13-0447 (BLCK)r P:O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
`4KT4/K�
13-00000447
57743 SALIDA DEL SOL
762-240-014-45 -34243
WALL/FENCE
RL AG/EQ OVERLAY
2250
I hereby affirm under penalty of perju
Section 000 of Division 3 of the -Br
License Vlassi
((. B 1
Date: • Contractor:..
TWyl 4 r7N
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
WA
CENSED CONTRACTOR'S DECATION
Iamlicensed .under. provisionsofC tar
9.(commencing with
and Professionals Code, a m Licens in full force and effect.
Licen N 921
� _ ,+ OWNER -BUILDER DE RATION,. '
I hereby affirm under penalty of perjury that am exempt from the ontractor's-Sta cense Law for the
following reason (Sec. 7031 .5, Business and Professions Code: ny city, or y that requires a permit.to
construct, alter, improve, demolish, or repair any.mructure,,prior t Dance, 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)•6f'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 (55001.:
1 _ 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 whotdoes the work himself or herself through hisor her own employees; provided•tkat•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 didnotbuild or
improve for the purpose of sale.).
(_ 1 I, asownerof 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 _ 1 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.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
AV CONSTRUCTION LLC
71905 HIGHWAY 111 #G
RANCHO•MIRAGE, CA 92270
(760)776-1111
Contractor:' .
ALTA VERDE -BUILDERS, INC.
71905 HIGHWAY 111, SUITE G
RANCHO MIRAGE, CA 92270
(760)776-1111
Lic. No.: 969219
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/18/13
-----=----------------------------------------—
WORKER'S COMPENSATION DECLARATION
`'Ihereby 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.!oi which this permit is
issued.
Lhave 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. 9006140
certify that, in t .performance of the work for which this permit is issued, I shall not employ any
person in any n rso as to become subject to th workers' compensation laws of California,
and agree that, i I s ould•become subject to the wor rs' compensation provisions of Section
3700 of the Lab C a;YI shall forthwith comply with ose provisions.
Dater ` `'� - Applicant:
WARNING: FAILURE TO SECURE R_KERS' COMPENSATION CO gbGES'
FUL, AND SHALL
SUBJECT AN EMPLOYER TO,CRIMI L PENALTIES AND.CIVIL F ESUNDRED THOUSAND
.-.DOLLARS (S100,0001. IN ADDITIO TO THE COST OF COMP SATAS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTO IN
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 issues a result of this application becomes -n II a void if work is not commenced
within 180 days from date of issuance of such permit, or cessati of work for 180'days will subject
per it to cane)) ,.n.
I certify t at I h ve read this a icati n and state that the above inform - ion is cor ct. I agree to comply with all
city and unty rdinances and to aws relating to building co99SStt ctio , and here authorize representatives
of his c �t�-j /e/,p r upon the bo -menti ned property for 'fispect' urposes.
Date: jy/ " �ignature (Applica or Agent):
�. Application Number . . . . . 13-00000447
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 54.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 2250
Expiration Date . . 10/07/13
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and Comments
BLACK WALL PER ORCO STANDARDS & APPROVED
PLANS. 90 LN FT X 6 FT HT.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
-----------------------------------------------
Permit Fee Total 54.00 54.00
----------
.00
.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 1.00
.00
.00
Grand Total 55.00 55.00
.00
.00
LQPERMIT
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: �"13 �OVOAt
Owner:
Property Address: L 7.5.0ENU "AM- .tao-L e4l& ' * AV CONSTRUCTION LLC
APN: 7-62-2-t - -34243 71905 HIGHWAY 111 #G
Application description: WALL/FENCE RANCHO MIRAGE, CA 92270
Property Zoning: RL'AG/EQ OVERLAY 1 ,t2 (760)7.76-1111
Application valuation: 2250 ' 7
Applicant:'
C6
Architect or Engineer:
LICENSED CONTRACTDECLARATION
I hereby affirm under penalty of per ry that I am licensed under provision
E=AT"
9 (commencing with
Sectio 00) of Division 3 of t66 iness and Professionals. Code, and my 'cense is in full force and effect.
Licens I s 'B ` Li o 6 19
Contractor..
OWNER-BUI R DECLARATION
I hereby ffirm nder penalty of perjury t t I am exempt I m;the Contractor's ate License Law for the
following reason (Sec.*7031 .5; Business and;Professions" ode: Any city or,c rity that requires a permit to
construct,'altar, improve, demolish„or repair: any structur ;,prior to its iss ce, also requires the,appljcant for the
permit to .file a signed statement, that he or she is licensed rsua a provisions of the Contractor's State
License* Law (Chapter 9 (commencing with Section?7000) of•Drirision 3 of'the Business and Professions Code) or
that he or she is exempt therefrom and 4iie basis for the alleged; exemption.- Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a•civilpenalty,of not more :than five hundred dollars ($500).: f
( _) 1!” owne'r'of the property, or my,employees with wages as their. sole compensation, will do the work, and 1
the structure is not intended or: offered for'sale iSec.1044, Business.and'Professions Code: The
Contractors` State.License•4Law,does not apply to an owner of property who builds or improves thereon,
and who does the Lwork himself or herself through his or her own employee's, provided that .the
improvements are not intended or offered for -sale': If, however; the building or improvement is sold within
one year 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 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:
LQPERMIT
Contractor:
ALTA VERDE BUILDERS, INC.
