BLCK (12-0811)50760 Mandarina
12-0811
P.O. BOX 1504
78=495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:. .
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
1-2 - O.OA_0 0 811--N
50760 MANDARINA
776-210-002- - -
WALL/FENCE
LOW DENSITY RESIDENTIAL
3675
T444t 4 4 Q"
Architect or Engineer:
P/A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 rofessionals Code, and my License is in full force and effect.
License Class: B License No.: 750957
/ate: 3 ontractor:
OWNER-BUILDER ECLARATION
I hereby affirmunder penalty of perjury that I am exempt from th 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 ($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.).
(—) 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 contractor(s) 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: Ir-
LQPERMIT
Owner:
CITRUS 18 GROUP, LLC
30875 DATE PALM DRIVE
CATHEDRAL CITY; CA 9223t/U
Contractor:
GRA ENTERPRISE, INC.
30875 DATE PALM DRIV ,
CATHEDRAL CITY,"CA 92234
(760)969-1400
Lic. No.: 750957
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/20/12
JULIO3
r lI
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 1 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 FUND 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 Cod atshall forthwith comp y with those provisions.
Uate: l Z plicant: `[ —/
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION/VERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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, 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' ormation is correct. I agree to comply with all
city and county ordinances and state laws relating to building ns uction, and he b authorize representatives
of this county to enter upon a above-mentioned property,r ins ction pos
P,fa: 7 Si nature (Applicant or Agent):
LQPERMIT
Application.Number 12-00000811
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 63.00 Plan Check Fee
.00
Issue Date Valuation,
3675
Expiration Date 1/16/13
Qty Unit Charge Per
Extension.
-BASE FEE
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.0.0
-----------------------------------------------------------------------------
Special Notes and Comments
147 L.F. 6' GARDEN WALL @ SIDE P/L, CITY
STANDARD. 2010 CODES.
----------------------------------------------------------------------------
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
#
PennIt #
ProjwAAddmm: 50-7 0 50.7 b0
Ci Of Quinia
BuMg a Safety D1visFon
P.O. Box 1504,"78-495 Caffe Tampico
La.Quf ita, CA 92253 -:(760) 777-7012
Building Permit Application and Tracidng Sheet
f Oi 90 owner's Name:. Ci-112.v$ ► 6 ^' v P . L G
A. P. Number. tM W1 1 DPIK T- 1 1
Address: 80$75 VAT-b fell rn ok,
Legal tion:
Contractor. G H* Eat Mpe, iS E S '2VC-
City, ST, Zip: c4T?"2a b G4'7 CQ g2Z3 4
Telephone: 7 ib - 9 69 - 1400
Project Description:
Address: 3 6 7C PMT-- P41 VA A—
City. $T, Zip- ta f p r, C14Y Ca
92.23 4
Go73o - . Zb9 L ►.t F4ctr-- WWI (X"- 4 -
Telephone:-74>-969- /4CO
State Lia#: 750957
City Lie #c
CiTr S*,.w> ave C,,
So760' I Ali Lrv#}T &Io(,k W411 trSihri
Arch., Bngr., Designer. MOS C.-XuLTW (7
Address:
507 9 0 = t LI-7 L:v "r' M OCl wall cc-#-n 6.
Cov 5f,,4ndotoD.5.63
Construction Type: Mt SOWY Occupancy:
City., ST, Zip:LA QUJM. 4 C#4
Telephone:
State Lia #:
Project type (circle one): ew Add'n Alter Repair Demo
Sq. FL: #Stories: #Univ:
Name of Contact Person:
Telephone # of Contact Person: 0 -
'i $ $4
Estimated Value of Project SO-000,00
APPLICANT: DO NOT WRITE BELOW THIS UNE
H
Submittal
Req'd
Recd
TRACING
PER?Arr FEES
Plan Sets
Plan Check submitted
Item Amount
Strgctural calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cal".
Called Contact Person
Pian Check Balance -
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted .' .
Mechanileal
Grading plan
'` Review, ready for correctiouslissue
Electrical
Subeontactor Ust
Called Contact Person
Plumbing .
Grant Deed
Plans pitied up
ML
H.O.A. Approval
Plana resubmitted
Grading . •
IN KOM:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.i.P.P.
Pub. Wks. Appr '
Date of permit Esme
School Fees
,
Total Permit Fees