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12-0386 (BLCK)P.O. BOX 1504 :78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-00000386 Property Address: 57815 SALIDA DEL SOL APN: 762-240-014-42 -34243 - Application description: WALL/FENCE Property Zoning: RL AG/EQ OVERLAY Application valuation: 650 TdAt 4- 4 " BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Applicant: Architect or Engineer: 'ate Owner: AV CONSTRUCTION LLC 315 S.BEVERLY DR 208 BEVERLY HILLS, CA 90212 tontractor: AA MASONRY. 77530. DELAWARE PL:. PALM,•DESERT, CA 92211 .(.76,0-)360-7388 Lic'. No..: 804168 VOICE (760) 77777012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/02/12 MAr .0 2.012 'CITY,OF ' QUINTQ FlW4CF )EPT ------ - - - - -- -- --- -- - - - -- - ------------------------------------------ -- ---------------- - -- - -- LICENSED.CONTRACTOR'S DECLARA ON - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that Iamlicensed under provisions apter:9 (commencing with I hereby affirm under penalty'of, perjury one of the following declarations: Section 7000)of Division 3 of: the Business and:Professionils Code, and License is in`full force and effect. _ I have and will maintain a certificate of consent.to self -insure fonworkers' compensation; as provided - License Class: C29 License . `804168 for,by Section 3700 of the Labor Code, for the performance of the work for which this permit is- < c t `issued., ate ontractor: - �al have and.will maintain workers', compensation insurance,.as,required by Section 3700 of the,Labor y ,,. 4 _ Code; forrthe performance of the work for -which this permitis issued. Myworkers' compensation OWNER -B LDER DECLAOf insurancecarrier and polic y.numbir are: - I herebyaffirm,tinder penalty of perjury that I am-exemptfro ontractor's State License Law for the Carrier DELOS FINS CO Policy Number WSI0047480-01 •` ' following reason (Sec?:7031.5, :Business and "Professions Code: 'Any city or county that requires a permit to _ I certify that, in the,performance of the work for which;this'permiris issue shall not employ any . construct, alter, improve,; demolish; or. repair_ any structure, prior to its"issuance, also:requires the applicant for the •• person in any manner so'as to become subject to the workers%, co - sation laws of California, permit to file a signed statement'that'he or she is licensed pursuant.to the provis6i'of the Contractor's State and.agree that, if I should become subject to the workers' co nsation provisions of Section 'License Law(Chapter9 (co'mmencing,with Section.7000) of Division33 of the Business and Professions Code). or 00 of the Labor Code, I shall forthwith comply with th .provisions. } that he or she is'exempt therefrom and the basis for the alleged exemption: `Any violation of Section 7031.5 by • �. , �� s.� �� ' • any applicant applicant for, a permit. subjects the,applicant to a civil penalty'of not more than-five,hundred,dollam ($500).:. 1 •r. 1 1, as'owner'of the property, or'rnyemployees with wages as their sole compensation',will do the work, and the structure is not intended or offered for sale (Sec.7044; Business:and Professions Code: The Contractors'': State License Law does not apply to an owner ofproperty who builds or improves thereon, • -and who does the workhimself.or herself through his or her own•employe'es, provided that the _ -improvements are not intended or offered foi sale'. df,, however, the building or improvement is sold within .one year, of completion; the owner -builder will -have the burden of proving that he or• she did not build or - improve for the r:improveforthe purpose of sale.). I, as owner ofthe property,'am exclusively contracting with licensedboritractois to construct the project (Sec. - ..7044, Business and'Professions Code: The Contractors' State*License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s)licensed pursuant to the Contractors' State License Law.). _ t• " I—) I am exempt under Sec. B.&P.C. for this reason. Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjurythat there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: . Lender's Address: LQPERMIT 'WAR G.FAIL RE TO SECURE WORKERS' O MPENSATIO COVERAG IS UNLAWFUL,'ANDSHALL SUBJECT•AN:ENIPLOYER.T,OCRIMINAL PENACTIES AND CIV ''FINESUP;, ONE HUNDRED THOUSAND ' DOLLARS ($.100,000).` IN ADDITION TO THE 'COST OFCOMPE ON; DA ES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FE - • 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 onthis application. -` - 1 . Each person upon' -whose behalf this application ismade, 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'hull 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 theabove information is rect. I agree to comply with all city and county ordinances and state laws relating to building construction, hereby authorize representatives ;/-tt-�nature pon the above-mentioned property for inspectio rposes. (Applicant or Agent): LQPERMIT - Application Number . . . . . 12-00000386 Permit . . . WALL/FENCE PERMIT. Additional desc . ' Permit Fee . . 19.00 Plan Check Fee .00 Issue Date Valuation . . . . 650 Expiration Date 10/29/12 Qty Unit Charge Per Extension.. BASE FEE 15.00 ' 2.00 ,2,:0000 HND BLDG"501-2,000 4.00 Special Notes' and Comments ` '(3)'P,DDRESSES REMOVE' 85 SQ . FT OF EXISTING 6'TALL 6" SLUMP':BLOCK WALL FACING'-STREET & REPLACEWITH-: 8!'. _TAN. "SPLIT.'FACE BLOCK AT 5!•.HIGH.-2010 CO - ---------------.---------------------------------------------- Other Fees BLDG STDS ADMIN."(SB1473) -------------- .:f. bo 5 :.. Fee summary, 'Charged Paid" Credited - - _ Due - - --= ----------- - - - - --------'-------- - - - ------ - ----- Permit Fee- Total 19.00 ..00, .00 -- - 19.•00 " Plan Check Total 00 00 00 00 Other Fee Total 1.00 ..00 .00 • -Grand Total2'0..00- 00 .00 20-.00 LQPERMIT - Bin. # Permit # Ptojecx Address: T->q ' $(0 5. CJty. 0f , Buildklg a Safety Diyiston P:O.'Box.lSO4,�78-495 Calle Tampico La.Quinta, GA 92253 -:(760) y77-7012 Building Permit Application and Tracking Sheet —Q?j�° �r� bCj. Owner's Name:..(? LG A. P. Number. V P, Pe\.1A CABAL T N Address: -t \ ply l \ Legal Description: Contractor. � �� City, ST, lap:O 1M (mac 6 Telephone: �� - (, - Address: �� ©� i � ` � , ProjecxDesc�iption: �—�c�U� City. ST, Zip: cnX I n 7� �v 1 Telephone: (p0-T? (-0'1 State Lic. #: 6 Z City is i��cb Ar6' 13W'' Designer Al.Address: LAN- City. ST. Zip: `'�-(�— 1. _ �W T Telephone: State Lia #: Construction Type: . Occupancy: Project type.(circle one): New Add'n Alter IT Ft: QS <wF # Stories: # Unit;;: Name of Contact'Peason: Telephone # of Contact Person: .. y .. Estimabod Value of Project APPLICANT: DO NOT,WRITE BELOW THIS LINE # Submittal Plan Sets RWd Reed ..V TRACK.IPIG Pian.Check submitted PERMFF FEES Item, Amount Structural (ales. Reviewed, ready for corrections Pias Check Deposit. . Truss Cala. Called Contact Person Plan Check Salanee, Title 24 Calea. Plana picked up Construction Flood plain plan Plans resubmitted. • Mechanical Giading plan 2'! Review, ready for correctionertoue Electrical Subeostactor List Called Contact Person Plumbing Grant Deed Plans plcked up S bLL H.O.A. Approval Plans resubmitted , Grading IN KOUSE:- ''� Review; ready for correcdonslissue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr ' Date of permit issue School Fees ]ITIot.al it Fees Q