09-0120 (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) 777-7153
BUILDING PERMIT.
Date: 2/12/09
Application Number. �r09-00000120 ` Owner:
Property Address: 79275 TORONJA RIVA DON
APN: 772-340-032- - - 79275 TORONJA
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL (760) 289-6940
Application valuation: 160
Contractor:
Applicant: Architect or Engineer: RESTORA
72120 NORTH SHORE STE A ITolfi, i--o
THOUSAND PALMS, CA 92276_ o
/ � dV
' A(760)343,-3333 fy2
Lic. No.: 659680, a 6q
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LICENSED ON CTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am I' n rider 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 o s onals 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
License Clas 06 License No.: 659680 for by Section 3700 of the Labor Code, for the performance of the work for whichthispermit is
issued.
Date: 6.i Con_t_ractor: ! _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor y
- 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 ASSURANCE CO OF Poli umber. WCO2842093900'
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance o ork 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 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 o e 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 3700 of the Labor Cod s I fo hwith 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 ($500).: Date V --Applicant:
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 SEC RE 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 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 1$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.). - APPLICANT ACKNOWLEDGEMENT
1 _ 1 I, 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
_ 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 _ I I am exempt under Sec. B.&P.C. for this reason 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.
Date: Owner: - 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 su/ii�rrtation
ation of work for 180 days.will 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 have read this application and state that th' correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to build hereby authorize representativesbf this co my o enter upon the above-mentionedpropertposes.
Lender's Name:
Date: Signature (Applicant or Agent):
Lender's Address: � �—
LQPERMIT
'Application Number . . . . .
09-00000120
Permit . . . WALL/FENCE
PERMIT
Additional desc
Permit Fee . . . 15.00
Plan Check Fee ..
.00
Issue Date
Valuation
160
Expiration Date 8/11/09
Qty Unit Charge.. Per
Extension
BASE
FEE
15.00_
Special Notes and Comments
10 LN FT X 4 FT HT GARDEN WALL
PER CITY
STANDARDS AND APPROVED PLANS.
Other Fees . . . . . . . .
BLDG STDS ADMIN (SB14:7.3).
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
_ .
.
CITY- OF LA QUINTA SUB -CONTRACTOR LIST
JOB ADDRESS PERMIT NUMBER OWNER BUILDER .
This form shall be posted on the job with the Building Inspection Card. at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable' trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade / Classification
Contractor
....:......:.. . .::;::::;::::.:...:...:..:.. .
::.:; ;..:.:::. Stata::Contractor.s Ucense... ::.:::.;:;
Workecs.Com ensaUon:lnsu e:" ' ' ::.::::::.::
City Buspes License'
Company Name
Classification
(e.g. A. B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp, Date
(xx/xx/xx)
EARTHWORK (C-12) :....
CONCRETE (C-8)'
FRAMING :fC-5)
STRUCT.:STEEL (G-5:1)
MASONRY 1C-29)
�07 70 %
PLUMBING' (C-36)
LATH; PLASTER ipr:35)
DRYWALL (C-9) •.: • .:
HVAC. (E-2QY .'. ` ..: .'
ELECTRICAL. (C=101' ... .
ROUFING tC.=39)
SHEET.METAL (043) ".
FL ING
• GLAZING (C-17)`
INSULATION (C72):
SEWAGE DISP (C-42)'
i
PAINTING (c-,331)`:
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C713)
LANDSCAPING (C=27)
POOL (C-53)
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72-210 North Shore St.
o Thousand Pals, CA 92276
Res'101'�ltm (7 0) 343-3333 *mFax 343-3005
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D R A i N
B'° #
City of La Quinta
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet.
Permit #
Project Address: '1 °'2 S (R 06 ( �
Owner's Name: t�6�C aj-^U
A. P. Number:
Address: 1-'Z� S l b -V �-fIA
Legal Description:
City, ST, Zip: L-A Q0lK(�� Z�j3
Contractor: Rt3To9-A
Telephone: 289 - �� y'0
Address: '� L—« ���"�
Project Description: -� GAP `(,(
City, ST, Zip: T ib i ACS. 5 CA-gU-716
CeM k-1—V—` P��-i� IiU�CS f(�.t LTC 1
Telephone:
City Lic. #:
State Lic. # : CA ���/ (O BO
V
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: �(�.��
Construction Type: Occupancy:
Project type (circle one): Add'n Alter Repair Demo
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person: 2--501j(p
Estimated Value of Project: 15DO
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd- -
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
'"' Review, ready for correctio6sfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees