12-0909 (RER)A - ,T
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1-2-_;00;0.0' 0'9;0'9_'
Property Address: 78-670 SAGUARO DR
APN:. 646-312-034-84 =000000-
4plication description: REMODEL - RESIDENTIAL,
Property Zoning: MEDIUM DENSITY RES
Application valuation: 5850.
r, '
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury, that I am licensed under provisions of Chapter's (commencing with
Section 7000) of Division 3 of the Business'and Professionals•Code, and.my License.is in full:force and effect.
.License Class: •B C10 License No:: 909599 '
` ADECLARATIO1
ate. :ontractor:OWNER-BUILDE
I'hereby affirm under penalty of'perjury that.1 am exempt from the.Contractor'sStatb.License Law.for the _
�•'� following reason' (Sec. 7031.5, Businessand Professions Code: Any city.or county that. requires a Permit to
t construct; alter,.improve, demolish, -or repair -any sfructure,'prior to itszissuance, also requires the applican6or 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•thebasis for,the alleged exemption. Any violation of Section 7,031.5 by
any applicanI 6-a. permit subjects the applicant -to a civil penalty o 'not more than -five hundredAoIWs:(S500).: '
as owner.of-the property„or my employees with wages; astheirsole compensation ,will do the work, and t�
the structure isnot intended or offered for sale (Sec., .7044, Business and. Professions�Coda: The
Contractors' State License Law does nof'apply to an owner of property whoibuilds or improves thereon,
and who does the;work himself or herself- through his or her''own employeei, provided that the`
improvements are`,not intended or. offered for sale... If, however; the building or improvement is sold within
one'year'of:completion, tne�owner-builder will have'the`aiurde'n of proving that he or she did not build or
improve for the purpose of.salejf
(_ 1 1, 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
°P pursuant to the' Contractors' State'License Law.).
(_) 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.I.
Lender's Name:
Lender's Address:'
LQPERMIT
Owner:
AI LIN YU
78670 SAGUARO DRIVE
LA QUINTA; CA 92253
Contractor:
UNDER CONSTRUCTION
15500 BUBBLING WELLS -R(
DESERT HOT SPRINGS, CA
(760)972-7721
LiC. No.: 909599
----------------------
WORKER'S COMPENS
hereby. affirm under penalty of perjury one of the following d
have and will maintain a certificate of consent t,
for:6y.Se6tlon 3700 of the Labor Code,,forth
issued..
I have and Will maintain workers',compans6tion insurance, as required. by -Section 37009! the Labor
Code for the performance of.the work -.for which this permit is issued. My workers' compensation
.insurance carrier an&policy;number are:
Carrier EXEMPT. ” Policy Number EXEMPT
IEWY—certify that, in the performance of the wo�k'.for which this permit is issued; V shall not employ.any
person in any,mannerso-as -to become subject mihe workers' compensation laws of.Califoka,
and agree the t,'if,l should become subject to the, workers'.compensation'provisioi s of. Section
_ 3%700. of tFie'Labor C de41-Ee with comply with,th se provisions.
at l P cant:
WARNING: FAIL RE TO SECURE ORKERS' COMPENSATION CO , - AGE IS UNLAWFUL AND SHALL
SUBJECT AN:EMPLOYER TO CRIMINAL PENALTIES•AND CAVIL FIN ES�UP TO`ONEHUNDRED'THOUSAND
i DOLLARS ($100,000).; I'N 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 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 that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of th. co1111u'''�n1111ty to ����enter upon the above-mentioned prop y for inspection purposes. •�
/Clat� Sig ura (Applicant or Agent): \
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
LQPERMIT
Application Number . . . . . 12-00000909
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . 81.00 Plan Check Fee
52.65
Issue Date . . . . Valuation . . . .
5850
Expiration- Date 2/09/13
Qty Unit Charge Per
Extension .
BASE FEE
45.00
4.00 9.0000 THOU. BLDG 21*001-25,000
36.00
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- -----------------Special Notes and Comments
Special
30, L:F. GARDEN WALL,. 69:5 L.:F. COMBO
_5'
WALL 1'41 RETAINING,, 6'-GARDEN,.138:5'
L:F: 5'5", ALL CITY STANDARD 2010
-----CODES. ^
------.---------------------------- a _
/ -L-- -------
--
Other. Fees .. . . . . . . . BLDG STDS ADMIN,.,(SB1473)
1.Q.0
ENERGY.`REVIEW FEE'..
5.27:.
STRONG MOTION .'(SMI) - RES
.59'
Fee summary Charged Paid Credited
Due`:
.. - - -- --- ----------
Permit Tee Total' 81:00 81.00 .00
.00
Plan Check Total; 52.65 52.65, too',
:`00:
oEher_Fee Total 6.861 6:86 .00
.00;
Grand, Total 140.'51 140.51 .00
. 00 -,
New LAIc, 11 r
t ADJ RE -S S -- 18 -� C S C RO _RD LA