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12-0385 (BLCK).Y' - * P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-000003 8.5 Property Address: 578.3.9SL I A DEL SOL APN:. 762-240-014-41 -34243 Application description: WALL/FENCE Property Zoning: " RL AG/EQ OVERLAY Application valuation: 541 • Applicant: t_ Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: AV CONSTRUCTION LLC 315 S BEVERLY DR 208 BEVERLY HILLS, CA.90212 Contractor: AA MASONRY 7753 Of DELAWARE PL. PALM DESERT, CA 922: ;('760) 360-7388" Lic.,No.: 804168 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/02/12 LQPERMIT LICENSED CONTRACTOR'S.DECLARATION .- ,v - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I, am'licenied�under: provisions of Chapter 9 (commencing with I herebyraffirm-under penalty of perjury one of, the following declarations: t . Section:7000_)of Division`3of the Business and Professionals Code,`anA my License is in full force and effect. I have and wilrmaintain a certificate of consent to self -insure for workers' compensation, as provided License Clas :- C29' = - License: No: 804168 - - _ _ '• fog 6y Section'3700;of the�Labor_Code, for the performance of.the work for which this permit is ..' ° ' •• _ .late., ='l' C rector. issued.. .. : - _ L �Fhaveand:will mamtaidworkers'compensationmsurance,'asrequired by, Section 3700of;iheLabor m f , ' ` ±ik - . • Co", for the performance of the work for which this permit is. issued. 'My workers' compensation OWNER -BUILDER ATION '' - .>'_ insurance carrier ind`policy numbef are:. ` - I hereby affirm under penalty of perjury than) -am exempt from the'Contractor's:State'License Law for the Carrier DELOS3' INS CO 2..Policy Number VSIO047480=01 ' • following reason (Sec. 7031-.5, Business and Professions Code: Any city or;courity.that requires'a permit to _ I certifythat, in the.performance of 'the work for which this permit is issued, l 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' compensation laws of California, ,permit to filea signed statement•that he or.she is licensed pursuant to the•p.rovisions of the Contractor's State and agree that, if I should become subject to the workers': compensation provisions of Section License Law'(Chapter:9;(commencing,witti.Section 70001`of Division 3 of the Business.antl'Professions Code) or. 3 700 of the Labor Code, I shall.fo with comply with those provisions. that he'orahe is exern tvtf;aiorpm�dnd,the basis for the,alleged.exemption.Any violation of Section 7031.5 by any applicant for a permit subjectsthe applicant toa civil'penaltyof not,more than five'hundreddollars (S5001.:' te:. �I.cant: ( 1 I, as owner of the property;, or my,employees with wages�as,thev'sole compensation 'will do:the work, and' the structure is notintended oroffered for -sale (Sec .7044, -Business and Professions Code:. The WARNI G FAIL EURE WORKE ''COMPENSATION CO �^ AGE IS WFUL, AND SHALL Contractors,,State Lrcen§e Law',;; s not apply town owner of property who builds or improvesthereon, -. SUBJECT AN EMPLOYER TO CRIMINALPENALTIES AND CIVIL FI S UPTO ON NDRED'THOUSAND. and who does tbe'work himself or herself through his.or her own employees, provided.that the DOLLARS (5100,000)• IN ADDITION TO-THE,COST OF.COMPENSA AGES AS.PROVIDEID FOR IN improvements are notintended-or offered for.sale. If; however, the building or improvement is soid'within SECTION 3706. OF•THE LABOR CODE, INTEREST; AND ATTORNEYS FEES. one.year of. completion, the owner -builder will have the'burden of proving that he or she did not build or. �' - • improve for the purpose of sale:)." i. -' - - APPLICANT ACKNOWLEDGEMENT 1 _) I, as owner of the