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BWFE2015-004078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: BWFE2015-0040 D VOICE (760) 777-7125 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/17/2015 Property Address: 43545 CROISETTE CT APN: 609052002 Application Description: 278LNFTX6 1OLNFTX6FTHT 15LNFTX6FTHTWALLS Property Zoning: _�7 Application Valuation: $4,000.00 L!—� Applicant: FEB 1.7 2015 G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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 Professions Code, and my License is in full force and effect. License Class• B License No • 750957 Owner: ADOM VENTURES 77-682 COUNTRY CLUB DR. STE A3 PALM DESERT, CA 92211 Contractor: G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 (760)969-1400 Llc. No.: 750957 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 performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by bate: 2 Contractor: 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: OWNER -BUILDER DrLexe TION Carrier: _ Policy Number: _ I hereby affirm under penalty of perjury that I a)the Contractor's State _ I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement. that he or she is licensed pursuant to the provisions of the comply with those provisions. 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 Date: 2 Applicant: basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars WARNING: FAILURE TO SECURE WORKERS' COM ENSATION ERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P IES AND CIVIL FINES UP TO (_) I, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of.completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (_) I am exempt under Sec. B.&P.C. for this reason 2. Any permit issued as a result of this application becomes null and void if work is 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: 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 this city to enter upon the above- mentioned property for inspection purposes. Date: Z ( Signature (Applicant or Agent): FINANCIAL •• • ,,DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $120.36 $0.00 PAID BY METHOD RECEIPT # CHECK .# CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD. RECEIPT # ' CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forFENCE OR FREESTANDING WALL- TOTALS:00 $229.13 $0.00 Description: 278LNFTX6 1OLNFTX6FTHT 15LNFTX6FTHTWALLS Type: WALL/FENCE Subtype: Status: UNDER REVIEW Applied: 2/17/2015 PJU Approved: Parcel No: 609052002 Site Address: 43545 CROISETTE CT LA QUINTA,CA 92253 Subdivision: Block: Lot: 11 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $4,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: ALL ANGELUS STANDARD 278 LNFTX6FHT/10 LN FT X6FT HT RETURN WALL/15LNFT X 6FT HT COURTYARD WALLS.PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. Printed: Tuesday, February 17, 2015 1:21:45 PM 1 of 2 C WrsrEMs ADDITIONAL CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989 MARIOGONZALEZ@GH DRIVE STE C CITY 3747 ACOMPANIES.COM CONTRACTOR G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989. MARIOGONZALEZ@GH DRIVE STE C CITY 13747 ACOMPANIES.COM OWNER ADOM VENTURES 77-682 COUNTRY CLUB PALM DESERT CA 92211 (760)200-5989 DR. STE A3 FINANCIAL INFORMATION Printed: Tuesday, February 17, 2015 1:21:45 PM 1 of 2 C WrsrEMs PARENT PROJECTS REVIEWS "7 REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS DATE NOTES y BOND INFORMATION NOTES SEQID INSPECTION TYPE 'INSPECTOR CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 1 101-0000-20306 0 $1.00 0.00 FOOTINGS AOR Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: WALL/FENCE - EA 101-0000-42404 0 $120.36 $0.00 ADDITIONAL 50 LF WALL/FENCE - FIRST 101-0000-42404 0 $47.86. $0.00 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $0.00 100 LF PC Total Paid for FENCE OR FREESTANDING WALL* $229.13 $0.00 TOTALS:00 PARENT PROJECTS REVIEWS "7 REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS DATE NOTES BOND INFORMATION NOTES SEQID INSPECTION TYPE 'INSPECTOR SCHEDULED DATE INSPECTIONS COMPLETED RESULT DATE REMARKS BOND BEAM FINAL*" FOOTINGS AOR PARENT PROJECTS REVIEWS "7 REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS DATE NOTES Printed: Tuesday, February 17, 2015 1:21:45 PM 2 of 2 CJ? -SYSTEMS i BOND INFORMATION ATTACHMENTS Printed: Tuesday, February 17, 2015 1:21:45 PM 2 of 2 CJ? -SYSTEMS i Bin # City of La Quinta. Building &r 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: 40a SS S' Com, Owner's Name: Address: s A. P.'Number: Legal Description: Lp'T" 1 City, ST, Zip: Contractor:2Ei.t,S ,C_ Telephone:hone: ' Address: 108-I Project Description: 27 a' %' 6A�• City, ST, zip: ca'tr.a.Xro,1 Cc>L g2Z3� I d (0" YL r % ' 15' 6' Ir-04 Telephone- P 6• -zs o- <:�%2 State Lic. # : 75(09 C City Lic. #: Arch., Engr., Designer: ��1� CC Cf.,1Ci4,.%irt�t.f Address: City., ST, Zip: Telephone::;::;hr•: ;;;:.;.;. ;rw ::v .< rk;:�' :cam:;;.,:,:,::.._f•...:!;4;,!. !:ni'1,.;:!.:isr•is i'::iti`:`.•}:: Aj6:::!ii.: �i Y.!^: J;: Construction Type: 6%ocAr— Occupancy: State Lic. #: Project type (circle one): ew Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: -7 #Stories: #Units: Telephone # of Contact Person:Estimated Value of Project: L4 0 , to 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 Cala.. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction' Flood plain plan Plans resubmitted . Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Callcd Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN I10USE:- '" Review, ready for corrcctions/issue Developer Impact Fee Planning Approval Called Contact.Person A.I.P.P. Pub. Wks. Appr. Date of permIt issue School Fees Total Permit Fees - � ' . _____ H N