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10-1127 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA; CALIFORNIA 92253 Application'Number: ,6 10-00001127 Property Address: 52685 AVENIDA VALLEJO APN: 773-292-020-8 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 750 T4tyl °f 4 Q" Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT . BUILDING PERMIT 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 P essi als Code, and my License is in full force and effect. Lice eClass: C29-053 e0ol.License No.: 81952 Date:Lrrontractor: 71 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from -the Contractor's State License Law for the following reason (Sec. 7031.5, Business and 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 (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).: (_) 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 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.). (_) 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. , 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 Owner: CITY OF LA QUINTA REDEVEL. 78-495.CALLE TAMPICO LA QUINTA, CA 92253 Contractor: LARA MASONRY 82373 KENNER AVENUE INDIO, CA 92201 (760) 702 - 593 9 Lic. No.: 81952 VOICE (760) 777-7012 FAX. (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/28/10 IF), , a -A n)) ;U uIt" T 2r' 2010 F i WORKER'S COMPENSATION DECLARATION 1 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 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 insurance carrier and policy number are: Carrier GOLDEN EAGLE P bar 10132010 _ 1 certify that, in the performance o the work f which this permit is issued, I shall not employ any person in any manner soas to come subject �workers'ompensation laws of California, and agree that, if I should become 'act to th ensation provisions of Section 3 00f the Labor C II forthwit ovisions. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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. 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 issuanc suc rmit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and sta that t formation is correct. I agree to comply with all city and county ordinances and state laws to building co tr n, and hereby authorize representatives of thi county to enter upon the abo ent d propert spection rposes. i at .. D6 S ature (Applicant or Agent): Application Number . . . . . 10-00001127 Permit WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 21.00 Plan Check Fee .00 .Issue Date . . . . Valuation 750 Expiration Date 4/26/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 2.0000 HND BLDG 501-2,000 6.00 Special Notes and Comments 30 L.F. 61 GARDEN WALL & 30 L.F. 1211 GARDEN WALL, CITY STANDARD. 2007 CODES. ---------------------------------------------------------------------------- Other Fees . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ---------- Paid Credited -------------------- Due ----------------- Permit Fee Total ---------- 21.00 .00 .00 21.00 Plan Check Total .00 .00 .00 .00 : Other Fee Total 1.00 .00 .00 1.00 Grand Total 22.00 . 00 ,- .00 -22. 00 LQPERD1IT Oct 2710 08:29a FREDDIE DIAZ LANDSCAPE 760-342-7412 p.2 LARA MASONRY "EXHIBIT A" 4. , Estimate -;� 82-373 KCNNER AVE , INDIO, CA 92201 CONTRACTORS L1U'NW9 81952 Date Estimate # 10112010- 104 Project. Description Qty . Rate RE: 52-685 AVENIDA VALLE)O, LAQUINTA, CA92253 r 154 LF X 6 H BLOCK WALLS WITH 8" X 8" X 16" TAN, 154 41.00 6,314.00 PRECISION BLOCK 30 LF X 12" Il BLOCK WALLS WITH 6"-X 18° X 16" TAN, 30 30.00 900.00 PRECISION BLOCK r r _ P r Thank you for your business Y. Total s $7,214.00, t f � Project. Description Qty . Rate RE: 52-685 AVENIDA VALLE)O, LAQUINTA, CA92253 r 154 LF X 6 H BLOCK WALLS WITH 8" X 8" X 16" TAN, 154 41.00 6,314.00 PRECISION BLOCK 30 LF X 12" Il BLOCK WALLS WITH 6"-X 18° X 16" TAN, 30 30.00 900.00 PRECISION BLOCK r r _ P r Thank you for your business Y. Total s $7,214.00, t I Bin # Peanit # Project Addim: ff.:? A- P. Number: Contrador.�� -7 Address:"'�-,373 City, ST, Zip: Tdephane: State Lia (1: 8' / J� 2 Azch-. EW.. Dedgaer: Adores: City., ST, Zip: Telepttoue: State L$. C Name of Comet Person: Telephoa0 g of Contact person: t{ Submittal Plan Seb Structural CjdCL Tlms oda. 71de 24 Cales. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE:- Pianeing Approval Pub. WkL Appr Sehool Feu — City Of Quints ------ BuMdfng & Safety Dlvtsfon P.O. Box 1504, 78-495 Calfe Tampk+o La Wnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet owner`s Name: L . Address: City. ST. zip: A-PPLICANT: Do NOT ViRrM - rel Reed 1 Plan Cb Revtgm Called t Plans pi Plans rt 2'! Revl • Called 1 Plans pi Plans n ua Rey, Called i Date of IMACIMG PERMTC FEES be k Ubmitted Ilem Mount d, ready for Corrections -------------- Plan Check Deposit :oataet Person Plan Check Ralam eked rP . Cosstmcdon mbmltted Mechanical tw, ready for eorrectiondissne FJeegiexl butact Person Plumbing eked up S.M.I. submitted- Grading :w, ready for eorrectionyissue Developer Impact Fee :outaet Person A.LP.P. permit Issue 4 Total Permit Fees