71'905 HIGHWAY 111, SUITE (
RANCHO MIRAGE, CA 92270
(760)776-1111
Lic. NCI.: 969219
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/10/13
' 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 of the.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, foi the performance of -the work for_which•this permit is issued. My workers' compensation
``insurance carrier a d.policy number. are:
Carrier STATE: -FUND Policy Number 9006140.
I certify that, in the p rmaitce of the work for which this permit is issued, I shall not employ any
person'in any mann" o as to become subject to the, orkers' compensation'laws of California,
and agree that, if I.Re,
d become subject to the works 'compensation provisions of Section '
3700 of the Labor I -shall forthwith comp) iih tlt a visions.
,WARNING: FAILURE FAILURE TO SECURE WORK S' COMPENSAT ON COVERAGE IS U WFUL, AND SHALL
SUBJECT AN E ` E
EMPLOYER TO,CRIMINALNALT,IES AND C 'FINES UP TO (HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSA ON, 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 fora 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. r
2. Any permit issued as a result of this application becomes null and void -if work is not commenced
within 180 days fr date of issuance of such permit, or cessation of work for 180 days will subject
//// permit -to cancellation
I certify hat I Jzore read this appliNaand state that the above informati n is cor ct. I agree to comply with all
city and countdinances and sts relating to building co ction, n torize re re entatives
of this S upAoenter upon the aemioned pIpperty for nspec[i
Application Number . . . . . 13-00000447
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 54.00 Plan Check
Fee
00
Issue Date . . . . Valuation
. . .
. 2250
Expiration Date 10/07/13
Qty Unit Charge --Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,0.01-25,000
9.00
-----------------------------------------------------------------------------
Special Notes and Comments
BLOCK WALL PER ORCO STANDARDS & APPROVED
PLANS. 90 IN FTX 6 FT HT.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
---------- ---
Due
------
----------------- ---------- ----------
Permit Fee Total 54.00 .00
.00
54.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 .00
.00
1.00
Grand Total 55.00 .00
.00
55.00
LQPERMIT
Bin. #
City of La Qurnta
'Bulldfng't3r5afety�,Diviislori;, • - .
P O. Box 1504;:78-495-0ffe,Tamp!CO
6..Qaint3,'CA 9225 (760) 777-7012•
Buildrng hith Applrcation and Tracking.Sheet.
Perin(t #
y
Projax Addrrss
' �
&nc s 4atne
A. P. Number. 77(.,2-, •-.:2iio ' -6(q
Address: l�
Legal Description: w
ST Zi
ty.. p: Q IM G Zz� J
Contractor. 1 `
C.`P�, �j
Telephone: . �((JIM
Address: 1� - �.flS� `C I
PeoJect Description: :`
City, ST, zip:, CA
�-
i
State Lia # : kp Ek City Lic N; O r: Z
Arc&, Bag, Designer.
Address:
City., ST, Zip:
Y
Telephone:
State Lia #:
Name of Contact Person`��
Construction Type:. Occupancy:
project type (circle oiie) NewA'dd'n Alter Repair Demo
.
Sq. : #Stories
# Units:
Telephone 9 of Contact Pelson: Estimated Value of Project:
'A CANT:DO-NOT WRITE BECOW TttIS UNE
b
Submittal
Req'd
''Reed
TRACMG
PERM[TFEES
Plan sell
Plan Cheek submitted
Item h Amount
Struduial Gales
'Reviewed, ready -for corrections
Plan Check Deposit. .
Itvu Csies.
a
COW Contact Pmon
Plan Check 8alanee
Title 24 Calea
Pimaeked
Pi-., up
Canstructlea
Flood plain plan
Plane reagbmitted
Meeb�ales!
Grading plan
2`! Review, ready for correctioasfi a
Electrical
Subeostactor Ust
Ca11ed Contact Person
Plwnbing
Grant Deed
Plana picked up
SALL
HOA Approval
Plans resubmitted
Grueling
iN HOUSE:-
Review; ready for eorrcctioes/tssae
Depdoper Impact Fee
Planning ApProral
Called Contact Person
A I P.P.
Pub. Wks. APpr •
Date of permit.bsue
Stbool Fees
Total Perukit Fits