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BLCK (07-2732)P.O. BOX 1504 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07-00002732 Owner: Property Address: 52486 AVENIDA MENDOZA TROVER RESIDENCE APN: 773-273-010-13 -000000- 52-486 AVENIDA MENDC Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL (760) 469-4842 Application valuation: 6350 Contractor: Applicant: Architect or Engineer: L & J MASONRY, INC. �� P.O. BOX 1172 1 LA QUINTA, CA 92247 `V (760)771-6873 Lic. No.: 809021 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. License Class: C29 / License No.: 809021 4Dati 1 �� - -Contractor: v OWNER -BUILDER DECLARATION 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 70001 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 1$5001.: (_ 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 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.l. (_ 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. , 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 10/09/07 OCT�9zoo� lD 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. 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 0025199-2007 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 co ly with those provisions. Date: (D/` Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. 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 prope inspection purposes. bate:la...y:. Signature (Applicant or Agent): l ��- i 4� Application Number . . . . . 07-00002732 Permit• . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 90.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 6350 Expiration Date 4/06/08 Qty. Unit Charge Per Extension BASE FEE 45.00 5.00 9.0000 THOU BLDG 2,001-25,000 45.00 ----------------------------------------- Special Notes and Comments ----------------------------------- 10OLN FT X 4FT HT 190LN FT X 6FT HT GARDEN WALLS PER ORCO STANDARDS AND APPROVRD PLANS Fee summary Charged ------------------------------------- Paid Credited -------------------- Due Permit Fee Total 90.00 .00 .00 90.00 Plan Check Total .00 .00 .00 .00 Grand Total 90.00 .00 .00 90.00 LQPERMIT 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 # Project Address: _ ��� AV, -FQCX52-A Owner's Name: 15 ux v A. P. Number:. Address:52 4 " Et) Z A Legal Description: City, ST, Zip: -A GQ..lO —A Z253 Contractor: Q� AA!S�N pyf I C_ Telephone: -I — 4g C4 a Address: p,�p,[ �'�Z Project Description: 4/ W64 City, ST, Zip: L-A, a LQ 0-7M. I C(A 9_2-v4-7 ISo Telephone:( -I( Z7 — -7 5 I State Lic. # : C g pct C) �;l, I City Lic. #: 3(_ 0153 Arch., Engr., Designer: Qfz,_-p C l SPAS A4,' II)T Address: City, ST, Zip: W.�$ Telephone: State Lic. #: Name of Contact Person: I fJ Construction Type: W O Occupancy: Project type (circle one): New . Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: —7 99 —5cC 4-4 Estimated Value of Project: Q APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. 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 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 P.O. BOX 1504 No. 15030 Building' 52-486 Ave. Mendoza 78-495 CALLE TAMPICO - Address LA QUINTA, CALIFORNIA 92253 Owner Hedges I ��:arl.es Address P.O. Box 2267 City Zip Tel. Indio, CA 92202 Contractor Alms Underground Constructs Add 39r�1s03 crista Dr. City Zip Tel.: Cathedral. Citi , CA 92234 324-191.1 State Lic. City & Classif. 482380 Lic. # 769 Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions ofyChapter 9 (commencing with Section 7000) of D Ion of the Business and Profess/ipfiM {pude, and my license is in full force and yjeffect. ef�� "I -,'i-1 •7�..% .✓Rif 5 SIGNATURE a 1 DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Sustness and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he 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 rive 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such 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 dM not build or improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and .Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) #tensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, labor Code.) Policy No..'� Company ffl;d5py is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any Parson in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT., N, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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. This is a building permit when properly filled out, signed and validated, and is.subject to expiration it work thereunder is suspended for 180 days. 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 city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip LDING: TYPE CONST. OCC. GRP.: P. Number Legal Description Project Description Selmer Connect Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ stimated Valuation . $1,980.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing 3 6.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 10.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from R�i� Line Side Street Setback f�j eSide Setback from Py FINAL DATE Issued by: Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE- DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB %/ FINAL INSP.. !/ d SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER VENTILATION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE I PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER R ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING. cu. yd. $ plus x$ _$ LUMBER GR.�� %/ FINAL INSP.. !/ d FRAMING FINAL INSP. f/ v ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL Remarks: Ks G.A. Code . S ' is �s"•av TOTAL S 9-�;) S • l G) ❑Copy to: 0WalerSe"Ic [n'h v7 Cashier 'CVWD-A3B(17189) - Received Fro Address: Account No. -? Add ress Service ❑ Meter(s) ' ❑ Service(s) ❑ Backflow(e) ❑ Housel.ateral(s) ❑ DetectorCheck(s) ❑ Meter Surcharge -Sanitation Capacity Charge _ S5 ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Tum on Charge ❑ Uncollected Account - Name - ❑ Inspection Fee - Tract - Fee - ❑ Plan Check Fees Water I Sewer - Tract - 0. Bond Payment - A.D. - Bond Assmt ❑ Customer Deposit , ❑ Other Remarks: Ks G.A. Code . S ' is �s"•av TOTAL S 9-�;) S • l G) ❑Copy to: 0WalerSe"Ic [n'h v7 Cashier 'CVWD-A3B(17189) - - CHUCK HCDGES 86-695 AVENUE 54, SUITE K COACHELLA, CALIFORNIA 92236 April 14, 1995. Coachella Valley Water Department Avenue 52 Coachella, Ca. 92236 To Whom It May Concern: Renee Brooks will be acting on my behalf with regards to the property at -52-486 Ave. Mendoza. Please issue her any piermits needed to update this property. Sincerely, Chuck Hodges