BLCK (12-0453)50670 Mandarina
12-0453
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: < 12-.00000453 t
Property Address: 50670 MANDARINA
APN: 776 -200 -005 -'-
Application description: WALL/FENCE
Property Zoning; LOW DENSITY RESIDENTIAL
Application valuation: . 3200
Td v 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/25/12
Owner:
CITRUS 18 GROUP, LLC
30875 DATE PALM DRIVE, STE. C
CATHEDRAL CITY, CA 92234
Contractor: D e a
Applicant: Architect or Engineer: GHA ENTERPRISE, INC. APR 3 0 2012
30875 DATE PALM DRIVE, SUIT C
CATHEDRAL.CITY, CA 92234
J1
(760)96 . 9-14001. CITY OF LADUIPtNTA
/ ------------------------------------------------------------------------------------------
Lic. No.: 750957 FINANCE DEPT.
. 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.
Licen Class: Bc e No.: 750957
Date: 4 -So - I tractor:
OWNER -BUILDER DECD. TION
I hereby affirm under penalty o r'erjury that I am exem t crGontractor's State License Law for the
following reason (Sec. 7031.5, B ass -and' ssions 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).:
(_) 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 contractors) licensed
pursuant to the Contractors' State License Law.).
I—) 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
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.
YL 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 'FOND Policy Number 71922311
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 pplicant: -
WARNING: FAILURE TO SECUR ORKERS' COMPENSATI RAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA 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, indemnity 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..lenter upon the above-mentioned party for inspection purposes.
%
Date: -3b "'Si ure (Applicant o g
Ti
Application Number 12-00000453
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 63.00 Plan Check Fee
.00
Issue.Date . . . Valuation
3200
Expiration Date 10/22/12
Qty Unit Charge Per.
Extension
BASE FEE
45.00
2.00• 9.0000.THOU BLDG 2,001-25,000
18.00
--------------
Special •Notes and Comments
128 L.F. 6' GARDEN WALL, CITY STANDARD.
2010 CODES.
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Other Fees' . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 63.00 ..00 .00
63.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 64.00 .00 .00
64.00'
LQPERMIT
Bin.#
Permit #
It. q 53
Project Address: 45o6lo raoj 0
C / (,f .L Q uInt >i .
Building 9. Safety Division .
P.O. Box 1SO4,"78-495 Calle Tampico.
la.QuInta, CA 92253 -:(760) 777-7012
Building Permit Application' and Tracking Sheet
fJ.IO ifO5 Owner'sName:<_ •Tt .. 1b (.coop "C--
A. P. Number: M 1%3VK Q,1 N DZ Address: .
Legal Descript on:.p[,1L %jp.^kN M1 ST, Zip:
Contractor: 6 Telephone: > S
Address: '4 -!S DpCTE MO-q- Project Descriptior(5pk70 1 Z$ (W ;:,T- B I ciGK-• W il
City, ST, Zip 'Q jL_ C ( +!,y. C4. cl, 223 4 S,Cpl y p) 13$ -t-T. .$ k ocg_ L.J .k ?
L
Telephone..%-".CiEA -14 d
1 t: S C qp 14 LN FT 1B\4,1L'
State Lic. # :75CA S'7 City Lie. #; Ito) 0 1A LN F-T- $\oe,IL tom•\ \ l 2 14
Arch,Engr.,Designer: MCS ConSuLTih 5%01.6). 10' 'FT BtcCJk_ q
Address:'JEAM N%f& L,"7
HIVID'=1.1% Pr*aO gAeru LtJ t-_wst$6p
City, ST, Zip: L.-k-jih•ko, coL
gZZS'3
Telephone: " j 60-7'71-1, 0 l3
r N Construction Type: g\IL. Wt \\ Occupancy: /.
State Lie #:$-" Project
.< ,,,•%. '" type (circle one): (5ew) Add'n Alter Repair Demo
Name of Contact Person: 1 -,%Sq, Ft.: # Stories: # Units:
Telephone # of Contact Person: -
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd .
Reed
TRACMG
PERMIT FEES
Pign Sets
Pian Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss talcs,
Called Contact Person
Plan Check Balance
Title 24 Calci.
Plans picked 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:LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees I
Total Permit Fees