13-0639 (BLCK)P.O. BOX 1504 -VOICE (760) 777-7012
78-495 CALLE TAMPICO ' FAX (760) 777-7011 ,
LA QUINTA; CALIFORNIA 92253. %BUILDING & SAFETY, DEPARTMENT • � INSPECTIONS (760).777-7 153
BUILDING PERMIT
Y"Date: 5/20/13 -
Applicatiori Number.— 13,000006-3-9 s Owner:
Property Address: 52720 AVENIDA VELASCO - `)Z.W.' REAL ESTATE ,
,APN: 773-295-012-13 .-000000- - P,O,-BOX 447.,.
Application description: WALL/FENCE . -4 •'• DESERT HOT SPRINGS, .CA 92240." - r
Property Zoning: COVE RESIDENTIAL D '(760) 619-7611
Application valuation: 1250 d
Applicant' : - Architect or Engineer: M`11 ZQ ZA� ITRON CONSTRUCTION r
!I 3, 0427 RIGO COURT
- C1OG COACHELLA, CA 92236• • r_ '
•
F1 .0 (760) 398-3227 ,
1 EDEpT Lic. No. 926190'
A- - - - , - - - - - - - - - - - - - - - - - .- - - - -
- - - - -- - - �� - - - - - - - �•� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
` - - LIC / SED CO TRACTOR'S DEC RATI N - _ WORKER'S COMPENSATION DECLARATION } - .•
{ I hereby affirm under penalty of perjury at a licens d under provis n f Cha er 9 (commencing with .. I hereby affirm under penalty of perjury one of the following declarations:
• Section 7000) of Division 3 of the Busi ess an Prof ionals Code, d y Lice a is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: - 13„. License 926 0 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
y - / - issued. .
�Dae-,,'�—i 0—' --Contractor_. �_� _ _ 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 r.
` OWNER -BUILDER DECLARATION ' insurance carrier and policy num r are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND olicy Number 0013718-2 1
• following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the perform ce the work for which this permit i ss , I shal of employ any b
construct, alter, improve, demolish, or repair any structure, prior to its issuance; also requires the applicant for the •.person in any manner s a t ecome. sub' ct to the workers' m e sation I s 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 sho d e e subjec o the workers', co e a on prow ions of Section -
License Law (Chapter 9 (commencing. with Section 7000) of Division 3 of the Business and Professions Code)'or 3700 of the Labor _ e, I I forth ith omply with thos isi ns.
.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).: ..,DateZC-7 Applicant: -
(_ I 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: FAILURE TO SECUR 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 EMPLOYER TO C IMINAL 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 1$100,0001• IN AD ITION 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 completiori, the owner -builder will have the burden of proving that he or she did not build or w • f - I 1 -
improve for the purpose'of sale.). 1 ` aAPPLICANT ACKNOWLEDGEMENT
. 1 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. ' ' IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
y 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed. 1 . Each person upon whose behalf this application is made, each person at whose request and for
• pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 1 I am exempt under Sec. B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnity 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.
Date: Owner: 2. Any permit issued as a'result of this application b comes ull and void if work is not commenced
• - within 180 days from date of issuance of such ermit, cessation of work for 180 ays II subject
• - CONSTRUCTION LENDING AGENCY` permit to cancellation. - - - -
- ' I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I°certify that-I•haveread this application and state that the ove ' f rmation i •correct. I ogre ly wit II
Work for which this permit is issued (Sec. 3097, Civ. C.). - .,,city-anWtounty ordinances�and-state laws relating to build co str coon, a hereby authoy z r pr entativ s
r of this county to enter upon the above-mentioned grope or ` s tion py oses.
Lender's Name:
_ - - •� KDat'�-�''�„S_ ignature (Applicant or Agent -
Lender's Address:
LQPER.MIT
Application Number 13-00000639
Permit . . . WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee . . . . 94.38 Plan Check Fee
.00
Issue•Date Valuation
1250
Expiration Date .� 11/16/13'
Qty Unit Charge Per
Extension
1.00 47:1900 LS MISC WALL, FIRST 100 LF
.47.19
' 1.00 -47.1900 LS MI RET WALL <=121, 1ST 100'
47.19
---------------------------------------------
Special Notes and Comments
--------------
RETAINING COMBO BLOCK'WALL 24" X 50 LN
FT ; 50 LN FT X 6 FT HT PER ORCO
STANDARDS AND APPROVED PLANS 2010 CODES
APPROVED BY S.T.
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Other Fees BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.06
Fee summary Charged Paid Credited
Due
Permit Fee Total 94.38 00 .00
94.38
Plan Check Total 00. 00 .00
.00
_
Other Fee Total 61.06 .00 .00
61.06
Grand Total 155.44 .00 .00
155.44
4
. LQPERA1IT - -
Bin.#
Permit #
O -
Project Address: —[ 2 07t-7-5
oty of La Quinta
BU11( t 8T Safety Division
P.O. Box 1504,78-495 Calte Tampico
ta.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application'and Tracking Sheet
C 10 Owner's Name:. In,
A. P. Number.
Address:
Legal Description:
CoRttactor:1
City, ST, Zip: CIA
Tele hone: x '
P
Address:
Project Description:
City, ST, Zip: `�
Telephone: Ao, lf�,5-1 9q(70 _
State Lic. # Lie. #;
Q Dt✓
I
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
Recd
TRACIt;IPiG PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Ca[cs
Reviewed, ready for corrections
Plan Check Deposit.
Truss Cates.
Called Contact Person
Plan Check Balance
Tide 24 Cake.
Plans picked up
Construction
Flood plain plan
Pians resubmitted..
Mechanical
Grading plan
2`' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact PersonPlumbing
Grant Deed
Pians picked up
S.NLL
H.O.A. Approval
Plans resubmitted
Grading
IN IXOUSE:-
7j° Review, ready for correetionsliissae
Developer Impact Fee
Planning Approval
Called Contact Person
I AXP -
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees