11-0439 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000439
Property Address:
52050 AVENIDA CARRANZA
APN:
773-221-001- -
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
4600
Applicant: Architect or Engineer:
•
��
VOICE (760) 777-7012 t 4 Xi& a
401-1,35,q-5.51,45-01 FAX(760)777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
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LICENSED TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am li nsed der provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of Business a P fessiona Code, and my License is in full force and effect.
Lic a Class: C27 ansa No.: 781250
/Date: Contractor:
r:
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 _ 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.).
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 penalt erjury hat there is a construction lending agency for the performance of the
work for which this pr't is is u ( c. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Date: 5/02/11
Owner:
CITY OF LA QUINTA
78495 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor:
z
i "
a.
DIAZ LANDSCAPE MA
FREDDIE
80360 AVE 43
J
; C�
INDIO, CA 92201
g�
LJ
(760)342-8124
l-ry(••-�
OYQ�:`LL,�Q-"--
Lic. No.: 781250C7
a
------------------
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.
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. orkers' compensation
insurance carrier and policy number are: .
Carrier GOLDEN EAGLE Policy umber 4006219417
I certify that, in the performance of the 1hich s mit is iss ed, I shall not employ any
person in any manner so as to beco aworke ' com nsatian laws of California,
and agree that, if I uld become lkers' co pen tion provisions of Section
of the Lab C e, I shall fo with those prov' ions.
ate• plicantWARNING: FAIL RE TO SECURE WORKERS' COMPEVERA I UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AES UP ONE HUNDRED THOUSAND
DOLLARS ($100,0001 IN ADDITION TO THE COST OF COMPENSATION, D MAGES 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 issu4e,
rmit, or cessation of work for 180 days I subject
permit to cancellation.
I certify that I have read this application and stae info all rect. I afire comply with all
city an ounty ordinances and state laws relatonstruction, nd here au ize representatives
oft county to e t r upon the above-mentionaction rposes.
Date: nature (Applicant or Ag
Application Number . . . . 11-00000439
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 72.00 Plan Check Fee
.00
Issue Date . . .
. Valuation . . .
. 4600
Expiration Date
10/29/11
Qty Unit Charge
Per
Extension
BASE FEE
45.00
3.00 9.0000
THOU BLDG 2,001-25,000
27.00
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Special Notes and
Comments
184 L.F. 6' GARDEN
WALL, CITY STANDARD.
2010 CODES.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total
72.00 .00 .00
72.00
Plan Check Total
.00 .00 .00
.00
Other Fee Total
1.00 .00 .00
1.00
Grand Total
73.00 .00 1. .00
73.00
LQPEPMIT
Apr 04 11 04:40p
FREDDIE DIAZ LANDSCAPE
MAINTENANCE
80-360 AVE 43
1NDIO, CA 92201
( 760) 342-8124 Fax (760) 342-7412
Contractors License #781250
Name /Address
CITY OF LA QUNTA
78495 CALLE TAMPICO
LA QUINTA, CA 92253
P.3
Estimate
Date Estimate #
4/1/2011 1 609
Project
Q Description !
Qty
Cost I
Total
52-96 AVCNIDA CARANZA LA QUINTA
184LF x. 611 BLOCK WALL WITH 6 x8'xI6" TAN PRECISION
184
44.00
8,096.00
BLOCK i
1
1
p
6
.
z4 q /t �
Total $8,0%.00
Rj) A .ham
4a/- iAsY-ss i. vs-oI
Bin #
Cit/ Of la Quinta
Building 8T 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: o) _ d Owner's Name:,
A. P. Number: Address:
Legal Description: City, ST, Zip:
Contractor: n
,y:'s:
Address:: Project Description:
City, ST, Zip: C I _
Telephone:
is i:::: i. •v}'lvn::: :;:. :::. :.
State Lie. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
'::<}:i'ly:.::::?:::i:CiL'; i• •.:L •:v,: <:%':::iii::::
f:: nom:>:<>:>:::;::.;:,:;::;;:;:: Construction Type: Occupancy:
;;<r.;...::;::r;;!•.;:.::.;;:> :»^% ' :> Project type (circle one): New Add'n Alter Repair Demo
State Lie. #:
Name of Contact Person: Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Title 24 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