BLCK (07-1851)50970 Mandarina
07-1851
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address: .
APN: .
Application description
Property Zoning:
-Application valuation:
Applicant:
j
07-00001851
50-9-70-MANDARINA
776-210-009-
WALL/FENCE
LOW DENSITY RESIDENTIAL
2950
T4ht 4 4Qur«rw
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
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 _ - --License No.: 846283
Date 07 Contractor:
OWNER -BUILDER WCLARATION
I hereby affirm under penalty of perjury that 1 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 (5500).:
(_ 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 orimprovement 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 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.).
( 1 I.am exempt under Sec. I 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
VOICE (760)777-7012
FAX (760)777-7011
INSPECTIONS (760) 777-7153
Date: 6/26/07
Owner:
MANDARINA ESTATES LP
5305 E. SECOND STREET #204
LONG BEACH, CA 90803
Contractor: . D
TP BUILDERS, IN
5305 E SECOND ST
LONG BEACH, CA°90 03 2 6 2007
(562)433-1286
Lic. No.: 846 cp,.9fLA- 01u.., -
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 thework for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
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
37070 of the Labor Code, shall forthwith comply with those provisions.
Date: _L6-0 r Applicant:
WARNING: FAILURE TO SECUR ORKERS' COMPENSATIO COVERAGE 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 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 f i spection purposes.
Date: .07
Signature (Applicant or Agent):
LQPERAIIT
Application Number . . . 07-00001851
Permit WALL/FENCE
PERMIT
Additional desc .
Permit Fee 54.00
Plan Check
Fee
..00
Issue Date
Valuation
. . .
. 2950.
Expiration Date 12/23/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.009.0000 THOU BLDG
2,001-25,000
9.00
" ------
Special Notes and Comments
347 ln. ft. block walls per orco
specs
rear and side walls
Fee summary Charged
Paid Credited
Due
Permit Fee Total 54.00
.00
.00.
54.00
Plan Check Total .00
.00.
.00 .
.00
Grand Total 54.00
.00
.00
54.00
LQPERAIIT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495. Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit.#
5
Project Address:' 5 Q- 576 omp r Ve
Owner's Name: a dU rinA E5fici+e5 L P
A. P. Number: I'llDdel LOT -4
Address: S.3OS C"SeColrIC $
Legal Description:
Contractor: Tali -4) PA f+ne (5 IFp
City, ST, Zip: Lon (7 6e6L G n 6A • cI 2 So 3
Telephone:
Address: CG 3 DS secol)d 6+- •
Project Description:
Q6-
City, ST, Zip: Lon(S Beetch GR 92803
Telephone: j• 2- 33" Sfo
State Lie. # : jam- $ ( g 3 . CityLic. #: I oZ132
Arch., Engr., Designer:
Or D '1-andcrrd b1f0(.KutA11S Dn AA
if'eL1' r e PIAN
3 y7 incl udeS Y df Lo+ l y e-4►* PA4h w,4Il
Rehr at16 siXe W AUS 4 ke,4u(n
Address:
City, ST, Zip:
Telephone:
Construction Type: Ul od( W A(I Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Ph 11 Larsen 95i= 3) y - 93 6 4
Ft.: '2,4-I
# Stories:
#Units:
Telephone # of Contact Person: 3ohn 6W;17& 760- fie -(Sq1
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIUNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Pian Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
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 correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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