14-0298 (BLCK)t
Y'
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
A, pplication Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:.
Applicant:
14- 00000298
80792 CASTILLO DEL AREANA
762-240-014-24 -34243 -
WALL/FENCE
RL AG/EQ OVERLAY
3000
Architect or Engineer:
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LICENSEDCONTRACTOR'S DECLARATION,
4
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/24/14
I hereby _ff_irm der penalty of perjury 't l am' licensed under provislons.of Chapter 9 (commencing with
Section 000) Division 3 of the Busin s nd Professionals Code my_Ltcen si 11 force and affect.
Ueense lass: Lice No 969219
Date. Contractor:
wNER-BUILDER D ON
I hereby affirm under penalty of perjury that) am xempt from th- ontractof's,Stat 'Law for the
following reason (Sec. 7031.5, Business and Pr
ass
Code: ny c that requires a permit to
construct, alter, Improve, demolish, or repair any structure, prior 4o, s Issuance, also requires the applicant for the
permit:mfile a signed,statement.that he or.she"is licensed pursuant to the provisions of:ihe Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 o the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the aileged'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 (8500).:
(_) 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 notapply 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 orimprovement 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 contractorsto.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 comractor(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
1 hereby affirm under penalty of perjury -that there is 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:
LQPERMrf
Owner:
AV CONSTRUCTION
71-905 HWY 111'#G
LA QUINTA, CA 92253 D
4"
Contractor: N 2011,
ALTA VERDE BUILDERS I
71905 HIGHWAY 111, UITE CITYOFLAQUINT� I
RANCHO MIRAGE, CA 9 FIfVANrvP U PT.
(7601)776-1111
Lic. NO.: 969219
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 ofthe 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 per tirm� ee of the work forwhich this permit is issued. My workers' compensation.
insurance carrier nd p it number are:
Carrier, STATE FQND Policy Number 9006140
_ 1 certify that, in the p rm oe of the work for which this permit is issued, I. shall not employ any
person in any mann r to becomesubject to the workers' compensation laws of.California,
and agree that, if. 1 ou becom_ a subject to the "workers' ompensation.provislons of Section
2 `3700 of Me LaborC a 11 forthwith comply wi til- ovisions.
Data: • t`� Applicant:
WARNI : FAILURE TO SECURE. WORKERS'' MPENSATION COV AGE IS UNLAWF , AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA IES AND CIVIL FI S UP TO ONE HUND D THOUSAND
DOLLARS (8100,000). IN ADDITION TO THE OST OF COM SATION; DAMAGES A ROVIDED.FOR IN
SECTION 3708 OF THE LABOR CODE, INTER , AND ATTO E'S FEES.
IMPORTANT Application is hereby made to the Director of BuildTi CT fdSefety 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 pursuantto any permit'issued as a result of this application„
the owner, and the applicant, each agrees to,.and shall defend, indemnify and hold ha'rmless: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 permh.
2. Any permit issued as a result his application becomes null and void it work is not commenced
within 180 days from date of i7state
ch permit,�or cessation of work for 180 days will subject
permit to cancellation.
I cert that have read tfiis application and hove informationis correct. 1: nee to comply
all
city a cou ,ordinances and state laws reildi construction, and hereby or repr as
oft c (n410terupon:the above mentoned,pr art o nspectionpurposes.
Dat .Signature (Applicant or Agent):
r 4
Application Number . . . . . 14-00000298
Permit. . . . WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee . . . 61.49 Plan Check Fee
.00
Issue Date . . Valuation . . .
. 3060
Expiration Date . 9/20/14
Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
1.00 14.3000 EA MISC WALL, ADDL 50 LF
14.3,0
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Special Notes and Comments
120 IN FT X 6 FT HT BLOCK WALL LOT 24
PER APPROVED PLANS[ORCO SPECIFICATIONS]
PRECISION CONCRETE BLOCK SHALL BE
COVERED WITH STUCCO, PAINT, OR TEXTURED
COATING WHERE VISIBLE FROM OUTSIDE THE
PROPERTY. 2013CBC. CODES.
-----------------.-.--------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.66
Fee summary Charged Paid Credited
Due
Permit Fee Total 61.49 .00 .00
61.49
Plan Check Total .00 .00 .00
.00
Other Fee Total 61.06 .00 .00
61.06
Grand Total 122.55 .00 .00
122.55
LQPERMIT