07-2904 (BLCK)P'J. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-ityl 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00002904 Owner:
Property Address: 53255 AVENIDA MENDOZA MICHAEL GARCIA
APN: 774-092-013-1 -000000= 7135 FOXCROFT ST
Application description: WALL/FENCE RIVERSIDE, CA 92506
Property Zoning: COVE RESIDENTIAL
Application valuation: 750
Applicant: Architect or Engineer:
e�,/ - d I A -
LICENSED CONTRACTOR'S DECLARATION
1 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 -C13 License No.: 634981
Date: Contractor:
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 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).:
(_) 1, 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—) I am exempt under Sec. , B.&P.C. for this reason 00
Vie:,( / Go ' o —7 , PT ner: /*—[ ---G
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the perfo ante of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
CORONEL CONSTRUCTIO
P.O. BOX 389 A
LA QUINTA, CA 92247
(760)564-4604
Lic. No.: 634981
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/06/07
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 MTE FUND Policy Number 0015999-2007
1 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 w ters' compensation provisions of Section
3700 of the Labor Code, I shall forth Rth compl ith those provisions.
.fd"ete: O%cant:
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.
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 gurppoon the above-mentioned property for inspec ' n pur es.
Da `�% Si ture (Applicant or Agent): aa��
,1
.i. ta
CIL}/ Of is Quin
Boiidtng Br Safety Dildsion
Permtt # P.O. Box 1504,78-495 Calle Tampico
.� La.QLdnta, CA 92253 (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: �� r1p0 �✓ Owner's Name:.
A P. Number. Address: f j
Legal Description: 6A_' City, ST, Zip—:&L �Mf1�ILA' %►� % /
Contractor. Telephone:
Address: Project Description: li !, V y 7 COX—
City, ST, Zip: % 'L YA✓ • �p�d� l
Telephone:
State Lic.# :
Matyc #: , `Q it.
Arch., Engr., Designer 4e..4 -A0 iws
i Address:
City, ST, Zip.
Telephone: Construction Type:. Occupancy:
State Lic. #: /' Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: �T'T 4, ! Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: %S - Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Req'd
Recd
TRACKIIVG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cala.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plana picked up
Construction
Flood plain plan
Pians resubmitted
Mechamw
Grading plan
2'! Review, ready for correctionsfcssue
Electrical V T ?
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S M,L
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
3" Review; ready for correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
11/14/2012 11:07 FAX
[a 002
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LOwt�nik%r if I aetl Ow propertyfor W" this PetWt b ,iMvd, l may bt brdd H&% for MYt or paaon' it#on attrAia by.nq subtwy art oww(s) dW remit UM any latent ootssbU06Oet de tb in tiro
wrOriaaeutship o4 tpct0otiila
9. 1 lbd I my obtain mace wormation revMft my Oblisadow as art',f0w ,K"6LM S� � iaMlwi
the Uahod Slat= Sahli Budom Admluistratiao, tbo Cali OIUI t N**Pco► of IS MOM Paye, 04 stye QUftsia
Divislnn of fudttatr'al Act W=w. I abo uedcastW 1 toy cooled the Califptoia Coats wre Stan L'teattea Doazd 1-
SM-321-CSLB (ZISZ) or www.cslb cL**v for Mt* information ebvut Rotund evuttactom.
�10. I no awwc of aed consort to as Owtttir$ulhtex Wldiag Permit alrpl'ted for in my uvat, and Understand lhtt t a® the
Ply -a-" � ".15 3 . CIODNA xtion a mY � m 9f� edd<cas;
11_ I same dt� ars do Party�Y and r%uci*W rtw i n iblo for slaw p gmattd ooe�tcuotiao "vW. I will %bide by a!1
L Hwa and n gWnq*n that �vae bwga 4hdlkm a well at etpploytxs.
