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13-1620 (BLCK)P.O. BOX 1504 C&t�l 4 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 13-00001620 Owner: Property Address: 53630 AVENIDA CARRANZA RW REAL ESTATE, INC. APN: 774-121-007-18 -000000-. P.O.BOX 447 Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL (760) 619-7611 Application valuation: 750 Contractor: Applicant: Architect or Engineer: HUITRON CONSTRUCTION 50427 RICO COURT i/ (� CJ � COACHELLA, CA 92236 (760)398-3227 Lic. No.: 926190 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/16/13 ID r 6 2013 CITY OF LA QUINTA FINANCE DEPT. ------------------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perju'A that I am licensed rider provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Ness and Professio als Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Ys License Class: BI�� Lice se No.: 926190 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is (//IV -�� issued. Date:/ Z -ISP 3 Contracto _ 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 OWNER -BUILDER DECLARATION insurance carrier and policy number are: 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0013718-2012 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in theIrr ance of the work f which this permit is issued, I shall not employ any rfle', construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any me as to become subj ct to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, isd be me subj t th workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the LabC I sj l forthwi i omp�y with those provisions. 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—) 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.). (_) 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. , BAP.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 WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLTO R OYER IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 01. DOLLARS ($100,00INA ITION 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 applicat becomes null and void if w rk is not commenced within 180 days from date of issuance of c permit, or cessation of wo k for 180 days will subject permit to cancellation. I certify that I have read this application and state that h ove i�nrrri,..tion is torr I agree o comply with all city and county ordinances and state laws relating to it g conctn, and her authon representatives of this county to enter upon the above-mentioned pro a or insltion purposes /1 ,_43 Signature (Applicant or Agei Application Number . . . . . 13-00001620 Permit . . . WALL/FENCE PERMIT 2013 Additional desc Permit Fee . . . . 47.19 Plan Check Fee .00 Issue Date Valuation . . . . 750 Expiration Date 6/14/14 Qty Unit Charge Per Extension 1.00 47.1900 LS MISC WALL, FIRST 100 LF 47.19 ---------------------------------------------------------------------------- Special Notes and Comments BLOCK WALL OCO STANDARDS 48" HT X 24 IN FT HT.ORCO SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2010 CBC ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, WALLS 60.06 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 47.19 .00 .00 47.19 Plan Check Total .00 .00 .00 .00 Other Fee Total 61.06 .00 .00 61.06 Grand Total 108.25 .00 .00 108.25 LQPERMIT # �. QI1rj/ Of Qultlta - Bulkrme Sc Safety Division . Permit # P.O. Box 1504,78-495 Calle Tampico La .Wena, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: b zil (Z, zl Y�Zs1 Ovmer's Name:. — �� i (� A. P. Number. Address: . Legal Description: City. ST, Zip: v - Contractor. q Telephone: Address: Project Description: City, ST, gym= Foo Telephone bA o State Lia # : Grty Lic. Arch., EV., Designer Address: City, ST. Zip: Telephone- Construction Type:. Occupancy: i State Lia M Project type (circle one): New Add n. Alter Repair Demo Name of Conte x Person a v o 4 Ft-.7Z 4 f n # Stories. #Units 4EsdmaW Telephone # of Contact Person o (=0 Value of Project: i APPLICAMI': DO NOT WRITE BELOW THIS UNE 0� . N Submittal Wd Ree'd TRACIMG PERMFEES. Plan Sete Plan Check submitted Item Amount Strgctuial Ca[es Reviewed, ready for corrections Pian Check Deposit • . Truss Cale. Called Contact Person Plan Check Balance. Tide 24 Cates. Plans picked up Constracdou • � _ .. _ .. mated . _....._rte_ ._._.._ .._. _ Giading plan - — 2'! Review, ready for correctioneiissue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up 5.M 1. H.O.A. Approval Plaus resubmitted Grading IN ROUSE'- ''` Review{ ready for correcdonsAssue Developer Impact Fee Planning Approval Called Coutact Person A.I.P.P. Pub. Wka. Appr Date of permit issue School Fees Total Permit Fees Ct �1 ��C��-�� X30 1O ��C��-�� X30