13-0315 (BLCK)P 6.''I k 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
t,oFr�QAcV7tiA/L-
13-00000315
57695 SALIDA DEL SOL
762-240-014-47 -34243
WALL/FENCE
RL AG/EQ OVERLAY.
4250
Tait 4 $Cka= VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 4/01/13
Owner:
ALTA VERDE CORAL MOUNTAIN, LLC
315 S BEVERLY DR 208
BEVERLY HILLS, CA 90212
Contractor:
Architect or Engineer- ALTA VERDE BUILDERS, INC.
7.1905 HIGHWAY 111, SUITE G
RANCHO MIRAGE,' CA 92270
NA, (760)776-1111
Lic. No.: 969219
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UCENSED.CONTRACTOR'S DECLARATION
I hereby affirm under. penalty -of p jury that.1 am licensed un provisions of Chapter 9 (commencing with
section 7000) of Division 3 of theusiness and Professionals C and my.License is in full force and effect.
License la's :''B License .i 969219
XDate. LI Contractor:
OWNEA-BUIL R DECLARATI N
I hereby affirm under penalty of perjury t at I am exempt from Contra' s State License Law for the
. following reason'(Sec..7031'.5, Business nd Professions Code: Any.city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to itsissuance, 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 ofnotmore 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 saleAec. 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 of 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 orimproves thereon, and who contracts for the projects with a contractorls) licensed
pursuant to the Contractors' State License Law.).
(_) 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
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one pi the following declarations:
.I have and will maintain a certificate'ofconsent to self-insure•for workersl•compensatiori, as provided.
for by Section 3700 of the Labor Code,for. the performanceof the work for which this permit is
issued ;
I have and will'rimaintain 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 -.9006140
I certify that, in the p formance of the work for whichthis-permit is issued,.I shall not employ any'
person in any man er so as to become subjecmo the workers' compensation laws of California,
and agree that, if I. Id become subject to fha Impensation provisions of'Section
3700 of the Labor C - e, I shall forthwith co iy those rovisionS.
Dater • t ( Applicant: -
r• t
WARNING: FAILURE TO SECURE�WORI. RS' COMPENSATION OVERAGE UNLAWFUL,�.AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES'ANO CIVIL.F0 ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATIbW',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 restrictionsset 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 issuan a of such permit, or cessatio ork for 180 days will subject
permit to cancellation.
I certify that I have read this application and state th t the above information is co ect. gree to comply with all
city and cour y ordinances and state laws relating uilding construction, an re y aut rize representatives
of this c unt to enter upon the above-mentioned oy for inspection p pos
Date: l Signature (Applicant or Agent):
Application Number . . . . 13-00000315
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 72.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 4250
Expiration Date 9/28/13
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001-25,000
27.00
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Special Notes and Comments
120LF OF 6' GARDEN BLOCK WALL AT NORTH
PROPERTY LINE AND HOUSE RETURNS (ORCO
SPECIFICATIONS] 2010 CALIFORNIA BUILDING
CODES.
April 1, 2013 9:03:39 AM AORTEGA
--------------------------------------------------------------=-------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 72.00 .00
.00
72.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 .00
.00
1.00
Grand Total 73.00. .00
.00
73.00
LQPERMIT