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12-1384 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICOl FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT ,,,,/ INSPECTIONS (760) 77777153 BUILDING PERMIT Date: 11/27/12 Application Number: 12-00001384 Owner: Property Address: 48801 SAN LUCAS ST PAGE TOBY C APN: 658-310-001- - - C/O CANTOR & FITZGERALD Application description: WALL/FENCE 3811 TUTLE CREEK DR NO 1671tt2 Property Zoning: LOW DENSITY RESIDENTIAL DALLAS, TX 75219 Application valuation: 5852012 Contractor: Applicant: Architect or Engineer: GOLDEN CONSTRUCTION INC, CITYOUINTA 73710 FRED WARING DR STE 101 FIN4MCEDI:PT.^_f PALM DESERT, CA 92260 (760)776-4215 Lic. No.: 786919 �A -------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury th licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busss an rofessionals Code, and my License is in full force and effect. License Ciasu B @ns 786919 DateZZJ, atractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to . construct, alter, improve, demolish, or repair any 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).: (_) 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 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 contractors) licensed pursuant to the Contractors' State License Law.). ( ) 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 --------------- - - - WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 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, 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 7190501532 certify that, in the performance of the. work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I sh,pATMome subject to the workers' compensation provisions of Section 3700 of the Labor ode, I ffiall folthwith ptnp�wjih those provisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, 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 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 stateothboveormation is correct. 1 gree to comply with all city and county ordinances and state laws relatinguction, and her thorize representatives sttoto enter po he above-mentioned pu s Date�� tura (Applicant or Agen r Application Number . . . . . 12-00001384 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 17.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 585 Expiration Date 5/26/13 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 2.0000 HND BLDG 501-2,000 2.00 ---------------------------------------------------------------------------- Special Notes and Comments 19 L.F. 5' GARDEN WALL WITH (2) 2' X 21. PILASTERS TO MATCH EXISTING. CITY STANDARD. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 17.00 .00 .00 17.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 18.00 .00 .00 18.00 LQPERMIT Bin. # Clay Of QWho Building 8t Safety Division P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 1 Project Address: Owner's Name:. A. P. Number. Address: . Legal Description: / Contracto C�� © �� City, ST, Zip: -telephone: o .:s't?': ' >z Address: Project Description: City, ST, Zip: % r f!Q C Biu_ �✓ Telephone: Stats Lic. # : City Lie'. M. Arch., Engr, Designer. Address: City., ST, Zip: Telephone: . State LIC. #: Name of Contact Person: Construction Type: , Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft. # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Rcc'd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit. . Truss Cates. Called Contact Person Plan Check Balance Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted.. Mecharilcal Grading plan V Review, ready for correctiionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '^' Review, ready for correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees A L6 ZL ls�6k NE (2) NEVA AG ---I GAS I r oe- e-- 5-01:1 C...:MYNAL L 6 ATE F. SIDS YARD!* A 'GES's'. ----------- -- 7 Z- IEW NOV 08 26' BY:-------------------- ITY OF LA QUINTA UILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE /I 1Z 7gy L 0 lC 'By