13-0305 (BLCK)P.O. BOX 1504 ^� "-
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
13-00000305
Property Address:
57887 SALIDA DEL SOL
APN:
762-240-014-39 -34243
Application description:
WALL/FENCE
Property Zoning:
RL AG/EQ OVERLAY
Application valuation:
3000
Applicant: Architect or Engineer:
�I11*1-Id�'�C.IL i
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirrrt under penalty of p od ry that I am licensed under pr'ons of Chapter 9 (commencing with
Section fOO) of Division 3 of thesiness and Professionals Code, an License is in full force and effect.
Licens1�ey! las : B Licen o.: 9 219
Date: —` Contractor:
OWNER -BUILD DECLARAT
I hereby affirm under penalty of perjury t at I am exempt from th or'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 re airany structure, prior to its issuance, 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 of not more than five hundred dollars ($500)•:
(_) 1, 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 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 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 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:
ALTA VERDE CORAL
315 S BEVERLY DR
BEVERLY HILLS, CA
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
MOUNTAIN, LLC
208
90212
Contractor:
ALTA VERDE BUILDERS, INC.
71905 HIGHWAY 111, SUITE G
RANCHO MIRAGE, CA 92270
(760)776-1111
Lic. No.: 969219
Date: 4/01/13
APR 0 4 2013
CITY OF LA QUINTA
FINANCE: DEPT
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.
1 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
insurance carrier a policy number are:
Carrier STATE FUND Policy Number' 006140
_ I certify that, in the p f mance of the work for which his permit is issued, I shall not employ any
person in any mann r o as to become subject to the orkers' compensation laws of California,
and agree that, if I s o Id become subject to th Ike
'compensation provisions of Section
(✓cI 700 of the Labor C , Id,
shall forthwith c ply h se provisions.
)(Dat `' Applicant: .
WARNING: FAILURE TO SECURE WORK S' COMPENSATI COVERAGE I UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P ALTIES AND CIVIL ES UP ONE HUNDRED THOUSAND
DOLLARS 1$100,000)• IN ADDITION TO T E COST OF COMPENSATION, is
AS PROVIDED FOR IN,
SECTION 3706 OF THE LABOR CODE, INT EST, 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 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 a lication becomes null and void if work is not commenced
within 180 days from date of issuanc of such permit, or cessation f work for 180 days will subject
permit to cancellation.
I certify at I ave read this application and state th the above information is corr t. 1 agree to comply with.all
city and ount ordinances and state laws relating t ilding construction, and hereb authorize representatives
of this unty nter upon the above-mentioned pr e y for inspection purp
I
6Date: ` �ignature (Applicant or Agent):
LQPERMIT
Application Number . . 13-00000305
Permit . . . WALL/FENCE PERMIT
Additional desc
-
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
3000
Expiration Date 9:/28/13
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
120LF OF 6' GARDEN BLOCK WALL AT SOUTH
PROPERTY LINE AND HOUSE RETURNS [ORCO '
SPECIFICATIONS] 2010 CALIFORNIA BUILDING
-
CODES.
`
April 1, 2013 9:33:06.AM AORTEGA
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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