13-1211 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
c&t�v 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
13-00001211 , �
57656 SALIDA DEL SOL Lo of
'5
762-240-014-55 -34243 -
WALL/FENCE
RL AG/EQ OVERLAY
4664
r
Architect or Engineer: D
LICENSED CONTRACTOR'S DEI
•1 herebyaffirm under enalt of a r that l am.licensedunder io isions
P Y p Y P,
Section?pp001 Division 3 of the mess'and Professionals Code,•and'n
License Class' _ _ Cicense.N..:
1`111V VLa UEPT. -
R ON
Chap 9 Itomm nen 'wi h I hereby aaffirm
.icense in full force•a nd effect. f
9219
'Date' Contrtor: -
_ v.� OW R-BUILDERMECLARATION '
.., � l hereby affirm under penalty of perjury the ;I am a rnpUfrom4he,Contractor's?State .Lice a Law'for the
following.reason (Sec.'7031 .5, Business a Profes 'ons'Cod6. Anp city or•'county that quires a permit to
construct, alter, improve, demolish, or rep r any strut ;.prior to its issuarice,al- - quires the applicant for the
permit to file a signed statement that he orshe is licensed p ions 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).:
I, as owner of. the property, or my employees with wages as their. sole compensation, will do the work, and
the structure is notintended &,offered forsale fSec:'7044; Business and Professions Code:. The.•
Contractors' Statelicense Law does;not applyto anjowner of property who builds or improves thereon,
and who does the work himself or herself through his ocher own employees,'provided that the
impro3ements, are not intended or offered for sale._ If; h6vever, the building or. improvement is`sold within
• oneyear of completion;,theowner-builder will have the burden of, proving that.he or she did•not build or
improve.for the purpose,of sale.)..
1 _ 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 anowner 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:
LQPERMIT
Carrier
Owner:
MADISON 58TH LA QUINTA, LLC
1282 PACIFIC OAKS PLACE
ESCONDIDO, CA 92,029
Contractor:
TA VERDE BUILDERS, INC.
05 HIGHWAY 111, SUITE G
CHO MIRAGE,.,CA,92270
TC(6�.
0)776-1111
:.,No. : 969219
J
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/24/13
WORKER'S COMPENSATIONDECLARATION
der penalty of perjury one of the following declarations:r'' '
and,will maintain a certificate of, consent,to self -insure for workers' compensation, as provided
r by Section 3700. of the Labor Code, for. the performance of the work for which this permit is
'i
and will maint n wiorkers' compensation insurance, as required by Section 3700 ofihe�Labor '
xde .for.the perf rmance of the work for which this pi rmit'is issued My,`workers',compensation
urance carrier a d policy number are: -
FUND Policy Number 9006140 '
ifthet, in the per ante of the'
ywork for which thisper 'ssued, I --shall not employ any
person.in any manner o as to become subject to thew ers' comp ation laws of California,
and agree that, if I sh .become subject to the workdrrrs' compensation, rovisions of Section
.� 317106 of the Labor C e, shall forthwith comply w'th.th ro -'errs.
alt 01�ca�nt.
WARNING: FAILURE TO SECURE WORKER ' CONIPENSATI COVERAGE IS UNLAWFUL, A SHALU
SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES`AND•C IL FINES UP TO ONE HUNDRED HOUSANO
DOLLARS ($100;0001.. IN ADDITION TO E COST OF CO PENSATION, DAMAGES AS VIDED FOR.IN
SECTION 3706 OF THE LABOR. CODE, INTEREST, AND ATT EY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application ishereby made to the Director of Building'and Safety for a permit subject to the
conditions and restrictions"set forth on this, application.
1 . - Each person"upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed;under•or following is$ a ce of this permit.
2. Any.permit.issued as a result oft 'application becomes null and void if work is not commenced
Within 180,days from date of issu 'ce of such permit, or cessation of work for 180 days will subject
permit to cancellation. - -�
I certify hat I have read this application and state at the above information is correct. I agr to comply with all
city and count ordinances and state laws relating building construction, and orifi co
of t ' c tyy a ter upon the above-mentioned r erty for inspection p -"
S40 00"
Date ,'� V Signat�ppli" cant or Agent):
-4i
Application Number . . . . . 13-00001211
Permit WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee . . . . 61.49 Plan Check Fee
- .00
Issue Date . . . . Valuation . . .
. 4664
Expiration Date 3/23/14
Qty Unit Charge Per
Extension
.1.00 47.190.0 LS MISC WALL, FIRST 100 LF
47.19.
1.00 14.3000. EA MISC WALL, ADDL 50 LF
14..30
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-.- Special Notes and -Comments -
BLOCK WALL - 106 LF OF 6 ft. HIGH GARDEN
WALL ON.NORTH PROPERTY LINE (DIFFERENCE. .
SPLIT BETWEEN NEIGHBORING PROPERTY)"AND 5
FT HIGH' <FRONT,'. FACING :WALLS [PER
' ATTACHED APPROVED ,PLAN.& ORCO
SPECIFICATIONS:],,PRECISION CONCRETE BLOCK
SHALL`-BE•COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING, WHERE VISIBLE FROM
OUTSIDE THE PROPERTY.' -201,0 CAALIFORNIA
BUILDING CODES,':
-- - - - - - - - - - ---- - - ---
.Other Fees • . . . .' . . . BLDG STDSIADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.06
Fee:.summary. Charged Paid Credited :.
j.Per[nt
Due
.:Fee Total 61.49 00 0.0: '
61.49
. P1ari:Check Total •00 .00 0"0"
.;00
Other Fee Total 61`.=06 00 .00
61:•.06
Gr --and Total 122.55 .00 .00
122.55
LQPERMIT