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12-1010 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: f 12-00001010 , Property Address: 77511 CALLE ARROBA APN: 774-155-022-2 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 2500 Tlu4t 4 e(P Q" Applicant: Architect or Engineer: aaKVt- �.JA- ------------------ LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT • BUILDING PERMIT 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: License No.: 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 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.). 1 I 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 there o contracts for the projects with a contractor's) licensed pursuant to the Contractors' StaS icense Law -.I (_ I I am exempt under Sec. /, B.&PPrfor thi eason i )k Dater — Y — CONSTRUCTIO -LENDING AGENCY I hereby affirm under penalty of perjury tha there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: RICHARD VARGE 51320 AVENIDA RUBIO LA QUINTA, CA 92253 ------------------------ Contractor: Owner VOICE (7&7 - FAX (76 INSPECTIONS (760) 777-7153 Date: 9/04/12 p � u SEP 04 2012 CITY OF LA QUINTA ----------------------------------------------- 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 / Policy Number I certify that, in the perfor >,ec', for which this permit is issued, I shall not employ any person in any ma so as to bject to the workers' compensation laws of California, and agree th , i I should be to )he workers' co��9PPensation v ions of Section 3700 of Labor Code, all forthwith Amply with thosq( rovisio Y�f 7i>applicant: WARNING: FAILURE TO SECURE WOR RS' COMPENSATION RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES 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 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 tha a above info r ation is correct. I agree to cnmnly with all city and county ordinances and state laws reletino buil ' g co uction orize re esentatives of this county to enter upon the above -menti d prope r i purposes. DIF _ L — Zbignature (Applicant or Agen . If - Application Number . . . . . 12-00001010 Permit WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date . . . . Valuation 2500 Expiration Date . . 3/03/13 Qty Unit Charge Per Extension. BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ---------------------------------------------------------------------------- Special Notes and Comments 100LF OF 6' GARDEN WALL AT SOUTH PL [ORCO SPEC] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2010 CALIFORNIA - BUILDING CODES. September 4, 2012 9:07:13 AM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited --------------------------------------------------------- ' Due Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 55.00 .00 .00 55.00 LQPERMIT - 9 CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTI N DA I Q CALLE ARROBA AWMOA MMOON AVEN Dk CARRANZA, � - I I ITTTTM w 0 zill p� A.V.N.: 6 AMMS, 71411 - LA OWOA, CAAI7 LEOAL L T/1 M.B.*2=4 LW22 Q Z m g � a � Q w �Q mpS zi Bin. #Qty Of La Quihta Building &r SafetyDivision P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # 12 . ford Project Address: / Owner's Name:. e. A. P. Number. 7 7 Lf - l ,S ,5 - o 2-2 _ S Address: 17 7 - 5-11 Legal Description: e ?�:F/ IAID ?8 O ;7- tk,�k 2-2 City, ST, Zip: 2S 3 !4 to sJ j} r� T C Contactor. © Lo N [- po— Telephone 5 -iso • Z7 2- e_ L F Address � j / 3 7� (� Project Description: City, ST, Zip: -C Telephonesyo-272-11 G 9% ? si c S♦t�a�[te Lic. : City Lic. #, p# ir., Designer. Address: City., ST, Zip: Telephone: Construction Type:6 Q e- p Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: S ` O . -?-7 Z— li G %�J Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE It Submittal Plgn Sets Req'd Recd TRACMG Plan Check submitted PERMIT FEES item Amount Structural Cairn. Reviewed, ready for corrections Plan Check Deposit. . Truss Cala. Called Contact Person Plan Check Balance_ Mde 24 Calc#. Plans picked up Contraction Flood plain plan Pians resubmitted Mechanical Grading plan 2'' Review, ready for correctioa4asue Electrical Subeontector List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plan resubmitted Grading IN HOUSE:- 3" Review, ready for correetionstissue Developer Impact Fee Pbtnolug Approval. Ca1Rd Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees