13-0220 (BLCK)P.b. 'Box 15o4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00000220 -
52730 AVENIDA VELASCO
773-295-013-12 -000000-
WALL/FENCE
COVE RESIDENTIAL
10119
Architect br
T,d4t 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR*S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
LicenseClass, C29 .: 3 018 8 0
e5 (A�� License No
Dat Contractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exe�npt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business a nd 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 1 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 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.).
1, as owner of the property, am exclusively contracting with licensed contractor� 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 LE NDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
wo!k for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address;
LQPERMIT
VOICE (760) 777-7012
/_0P7_*N 1___11 FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/04/13
Owner:.
THE EMBERS GROUP
42575 MELANIE PLACE
PALM DESERT, CA 92211
(760)568-2850
Contractor:
VELASQUEZ MASONRY
30266 MUIRFIELD WAY
CATHEDRAL CITY, CA 92234
(760)321-2193
Lic. No.: 301880.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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 perfoirmance of the work for which this permit is
i sued.
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 TOWER INS Policy Number 7763251489,
I 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, it I should become subject to the workers' compensation provisions of Section
3700 of the Labor C?,dA...[ shall I rt w�ith �comply with �th �visions.
Date: Applicant:' C_4_� L
WARNING: FAILURE TO SECURE W&ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$ 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.
I . 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 state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of th*� coymy to enter upon the above-mentioned propeZ)
136teR., 11� Signature lApplicant or Agent):
Application Number 131-00000220
Permit WALL/FENCE PERMIT
on 1 desc
Additi a
Permit Fee 126.00 Plan Check Fee
.00,
Issue Date valuation . . .
. 10119
Expiration Date 8/31/113
Qty uhit.Chdrge Per
Extension
BASE FEE
45.00
9.00- 9.0000 THOU BLDG.2,001-25,000
81.00
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Special Notes and�Comments
INSTALL 165 L.F. OF 6 FT. HIGH GARDEN
WALL AND:58 L. -F. OF 5 FT. HIGH GARDEN
WALL ON TOP OF >2 FT. RETAINING WAL L PER
APPROVED ORCO BLOCK DETAILS AND SIGHT.
PLAN. 2010 CODES...
------------------------------ ------------------------
Other Fe&s . ... . . . BLDG STDS-AbMIN,(SB1473)
--------
1.00
Fee summary Charged Paid Credited
- - -------------- ------------ ---------- I ---------
Due
i
Permit Fee,Total 126.00 ..00 00
126..00
Plan'Check Total .00 .00 .'00
.00
1'.00 .0'0
other Fee 'total .00
1.00
Grand Total 127.00 - -00
1:2 7. 0 0'
LQPERMIT
Bin. #
PemVt #
PrqjwA.Addmm: 14 Veit 14
Oty of La Quin'ta
BuMpg ff Safety MM6n
K0. Box 1504,*78-495 Calle Tampico
La QLqnta, CA 92253 - -(760) 777-7012
Building Pennit A0plication'and Tracking Sheet
Valasco Owner's Name:. q
. em h4VT L,
A. P.'Number '77 6
o&A., L
I
Address: 419
Legal Descripfion-aaaktisp . er4&
w4rric
- City, ST, Zip:
Contractor. Y1 lao 9 f4 ex a 14Z (1(VA
iclephone: _-qre
Address:- 14t—dCM1,11
Proje,ct Description:
City, ST, Zip-.Cal"f 6,& rA
�14 �4
';tYaQ /ko IA��
Telephone:-,ke e;l 4 9b,0' -
.4
A01,
/dd // -
State Lic. #: -34pleo!�Ze-
loe /
Arcft, Engr-, Designer
Address:
V Fee
ea re
City., ST, Zip:
Tel6phone:
State Lic. #:
Name of Contact Person:
2
Construction Type: Oc�upan,cy:
PrqjectVfpe(cWconc): New Add'n. Alter Repair Demo
Sq.'Ft-: # Stories:
0 Units:
Telephone of Contact Person:
Z5
Estimated V of P ---
APPLICANT: DO NOT WRITE BELOW THIS LINE
M Submittal Reqld
Reed
TRACMG PER?drrFEES-
Plan Sets
Plan Check submitted item Amount
Structural Calcs.
Reviewed, ready for correction Plan Check Deposit.
Truss Calct.
CAlled Contact Person Plan Check Balance
Mde 24 Calm
Plans pickid up Construction
Flood plain plan
Plans resubmitt.ed Mechanical
Grading plan
V Review, ready 'for correctionemut Electrical
Subcontactor List
Called Contatt Person Pitmabing
Grant Deed
Plans picked up S.NLL
H.O_A_ Approval
Plans resubmitted Grading
M HOUSE:-
3" Wvicwl ready for correctionsAssuc Developer Impact Fee
Planning Approval
Called Contact Person AJ.P.P.
-%jj.,Pub.Wks.Appr-
Date of permit Issue
V
Total Permit Fees
J
comzor�F, iA Q,U11V'rA
OPMENT
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