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BLCK (11-1208)50760 Mandarina 11-1208 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number:. `- 11'-00001208 `! , Property Address: - 50760 MANDARINA APN: 776 -210 -002 - Application description: WALL/FENCE Property Zoning: . LOW DENSITY RESIDENTIAL. Application valuation: 1625 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CITRUS 18 GROUP, LLC 30875 DATE PALM ROAD CATHEDRAL CITY, CA 92234 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/03/11 Contractor: — — --- Applicant: Architect or Engineer: GRA ENTERPRISE, INC. 9 30875 DATE. PALM DRI\/E CATHEDRAL CITY, CA 92 (760)969-1400 «V 03 Zai! t Lic. No.: 750957 r I'` CITY OF L ► Q6lIfdTA F-INAN,' DEPT: LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION - 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._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B License No.: 750957 for by Section 3700 of the Labor Code, for the performance of the work for which -this permit is issued. Date:. 3' I ntractor: 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 -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0000223-2010 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 subject 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 shall forthwith comply with thoseprovisions. 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 (5500).:ate: 11 ant: (_) 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 WARNING: FAILURE TO SECUREW RKERS' CO 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 CRIMIN TIES AND 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, 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 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 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 thiiss c/°unty to enter upon the above-mentioned property for inspection purposes. )jAfe: }t-3 tL nature (Applicant orA LQPERMIT Application Number . . . . . 11-0000120.8 .� Permit . . . WALL/FENCE PERMIT -Additional desc . Permit Fee, 39.00 PlanCheck Fee 00 Issue Date Valuation '1625 Expiration Date 5/01/12 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 2.0000 HND BLDG 501-2,000 24:00 Special Notes and Comments 65 L.F. 6' GARDEN WALL AT REAR P/L;.CITY STANDARD. 2010 CODES. -----------------_---------------------------------------------------------- Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 1..00 Fee summary Charged Paid Credited Due Permit Fee Total 39.00 .00 ,.00 39.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 40.00 .00 .00 40.00 LQPERMIT flfl sS x 5 Bin # So b -i a City. of La Quinta . Building Br Safety.Divislon.. i' Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 BuildingPermit Application and Tracking Sheet Permit #P.O. Project Address: ff\a v CK R %-J \'A 1Z U 0 Owner's Name: E k'kr u S k% 6 ro u p i l -LC_ A. P. Number: Address: Pa1tr a t2. . Legal Description: T 1-\ (-, C-• l -v Contractor: Q) Vk W Pr-; S 1 ri C_ City, ST, Zip: Cc:r,,T(-F C -V f u\ C4--( C a. c1Z 2 3" Telephone: 1(-d' ) bcl - t LAOO Address: O. "1 S c)&T-C gyp.\ir c r Project Description: h(&\nl 6LO(i -- VQoAk S . City, ST, Zip: C(jL{-•ti. v -o-,\ c-O—t Cc& 01- 5 LoT S Telephone:' —1(Cd q 69 -1 "' " > >•>::< < >>•-••3 :. C U tj 1T State Lic. A: -1 S Cd S City Lic. #: Arch., Engr.,' Designer: I R D S Cons ul l i n 325 Lim) F T 7-0-T- Pl t LL Address: 1 80loo pts 4-1 City, ST, Zip: 1,4 CP, aZZZS 3 Telephone: -i• 11 - 40 t 3 State Lic. #: 1 >. app• 4..rh<v Construction Type: 61oLjc Wki1\ Occupancy: .'3..'' '""'°' "" Project type circle one): New Add'n Alter Repair Demo Name of Contact Person: \-e-Y, Gon zc, S Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: - 250 ' ' ' S y Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Plan Sets Req'd Rec'd TRACMG Plan Check submitted PERMIT FEES Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Pian Check Balance Tide 24 Cafes. 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 H.O.A. Approval Plans resubmitted Grading IN HOUSE:- I 1rd 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