CLUBHOUSE ASSOC LLC 341 BAYSIDE DR STE 7 �✓� NEWPORT BEACH, CA 92660 Contractor: D CC GREYSTONE MULTI- LD!EFANC 341 BAYSIDE DRIVE 4�p NEWPORT BEACH, CA 92 60Cv� of: LCA (949)566-9230 Lic. No.: 774293 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 ZENITH INS CO Policy Number Z066293904 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 3700 of the Labor Code,I shall forthwith comply with those provisions. Date:�� t 7ApplicanC /x 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 J$1 00,000). 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 building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date:�, Signature (Applicant or Agent), ,r LQPERMIT Application Number ... . . . 07-00000432 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 284.50 Plan Check Fee 00 Issue Date . . . . Valuation 30000 Expiration Date 8/06/07 Qty Unit Charge Per Extension BASE FEE 252.00 5.00 6.5000 THOU BLDG 25,001-50,000 32.50 --------------------------------------------------'-------- Special Notes and Comments 1200 LF 8' BLOCK WALL PER ORCO DETAIL & CDD/P/W'S APPROVED PLAN Fee summary Charged Permit Fee Total 284.50 Plan Check Total .00 Grand Total 284.50 Paid Credited Due .00 .00 284.50 .00 .00 .00 .00 .00 284.50 .J Bin #City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking. Sheet Permit # r �, 2 7' ` J Project Address.` t D� �� �� Owner's Name: �E`l$ ibN� CC �tBKo�trt� /SSS . LL . A. P. Number:. 7-� O — d y --� Address: 3 qj 4151 Ot- 'Pt Su. t � ��% Legal Description': City, ST, Zip: NF } (Pv r1.ir CA 2, 6 60 Contractor. P�5 (-Z*� 6, GC(, F % Aft ., -j -Telephone:- Project Description: Address: q( S t nC 9/2 City, ST, zip: f6 ?d,0U— of 12 Telephone: State Lic. # : 7 Z q3 City Lic. #: "63 Arch., Engr., Designer. Address:. �.G1J G U SZ t!MF•ti 7 City, ST, Zip: Telephone: } State Lic. #: Construction T ype: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: L, FL: # Stories: IT Units: �! Telephone # of Contact Person: Estimated Value of Project: 7® ' APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed TRACIMG PERMIT FEES Ian Sets Plan Check submitted No Item Amount Structural Calcs. Reviewed, ready for corrections Plan Cheek Deposit Truss Calcar • Called Contact Person Plan Check Balance Energy Cal cs. Plans ticked up Construction Flood plain plau Plans resubmitted Mechanical Grading Pl o 2" Review, ready for corrections/issue Electrical Subcoutactor List Called Contact Person Plumbing Grant Deed! Plans picked up S.M.L H.O.A. Approval i. Plans resubmitted Grading. IN ROUSES- ''' Review ready for.corrections/issne Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees} Total Permit Fees±sy J Q CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 11/17/2006 Green Sheet approvals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be proc71, ed will be returned to applicant. Date: Developer: 6ZPYSM uLT( F14r^1 I c` Tract o.: Tract Name: �:rt- Lot No. (s): Address(s); •9r',A� c _ _ _A, The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: CUSTOM HOMES: PROVIDE ITEMS #2 #3 #4 AND #5 BELOW TRACT HOMES: PROVIDE ITEMS #1 #2 #3 #4 (AS APPLICABLE) AND #6 BELOW ❖ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1 #2 #3 AND #5 BELOW ❖ ALLS: PROVIDE ITEMS #7 BELOW ❖ SIGNS: PROVIDE ITEMS #8 BELOW 1. Attach Pad Elevation Certificates in compliance with the approved design elevation for building pad (maximum allowable deviation of .+/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. 2. Attach geotechnical certification of grading plan compliance. 3. Attach recorded final map showing proposed building locations are legal lots. 4. Attach a completed < 1 acre per lot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans & are subject to additional requirements. 5. Attach an approved precise grading plan for the building location(s). AO flood zone developments will require an approved flood plain development plan. 6. Attach a pproved rough grading plan for the building location(s). ttach wall plan & related approved grading plan. 8. Attach sign layout/plan & related precise grading/landscape plan. I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently co It for const tion o the ro osed buildings/structures/walls/signs on the subject lot(s). Pursuant to mn the a v of ct ay be released for building permit issuance. Recommended by: Dated: Public Works Distribution: (_ Green Sheet to Building & Safety counter (_) Green Sheet to Community Development Declined for approval for reason(s) as follow(s), please correct and resubmit: L City of La Quinta - PM 10 Project Information ( < 1 acre per Lot or Infill Project) Page 1 of 3 19 Form updated & effective 8/251'2005 Project Information Project Phase Project Contractor: Project Phase (Check One): ❑ Construction ❑ Demolition Project Name: Project Tract Number: _ Lot Number(s): Anticipated Start Date: Project Street Address: Anticipated Completion: Total acres in active construction (< 1 acre per Lot): Project Contact Information Please Note: Dust control is required 24 hours a day, 7 days a week, regardless of construction status. Person listed below is responsible for dust control during business and non- business hours. 1 Name: Title: o Company Name: Mailing Address: City: State: Zip Code: Primary Telephone Number: Fax: 24 Hour Access/Emergency Phone: Cell Phone: PM 10 Certificate Number: ❖ Expanded PM 10 plans for commercial and residential developments > 1 acre are required by the City of La Quinta.