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12-1274 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: - 12-0 0 0 012 74~ Property Address:43583 VERONA CT APN: 609-552-028-47 -28458 - Application description:' WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 448 Applicant: T4ht 4 4 Q" Architect or Engineer: pip BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: LEITCH WILLIAM R 43583 VERONA COURT LA QUINTA, CA 92253 Contractor: WESTLAKE LANDSCAPE INC, P.O. BOX 5175 LA QUINTA, CA 92248 (760)399-1506 Lic. No.: 857801 C -_,,A2 VOICE (760) FAX (760') � X70 INSPECTIONS (760) 777-7153 Date: 10/25/12 1 4 0�, OCT 2 5 2012 C�rY OF QUINTA Ty ...L -- 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: 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 Licen Class: C27 License No.: 857801 ate:/�2S / Z C ractor: 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 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 GRANITE STATE Policy Number WC019396304 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 subJ''ect 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 I shall fortCuvith 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 155001.: / A plicant: �-'`- (_ 1 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: FAILU E TO SECURE WORKER(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 EMPLOYER 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.). 1 _ 1 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. , 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 applic tion and state that the above information is correct. I agree to comply with all city and c unty ordinances and to laws relating to building constructio ,and hereby authorize representatives of thisWunye.r upo eabove-mentioned propert inspeo purposes. e: ' nature (Applicant or Agentl: �- Application Number . . . . . 12-00001274 Permit WALL/FENCE PERMIT Additional desc . Permit Fee 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 448 Expiration Date 4/23/13 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------=------------------------------------------------ Special Notes and Comments 20 L.F. 3' GARDEN WALL WITH (2) PILLARS a@ 6' AND (2) PILLARS @ 5' STUCCOED TO MATCH, CITY STANDARD. 2010 CODES. ------------------=---------------- Other Fees . . . ---------------------------------- . . . . . .. BLDG STDS ADMIN (SB1473) ------ 1.00 Fee summary Charged Paid Credited -------------------- Due ----------------- Permit Fee Total -------------------- 15.00 .00 .00 15.00 Plan Check Total .00 .00. .00 .00 Other Fee Total 1.00 .00 .00 1..00 Grand Total 16.00 .00 .00 16.00 LQPERMIT Bin.# Qty Of La Quinta Bullding ST Safety Division Box 1504,78-49S Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application'and Tracking Sheet Permit #P.O. � Project Address: — •-5'f% 3 Ve rcxl\-eL Owner's Name:. A. P. Number. Address: —S�' 3 Llf ,cv o, Legal Description: City, ST, Zip: LGt C� u / 4-ct Contractor. Telephone Dov L SG Z `1 2 - Address: Address: 10v �j �L S I .7 S Project Description: v) LA Pere) City, sr, zip: Lek k - C, Telephone: Z 6 U ZSG 2- `f 2 L p` State Lie. # :.S gU ( City Lic #; s �% /,�� s s f,� c C- v Arch., Engr., Designer. - .. •. f J J'L, c� SLC L" � ,V- se - Address: City, ST, Zip: Telephone: State Lie. -,..... Name of Contact Person: �� 14 Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: #Stories: #units: Telephone # of Contact Person: L Estimated Value of Proj 2- v. APPLICANT: DO NOT WRITE BELOW THIS UNE P Submittal Req'd'Rec'd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan Review, ready for correctioaslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 1I.O.A. Approval Plans resubmitted Grading IPI HOUSE:- 1jd Review; ready for correctioasfissue Developer Impact Fee Ptanning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr ' Date of permit issue School Fees Total Permit Fees