BLCK (08-0046)54860 Avenida Madero
08-0046
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 ' )
Application Number:
_ Property Address:
` APN:
Application description:
Property Zoning:
Application valuation:
Applicant•
C
08-00000046
54860 AVENIDk MADERO
774-265-028-19 -0000'00-
WALL/FENCE
COVE RESIDENTIAL -
1300
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
VANDIVER GWENDOLYN A
_ 54860 AVENIDA MADERA
LA QUINTA, CA 92253
(760)564-3348
Architect or Engineer:
. VOICE (760) 777-7012
FAX (760) 777-701-1
INSPECTIONS (760) 777-7153
Date: 1/08/08
Contractor:
PREMIER BLDRS & CONSTR
P.O. BOX61.1
CORONA DEL MAR, CA 92625
(949)673-6046
Lic. No.: 895721
- LICENSED CONTRACTOR'S DECLARATION -
WORKER'S COMPENSATION DECLARATION
- I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: "
- Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
_ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B License No.: 895721
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
_4 - - -Date: l V Contractor:
_ 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
-- O e -BUILDER DECLARATION
insurance carrier and policy number are: '
I hereby affirm under penalty of perjury that I am at from the Contractor's State License Law for the
Carrier DELOS INS CO Policy Number 01DKRM12000846
- following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any -
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become ubject to the workers' compensation provisions of Section
- - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
_ 3700 of the Labor Code, I sha with comply with those provisions.
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).:
- Date:— Applicant:
_Applicant:
1I, 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
WARNING: FAILURE TO SECURE WORKERS' COMON ATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENAL' CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS (5100,000). IN ADDITION TOTHECOSCOMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made,. each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
{ _ 1 I am exempt under Sec. _ , B.&P.C. for this reason
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.
Date: Owner: -
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
• - CONSTRUCTION LENDING AGENCY
permit to cancellation. -
'- I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is c ect. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). -
city and county ordinances and state laws relating to buil " construction, a ereby authorize representatives
- -
Of this countto-enter upon the above-mentioned prop , f inspection rposes.
YY
Lender's Name:
Date: J D. -Signature A oli ant or Agent): --
- - Lender's Address: "
LQPERMIT
n
Application Number 08-00000046
"
Permit . . . . . .WALL/FENCE PERMIT
-
s
Additional desc
Permit,Fee 31.00 Plan Check Fee
.. .00
:`•3
Issue Date Valuation
1300.
Expiration Date . 7/06/08
Qty ' Unit Charge
Extension
.Per
BASE FEE
15.00
8.00 .2.0000 HND BLDG 501-2•,000
16.00
1. t
--------------------------_----------.----- --- ------------ -- - ---
----- -- - - - - --
Special•Notes and Comments
-
52 LN FT X 6 FT HT GARDEN WALL PER CITY
STANDARDS AND RELOCATING TWO IRON GATES
4FT HT
`
Fee summary Charged Paid Credited'
Due t'
Permit. Fee Total 31.00 .00 .00
31.00
Plan Check Total .00 .00 .00
.00
Grand Total 31.00 .00 .00
31.00 4'
Bh #
-7
N City of LaQ uinta
Building U Safety Division
P.Q. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 -'(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:D
A. P. Number:
,,i n q Np
Owner's Name: A 1,✓ , (p. • V
Address:. !' Sib A
Legal'Description: CU
City, ST; Zip: LA
Contractor:./
Telephone: o) j
Address:
City, ST, Zip: vM4A ' CN
Telephone % 1--63 01
State Lic. # : VI S_TL
"W1
City Lic: #:
Project Description:
fto 2 / ✓ V✓' 2 ^ 14
Arch.;'Engr., Designer:
.Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:.
Telephone # of Contact Person:
Construction Type: Occupancy:
Project.type (circle one): New-. Add'n Alter ' Repair Demo
Sq. Ft:: #Stories: #Units:
Estimated Value of Project:
APPLICANT:. DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd 1
Recd
TRACEING G.
PEitMIT FEES
Plan Sets
Plan Check submitted .
'
TCheckDeposit
Amount
Structural Calcs.
Reviewed, ready for corrections .
Truss Caics.
Called Contact Person
Plan Check Balance
Energy Caics.
Planspicked'up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval.
Plans resubmitted
Grading
IN HOUSE:-
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees