The URL can be used to link to this page

12-0675 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: --i2-00000675 Property Address: 53405 AVENIDA JUAREZ APN: 774-034-020-8 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 4150 Applicant: Tiht 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: COOPER NANCY 53405 AVENIDA JUAREZ LA QUINTA, CA 92253 Contractor: TESERRA P.O. BOX 1280 COACHELLA, CA 92236 (760)398-9222 Lic. No.: 656128 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/18/12 O A"Pll// -----------7------------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Sectio 7000) of Division 3 of the Busine s nd 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 ,27, 2 License No.: 656128 , 10,27 , Licens la s: C8,1 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ `, issued. Date: ntractor: OLI 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 OWNER -BUILDER DECLARATION - insurance carrier and policy number are: _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EVEREST NATL IN Policy Number 7600006481121 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance f 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 bec me 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 b o 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 37 of the Labor Code, I s forthwith 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 Q any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500): ate: Z Applic (_) 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: FAILUR O SECURE WORKERS` COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL ' Contractors' State License Law does -not apply to an owner of property who builds or improves thereon, SUBJECT AN EMP OYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 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.). (_) 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 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 1s 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 abo inf mation is correct. I agree to comply with all city and county ordinances and state laws relating to building on uction, and hereby authorize representatives of this county e r upon the above-mentioned property fo i pection purposes. � A Date: C ` Signature (Applicant or Agent): Application Number . . . . . 12-00000675 Permit WALL/FENCE PERMIT Additional desc . . Permit Fee 72.00 Plan Check_ Fee . . . . Issue Date . . . . Valuation . . . .00 . 4150 Expiration Date 12/15/12 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 27.00 ---------------------------------------------------------------------------- Special Notes and Comments A TOTAL OF 166 L.F. COMBO WALLS, 2' RETAINING, 6' GARDEN, & 40 L.F. 2' PONY WALLS @ SIDE P/L'S, ORCO SYSTEM. 2010 CODES. ----------------------------7------------------------------------------------ Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited --------------------------- Due ------------------------------ Permit Fee Total 72.00 .00 .00 72.00 Plan Check Total. .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 73.00 .00 .00 73.00 LQPERMIT 53 ANfe.fn«la- J QareZ �m o N CITY OF LA � C�:I�INT 5 BUILDING & SAFETY DEPT. r� APPROVE® p, FOR CONSTRUCTION 1-11 L DATE �`ZBY i W 0 Bill # Qtt Of La Quints Buttding 8Sa Safety Division P.O. Box 1504,78-495 Calle Tampico 14.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �� ProjectAddtess: Owner's Name:. V %7 t �1` ntj LS A. P. Number. Address: S �CJ� i f c�J l 17 •� `�� CL .EZ Legal Description: City, ST, Zip. u 3 �/7"°Z Z S 3 Contractor.. Telephone: Address: / Cl ✓` Ci/ Project Description: o Clty, ST, Zip: C0. 44• �- - Z2.3 C Telephone: ' ;�z ZZ State Lia #: S , . L City L i c', #: Arch, Engr., Designer. Address: City., ST, Zip: Telephone: Construction Type:. Occupancy: State Lic. #: Project type (circle one): New Add'n' Alter Repair Demo Name of Contact Person: `R �� 1, _ L Sq. Ft :# Stories: # Unitg Telephone # of Contact Person: "' _• f� . C' i Estimated Value of Project: / �:• U �� APPLICANT: DO NOT WRITE BELOW *HIS UNE M Submittal Rcq'd Recd TRACK.IIHG PERMLT FEES Pian Sets Plan Check submitted Item Amount Structural Caics. Reviewed, ready for corrections Plan Check Deposit. . Truss Calci. Called Contact Person Plan Check Balance. Title 24 Calci. Plans picked up Construction Flood plain plan Plans resubmitted ' Mecharileal Giadlug plea Z'! Review, ready for correctioasrmut Electrical Subeontaetor List Called Contact Person Plumbing Grant Deed Plans picked up ML MO.& Approval Plans resubmitted Grading IN MUM- 3" Review; ready for correctionsAssue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees