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10-0048 (BLCK)P.O. hOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000048 Property Address: 77933 CALLE COLIMA APN: 774-134-012-2 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 6495 I BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ACKERMAN TERRY 77933 CALLE COLIMA LA QUINTA, CA 92253 Contractor: ' Applicant: Architect or Engineer: GUTIERREZ MASONRY/CONRETE, 31695 AVENIDA DEL PADRE DIU CATHEDRAL CITY, CA 92234 (760)770-3388 A 4 Lic. No.: 725297 CENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjur t t I m lic nsed under ovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the B i ss d P ssionals de, and my, cense is in full force and effect. LicenseClass: ]C8 -C29 e Date1 ' � � ` Cont racto " 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 ($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. , 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: LQPER111IT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/19/10 WORKER'S COMPENSATION DECLARATION 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. My workers' compensation insurance carrier and policy number are: Carrier STATE FUND Policy Number WS100322501 _ I certify that, in tAperforfof the work for which this permit is issued, I shall not employ any person in any e ome jest to the rkers' compe ation laws of California, and agree thate sub' t to thew rs' compens n provisions of Section 3700 of the Lforth ith comply rhos3 DatJ 0 ApplicanWARNING:FAILURETO SEC COMPENSATION COVERAGE IS UNLAWFUL, D HALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 s null and void if work is not commenced within 180 days from date of issuance of s perm' , or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that t e ab e i r Jonec' Iagrecomplywithall city and county ordinances and state laws relating to bu di co tr obs autho representativesof thisscountttyy to antter upon the above-mentionedgrape f sp ion Date( `�'l ` T �✓ Signature (Applicant or Agent Application Number . . . . . 10-00000048 Permit . . . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 90.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 6495 Expiration Date 7/18/10 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 300 LN FT X 5 FT HT GARDEN BLOCK WALL PER CITY STANDARDS & APPROVED PLANS. APPROVED PER K.K. = ----------------------------- Other Fees . . . ---------------------------------------------- . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary ----------------- Charged Paid -------------------- Credited -------------------- Due Permit Fee Total 90.00 .00 .00 90.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 91.00 .00 .00 91.00 LQPERMIT Sin # Cit}/ Of La Q uin to Building t- Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # o ' Project Address: Owner's Name: -/ A. P. Number: v �J O/� Address: 7/ 3 ` e7�js�� Legal Description: City, ST, Zip: P' . 4::!�2 0v/ Contractor: �• .y� 7' Tel hone: Address:Ab 7 AV-e C(49 Project Description: City, ST, Telephone: State Lic. # :-72-S Zq7 City Lic. #•: ' Arch., Engr., Designer: Address: City, ST, Zip: Telephone: ; Construction T an State Lic. #: �>' '""` Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. FL: . DD a # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Plan Sets Req'd Recd TRACKING PERMIT FEES Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Coles. 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 correction0i sue Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.OA. 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 111 E CALLE IMA i 0° -01 20'-V I-)1 -011 i a,-0H nl z w TH15 FLAN 5U5`11TTED FO� �LO�K WA LL FEifi �N�Y N 0 C%TN�fR UjofR< TO 5E INCLUDED_ a] PROGRESSIVE DESIGN CONCEPTS - Architectural Design • Residential and Cornniei°ciai • Planning and Development 78-115 Calle Estado, Ste, 105 La Quinta, CA 92253 Office (760) 554-4707 Fax (760) 564-49 www.swconcepts.com PROJECT TITLE AdditionAddition& Remodel for Terry Ackerman 77933 Calle Colima La Quintal CA 92253 AX.N.: 774-134-012 Date/ Description Number f I Drawn By Approved By Project Manager Date: 1 /13/2010 51TE-FLAN SCALE: 1/8" =1' - m"