�12.1 arrow to ba* as isar err of dib (ora inum iAdy of arty addldont; dafetitrar, OF CbPVW to may' Uf d3s I
vtprovided an thin fain Lacamd cootraAM aro mgulated by laws deaigtred to VOtact rho public. iEY*d "MU" whb
orb duos not bave a lieaaatt, dw Oeet wWW Satre Lioeoae Bo�od be m%bla 1t► araiR yo,a wim �Y tbartalai I&"
you may wntais w a reaalt of t cumoaint Ycror o* remedy adaitxt vulioewad CoubIMers ny M io vIvG OWL It i! abv
icWyoatbt for is ifa>t nntiaaoutid Ooatrioioraeeaploree 4dw h divideal oiler is b&W .rvrloog
on 7our POpm you mybe It M iittbiit: l.w *mgpt. if ym obt & a porosis at o+anaar8.itdet cab •tial+ to bba Qoaw�otv+s,
yod wd8 be Rig paalble for vetifft nboin or stet shoat C=&Kwa acv pnpeell► lioeatad sad ire dtates Ord* mss'
BOPre a buldiq petals ata Ire bn4"tam ant'be oemgleaod sad dgpad by the "O"M aWrcear'ad mUrs" to
tiro *Mq respowNt: fear b*vb ,/wt.perail. N*W,4 ,ems' qf *rmnrwV 0 1 A W's ttii>t0*AwM4lffw mfthwh04 K
eAcr vwf w oa Map"& a *0 41MW fr ropbiwl a ba prwsrrtal n#w rhos pt>tta& is finrwd to vw* dw pwfwv
Sigasimry vfproporty oww Dat:
Note: 77a follawt!r *Au dwrizadon Form is teplmd 0 be completed by Ad pr+nperty ower only wdewr daignadng
an #V ra of the property owner to applyfir a aonsuuction potash for the 0vmer+-Build—
FsoloditaS lite Notice to Property 0*ww. the Nowdon of WU& l uaderapuad is my porrotad c�pot++�Y'
! hereby anlhotir+e
the f0ftwing peraon(e) to as of my asaat(;) to apply tor. tin and tale the doatmeots Mccaa>;y to obtain go Ow WNAidar
Petals tar ray piojsa•
Soo" of Conrhacriott PH4WA (or�Dooiption of Work):
Project Lotation a G� Add=-
Naof A►rihmiaod Adtxit: Tal So
Nam
... A
AddrM of Audwrind Ag=t.
-T .—..�t deelsmu pity bf—Aii ry � aper F"Perty owner the GR—mw� oT vdter wioaiioW
iub urtica and ocriiiy its accuracy. Nott. c*y oflks orrrur's drfwr's Hawse. f+
accWabkt*th*agwmyiwrequind, bepremaehd Oho the permit is izu;vd to verO ilia prapa►h otwrer's slanadrn.
Property QwUWs Sipa.
d tM 'ON wdt�.ot Zl01 'tit 'AON
11/14/2012 11:07 FAX
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P.O. BOX 1504
LA QUINTA; CALIFORNIA 92247-1504
79-495 CALLF, TAMPico
LA QUINTA, CALIFORNIA 42253
[a001
BUILVING dt SAFETY DIMAItTMENT
PR,O RTY Q"E— !S P COAG
(760) 777-7012
]FAX (760) 177-7011
01sciosares & Forms for Owner-ft3ders ApplYW9 for ConstmedOp ftlnits
�P_QRTdNg'd �Q7,'L�t? PRQ�PR�t`Y��i� .
.}firI�mpatyOwner as the Vw- of the ,VmV0dY
AA. spplicatiol�FW 0 baiidl� been I�ubme'stsed in yoetc =WWdnY b 4j j
to MIM onn o of
va M* rMvi#ng You vdth as ale►W a0ldorand v Forw Y Y
p A ies 4adpm Ali dais you Ray impr by itty tldr pemdtt•it is cow m 60
0 we WE sot bw a bedl,Alles.Ptetmit "a 7 hove "04 mitis T W w of OR& mon'
sad r�etarned thin tom to eta at our o®dat adis m tedhiate . An agent of ft Oww c eXet"t'A# avlioe
Wen ym Ike pmpaty owner, obtain rho prior approval of ft pwniuiag authority,
t�d.md•i� a�mdFap�nas�fis�w•ei Y� poi�tand w ++�j dais ir,Jbnnar�+t• ,
1. 1 rmdasb�od a ftegeeetlt practice of unlieeegod puss is to have dw p vpm= y owner dbtain as " Uwas'BaiMW
�E peanit that etmAevusty implies dint The propaW ownet is pro Adin8 his or -her awn bihor sad POSY, L as
an (Terns'-Buddrx, uny be Meld (We and aobjed to sgioas twoodal risk On 4ny WimIcSMwAtwdby an unlpara°°
and by of her W%Aoym while wating on my ptuperty, 'W Wmawneer. iaaursnoo °say not ptovide coveir a fen Uloea
Wusim i am willFi* acW* sa an Owncr Deno and am:wa= of the Waits of any imume .=wage for wMics to woricrM
on mmy 0'-
2.1 undetstaad building permit$ aro not regaind to be signed by pwpwty owiens wnleas they » rWfi'te For the
constfucuon aid nae not hinag a hoeased ConuActor to ammo this ravomllit .
3.1=derette3d u an "Owner-Boiidtrc' I Ism dW tespbeaible party of re and an 160 pclmiL I undaxsteud that i may pmol
elf Eros° potential f5aapcial risk by hiring s Iiceaaod Ceatracwr sad havia eke pe>aoit 51ed in bin of Iter nao�e iaate.d of my
ONM
4. 1 understand Coatmaofa m required by Ism to be licensed and bonded in California and to list thou' liconse Eben on
-.t
pjwWB and contracts.
4�_ I tmdentand if I =ploy or is*erwiec evM0 any pttsoue. odd tbao California licensed CouUTAurt;, and the total value
p co=U=tioA is at least five handmd. dollars ($5o0), taaWding labor and materia* I may be c as wasploya"
under sate and Federal law,
fm6.1 vnde ra�ad if Iran coasiderod an "ompioyee aider pate mad &&Aid kw, 1=A megwW with d2c MWaid Federal
=mt, vvltbhold p*"U taxgs, lxavWc woiioer'S' compeiesmtion diaabilily iltsvatiiuco, oontribtele b uoepoploytntat
compca orlon for escle "omploym" i also Understand my feitwe to abide by these laws may subject me to Mia m 6mmntW
tisk.
40
�71understated ander Calit'oneia ContraclaW State Cicely L W, an Owmr-Buildm wet° builds sipgle-CamilY deuti><I
cannot-IegaUy build them with ttie int%t to efUr themes for sato, unlasa aft wodc is i>er bMwd. by lictcwd
nbcowsmors and the number of scree UMM does not txneal Four within soy calendar year, or aU of d w work is perfornk
under cowfact with a lk=sed generel building Contreator.
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
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CITY OF LA QUINA
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CITY OF LA QUINA
BUILDING & SAFETY DEp-i'
,. APPROVED,
OR CONSTRUCTION
DAT ' d % BY__ I
Bin #
City of La Quinta
Building & Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet ;.
Permit #P.O.
i Project Address:'S 3 Z 55
Owner's Name: w.cir" t "s,
A. P. Number: -7 -7 L-A . O 1 Z . d \
Address:
Legal Description:
Contractor:Co tt.u0, •cTelephone:'i5l
�.� �����
City, ST, Zip: ��_r �. 2 5b (e
3K `i6`5"
Address:
Project Description:
City, ST, Zip:
Telephone: 'j (.0 77 T, IT- 14*
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
W
Construction Type: Occupancy:
State Lic. V
Project type (circle one): New Add'n Alter Repair Demo
`
Name of Contact Person:
Sq. Ft.:
#Stories:
# Uriits:
Telephone # of Contact Person: '\'Sl• S "q -k• 1-- S -\
Estimated Value of Project:
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
2nd 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