BLCK (12-1079)51060 Mandarina
12-1079
r
P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:12, 00001079"''
Property Address: 51060 MANDARINA
APN: 776-210-012- -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3275
Applicant: Architect or EngineerAi
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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 Busines nd Pr fessionals Code, and my License is in full force and effect.
Licensee Class! B Licens No.: 750957
Date: `^ /Z•Contractor:
OWNER-BUILDE97DECLARATION,
I hereby affirm under penalty of perjury that I 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 ($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 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 1 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
Owner:
CITRUS 18 GROUP
30875 DATE PALM DRIVE
LA QUINTA, CA 92253
(760)969-1400
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/20/12
Contractor: D
GHA ENTERPRISE, INC..
30875 DATE PALM DRIVE, TE _
CATHEDRAL CITY, CA 922 2 0
(760)969-1400
Lic. No.: 750957 CI I
PJ A ..__ 2 -PAI A
1 NANrr
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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 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 b o e subject to the w iers' compensation provisions of Section
3700 of the Labor Code, shall orthwith dy ith those provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIV FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 Ouinta, 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 inf motion is correct. I agree to comply with all
city and county ordinances and state laws relating to building c ru tion, and hereby uthorize representatives
of this county to enter upon the above-mentioned property f insp tion p o es.
Date: Xignature (Applicant or Agent):
Application Number . . . . . 12-00001079
Permit WALL/FENCE PERMIT
`
Additional desc .
Permit Fee . . . . 63.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
3275
Expiration Date 3/19/13
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
131 IN FT X 6 FT HT BLOCK WALL CITY
STANDARDS AND APPROVED PLANS. 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
.AP / OVED :FOR IP MITTING: PLANNING, ZONING 'COMPCYINCF'
\ /
16AM U N
• RlR' G,MID SAFETY iORiECTOR N ,DIRECTOR
\ / " - CITY SOF is Ol6MTA CITY OF iU OUINTA
y
l` FF a 3137
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NOTES c`5MoaE
MANDARINA o0 fmDffd]W ARdWcm OF LA awu SM we In m R.2096
—4, — — — N -F-L . _ / .DATE: / /ZUssomaDILM tT Oa<
UIUJM PRIVATE ENGINEERING NOTE " PREF . TM 00MCIwaI CFF neN „' IN THE CITY OF LA QUINTA. STATE OF cAuFORNiA `' _ 4
ADIL yA1V78§ OR R'EPORfFD 9Y TIE ONaER OR CONSIRIICIION CONTRACTOR AGREES THAT w ACCORDIKE MH GEWEPA Y MV LOF 18 FROM PUN 2RC TD REV. LOT L a(5S . . r a a a e os of TRACT NO. 24890-1 4•
tT11F aY® DFOSE SwOXII OM TIB R OR>98 f7wm9EID ARE NOIGTFO 1IIIH ACCEPTED COIISTRIICTIDN PRACTIOS CONSIRMCMH CONTRACTOR R 9E 19 FRWI RAN 2C TO RFV. IOf 7D FIiOY (, ✓ I.o m.GPL9 SMT._
%OFF AWRWkXM IOMW 40B MON TAS OWIM 9Y ACOPIM REWIRED TO ASSUME SOLE AND caaTETE R(•SPplSlfm,fY FOR A79 SUE PLAN ?A TD 2e • C"U E T T PRECISE GRADING PLANS -
ndW PUM OR jMW M WAWONFRM PIIRSIATF THIMETO. AGRFE3 COMORIOLS DURDIC TIE 0 OR COSTRIICRON OF THE PRO.ECf. RV. lOf I6 RID 8 IFF f3EV' REV. IIIf IS '= •'• Rn m6ay R.CL 205M FAx TTIDiR4AlTl
ro b OOf== me to FIORD QED "Imam FOR MY DAIMOES ORc I SAFETY OF ALL PER6O6 AND PROPFRi1': THAT THS REOWEYENT OF 4 SHTS
WMmw Ms Mw onvsa6RE¢ OF uRR49 OR sIRMcRoms NOT %WL 9E MADE TO APPLY CpNTwuOlSLY AND NOf BE Lsaym To NODAL FF ELPF- REP. LDr T9 TO RAN 2C EV, 9-3D-FS APPROVED B/: PF.AmtlTiRD Etl91NEER9 RuaVEYORs LOTS 16-20 w
RMRMW 0 RXS UTA2 an =maw OR 9tlriF Oa TFIE RFL'ORDS wO MK "Mom AND OONSTRUCRON W =0oR HARDER AGREES TO RDA6ED RAN RORDIG l06 IB AKD 2Dym-
emm m. Tw ON4DFA¢RDte Ifa WA'E D TO TOY OK PRCGWFikIARY DUE" wDFA08Y AND HOD OESCH PROFESSO L HAIORESS FROM 1? RT'IL - s O E ... • A R AL 1 I/! ORIF. RUED %COC. • 5
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1 - - F.\67000\PG\PG-N 4-5-12
City of La Quinta'
Buui ng ar Safety Division
Permit # rn P.O. Box 1544, 78.495 Cage Tampico
u\ Ya Ql Rta, CA 922$3 - (760) 777-7 -12
oft V. `0•. Building, Permit Application and Trackin' eetSh `
.
X Project Address:`,!5IQbo'F la(Lt>1a FA
:ChiQUS [$ $
A. P. Number:
'2-()b-75 Dmf
Legal Description: S li.l (( mid : tit v E +(AContractor: ( dCO- GtZi7Z34
4 C `Lp_gb9-1t-1¢tb. `Ya
Andress t3 t -i S fa 12r
Project besctiplion: i c !I, Lt 1^GCl
4' City, ST. Zip L
-4 Tc1cP -76,D--C?,( 9 (t'I G °
hone:
C State Lic. # : "75095-7 .. `City Lic.
Arch., Engr., Designer: Mps t=s3tist a,,,
Address:,
City, ST. Zip: LQ _r7CA, Y
Tele b
• phone:_ ,, '•'a;hh:: ° ;':• _ ' , .
< Consttvctiop Type: Occup
State Lic.
Project type (circle one):,,e Add'n Alter
Repair Demo
emo
Name of Contact Person: recxy_
Sq. Ft.: # Stories: q Units:
Telephone b of Contact Pcrson: 'j 60 • -q (A .•kms ' Estimated Value of Project: '7 cOz)ro _ CO
APPLICANT: DO NOT WRITE BELOW THjUNE
r p Submittal t Req'd .; Rtc'd r
a PERMIT FEE$
. TRACKING: p>
Play Sets , . • • 'Plan Check subptitud `
Amount
Structural Cities. Reviewed. ready for corrections
tk Deposit
Truss'Calm Called (:oolact Person
ek Salaoce
Tide 34 Cales. Plans picked up
tiop
Flood plain plan.Plans resubmittedcal
Gr>tding piRq 2".Arvie.w; ready for'coirections/issere'"j '
Flfctrint
Subcoamctor Liar' t t Called Contact person
Plumbing
Grant Deed'
Ptani picked up` . S -AU
` II O A. Approval Plan
- s resubmitted
Grading „• , .. k..
IW ''ltevitw, ready for corrections/issue ' ' '
De 'eluper lippaet Fee
Approl`_!
` Called Contact +
et Peron A,I:P.P.
Pu E, Wks. Appr Date of permit pe issue ,.
School
' Tuts) "Permii_Fccs
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