property,:arn exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application. is hereby made to the•Director of Building and Safety for a'permit subject to the • 7044, Business and Professions ,Code:. The Contractors';Staie License Law does not apply to an owner of conditions and restrictions set forth on this application. .. - - ..,property who:builds or Improves thereon, and who contracts for`the projects with a contractor(s) licensed 1.' Each'person upon whose behalf this application is made, each person at whose request and for ' pursuant to the'Contraciors' State Licensetaw.). �'- whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_ 1 I am exempt under Sec: , B-AP.C.. for this reason 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. Date: ,Owner: 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 ofstich permit, or cessation of work for. 180 days will subject CONSTRUCTION LENDING AGENCY permit to cancellation., ' I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. 1 agree to'comply with all work for which this permit is issued (Sec. 3097, Civ. C.1. city and unty or and state laws relating to building. construction, and hereby authorize representatives of th' county to mer upon a above-mentioned property for inspectio purposes. Lender's, Name•, " ate: Si ature (Applicant or Agent): Lender's Address: LQPERMIT Application Number . . . . . 12-00000385 Permit . .. . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . .17.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 541 Expiration -Date 10/29/12 Qty :Unit Charge Per Extension BASE - FEE 15.00 1.00 .2-.0000 HND BLDG .-501-2, 000• 2.:00 ------- ------------------------------------ Special Notes and Comments.,". (3) ADDRESSES REMOVE .85,'SQ.. FT OF .. �. EXISTING . 6'' TALL'6 " SLUMP :BLOCK . WALL' FACING:, STREET &.-REPLACE' WITH 8" .TAN -. `t SPLIT` "FACE' BLOCK AT '5.'. 'HIGH.' 2010 CODES, -.------- -- - Other Fees BLDG., STDSP ADMfiN- (SB1-473) - 1.-00. Fee summary Charged Paid. Credited Due.. - ---- - - - -- -- - -- - -- Permit Fee; Total 17.00 ^00 -- - .00 17.00 Phan .Check Total:.; 00 00 ,' :'00 .00:' Other Fee Total" 1.00 ..00 00 1.'0:0' Grand Total-. 'i-8. 00-. .00 00 -18.00,.' :. .. . LQPERMIT .. Bin. # oty. of'. Q60 . BLdkgng a Safety:Dh>Isfon Y.O. Box.1504, "78-495 Caffe :Tampkv . fa:Quanta,..CA 92253 -:(760)'Y77-7012,: Building Permit A lfcad6n and Tracktn Sheet ' Permit # ") Projecx Add=: rj, " �`C7 Owner's Name A. P. Nmber.si-M�' \ a Pc\.� ttAL T Address: Legal Description: Contractor. Cit' y, ST, Zip: R-Oe� 5CXt o 1M \ (L -N 6 Telephone: `��� Address: 5 { 1 © Project Description: C7U City.sT. Zip: Telephone: (p0 State Lic. #: �0 2 City ie. i iGb„ AmfL, BW., Designer Address:W� CRY, ST. Zip: 1 C— Off T f`� Telephone: State Lia #:pro _ Name of CoaW Person :Construction Type:. Occupancy: )ed type (circle -one): New Add'n Alper �¢ Ft: QS t -F # Stories: .' # Unitg: Telephone I of Contact Person: Estimated Vatire of Project APPLICANT: DO NOT WRITE BELOW .THM UNE # Submittal Plan Sets Eeq'd Redd TRACKING Pian Check submitted Q 2- PERM T FEES Item Amount Structural Cale& Revkwed, ready for corrections Plan Check Deposit, . Truss Cala. Called Contact Person :Pian Check Baianee Mde24 Cates. Plans picked'uP Canstrnctlon Flood plain plan Plans resubmitted .. Mechaliieal Gtnding plan 2'! Revltw, ready for corrtictionsiuswce Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans.pickei up S bLL H.O.A. Approval -Plans resubmitted Grading INROUSE:- *' Review; ready for correctionaA=c Developer Impact Fee Planning Approval Called Contact Pelson Ad.P.Y. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees t6- ou qjq