The URL can be used to link to this page

12-0376 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: r12-000003767 Property Address: C '57863 SALIDA DEL SOL APN: 762-240-014-40 -34243 Application description: WALL/FENCE Property Zoning: RL AG/EQ OVERLAY Application valuation: 650 - 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: AV CONSTRUCT 315 S BEVERL BEVERLY HILL OLga u .,. F2,69Y 0 2 2012 ON D LA QUINTI CF, 9 M&CE DEPT. VOICE (760) 777-7012 FAX (760) 777-7011 IONS (760) 777-7153 Date: 5/02/12 Contractor: { Applicant: Architect or Engineer: AA MASONRY .77530 DELAWARE PL -PALM DESERT,.CA 92211 (760)360-7388 I�. Lic. No.: 804168 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION_ N-, .— • I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with (.hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Licens ss: C29 License No.: 804168 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ate: y ontraaor: issued. have 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 WNER-BUILDER DECLA10 insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contr tor's ate License Law for the Carrier DELOS INS CO Policy Number WSIO047480-01 ' 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 permit is issued, I 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 file a signed statement that he or she is licensed pursuant to the provisions 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 with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, 1 shall forthwi comply with those provisions. 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).: te. pli'ant:. (_) 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 WARNING: ILLI E TO SECURE WORK RS' COMPENSATIO OVERAG IS UNLAWFUL, AND SHALL ' Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 'AND CIVIL O ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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, 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 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 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 issued as a result of this application becomes null 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 the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection p rpos a0 t�_7��/� Si ature (Applicant or Agent): Application Number 12-00000376 Permit WALL/FENCE PERMIT Additional desc Permit.Fee . . . 19.00 Plan Check Fee .00 Issue Date Valuation 650 Expiration Date . 10/07/12 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)ADDRESSES REMOVE 85 SQ. FT OF EXISTING 61TALL 6" SLUMP BLOCK WALL FACING STREET & REPLACE WITH 8" TAN 'SPLIT FACE BLOCK AT 5' HIGH. 2010 CODES -------------------_-------------------------------------------------------- Other Fees . . . . . .. BLDG STDS ADMIN (SB1473) 1.00 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 1.00 Grand Total 20.00 .00 .00 20.00 i LQPERMIT L� Bin # C[ty. Of .: Qtplt"Itd. ,.:. Buffdfng g Safety Division P.O. Boy .1504, '78-495.C. alle Tampico 14.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application' and Tracking Sheet Permit # Project Address .l S Owner's Name:. t% Ll.G A. P. N.uinber.St°iLl t] L a Pct. ; &WLD(EAL. T ti Address: Legal Description: City, ST, ZAP -VA Contractor. ��1A V � J � Telephone: � lI Address: -D-ROS. ` \ i Project Description:t�- City, ST, Zap: Tpi Telephone: (pp •�� (p- ` 11:, State Lia # Z ctCity is t iD9462 �� - Arch, Eng., Designer. T - •Address: City., ST, Zip: ��G - TW S t Q T fV Telephone: State Lia #: Construction Type:. Occupancy: Project type (circle one): New Add'a Alter Lr �¢ Ft.: QS t -F #Stories: # Unit$: Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE !� Submittal Plan Sets Req'd Recd TRAMING PERMIT FEES Pian Check submitted Q Item Amount &Wqd+ral Calm Reviewed, ready for corrections Plan Check Deposit. . Ttuss Calcs. CaUed Contact Person Plan Check Balance M le 24 Calci. Plans picked up Construction Flood plain plan Pians resubmitted.'. Mechankd Grading plan 2'` Review, ready for corrections/issue Electrteal Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up SILL ILOAL Approval Plans resubmitted Gradlog Review; ready for correctlonslissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr - Date of permit issue School Fees Total Permit Fees IW 4