11-0270 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000270
Property Address:
53502 HUMBOLDT BLVD
APN:
767-200-998-R -330762-
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
750
Tu�/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner: (�
EAST OF MADISON LLC r`)
PO BOX 1482 I
LA QUINTA, CA 92247 r
Contractor:
Applicant: Architect or Engineer: DBCA INC.
P.O. BOX 1482
LA QUINTA, CA 92247'
/^ (760)393-5271
Lid. No.: 915336
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I a nsed under provisions of Chapter 9 (commencing. with
Section 7000).of Division 3 of the Business an of nals Code, and my License is in full force and effect.
LicenseQpClys,: ense No.: 915336
ate.J u fe ntractor:
NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that Ia xempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Pr ssions 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.).
(_ 1 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.).
(_ 1 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: iD Y`
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/17/11
CITY i, 4`"l% df�tfN�'�IfA
rplfr'�,*F„r� v �
---------------------------------- — ------------
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 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 TRAVELERS PROP Policy Number YEUB282D779708
1 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 tilybecome subject to the workers' compensation laws of California,
and agree that, if[ shouldme t to the workers' compensation provisions of Section
3700 of the Labor Code, Is II hwith mply with those provisions.
WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL -
SUBJECT AN EMPLOYER TO CRIMINAL P LTIES 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, 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.
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 ab a info
correct. I agree to comply with all
city and unt ordinances and state laws relating to building nstrhereby authorize representatives
of thiscerupon the above-mentioned property fo ipses.
aD tof;�n.tur. (Applicant or
Application Number . . . . . 11-00000270
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 21.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
750
Expiration Date.. 9/13/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
3.00 2.0000 HIND BLDG 501-2,000
6..00
--------------------------------------------------------
Special Notes and Comments
--------------------
30 L.F. 6' GARDEN WALL, CITY STANDARD -
INFILL TO PERIMETER AT CUL DE SAC AT END
OF AVENUE 53. 2010 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
LQPERMIT -
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WALL 5 PROFILE 1
rHSCALE: 1•• 40
VSCALE: 1. • 4.
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3rd SUBSTITUTE MYLAR
This moor Is Identical to the moor approved
WALL 5 PLAN by the City Engineer on 7/18/07
CONSTRUCTION NOTES except for the revisions noted hereon. 7
R N d I t II &
GRAPHIC SCALE
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BASIS OF BEARINGS
I BENCH MARK
APPROVED BY:
CITY OF LA QUINTA ORAYANG NAME:
MS GRADING(SITE) REVISED AND PRECISE GRADING MG-MIRCH-03111)3
AS
FOR PERIMETER WALL AND BERM PROJECT No.
MADISON CLUB coot MDG
WALL 5
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REVISIONS
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SCALE:
1• 40'
FILE No.
0502
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TRACT MAP NO.33076 SHEET II OF 27
PORTONS OF CTION 10 T 6.S.. R.7.E. S.B.M.
Bin #
City Of ,a Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Bdilding Permit Application and Tracking Sheet
Permit #Q
/j�
Project Address: 5�. 5�a2
Owner's Name:
A. P. Number:
Address: kV,6' ZZ
Legal Description:
City, ST, Zip: (//A%%* 6-*
ConVactor: ��oo �,�
P1�� f�lA� � C
/�
Telephone Y/��i>:.:v
v:<;».�.:.a:<;>.a.>.
Address:�"�Tj z
Project Description:
City, ST, Zip: lil///l' %a, 5;3
/��� (N/� LL7 fe_94 E17Z-f
Telephone -(94 92Q 7`6
_
s#< :;'>:;:>;
F:ria::v:.'•.`•is.'i;i5?{.:<%ii
State Lic. # :
City Lic.
Arch., Engr., Designer:
t %✓ 30
Address:
City., ST, Zip:
Telephone:
;.<.;:;• :;•;;>:."or —>;::
^iii• •ri?'lig. •iv�':.i
,.•vii:;i ilii: }:!4�. tii.;i�:x{r,.i:.:.:...
Mf>:;;.:rs':»:;s::;;;;:-;>;:;:<:>:<::>;::><:
.:>v<:;;:..R„'i�^:>.Y;:•i::wrii<%;i.gr.y:'•.:;
Construction Type: Occupancy:
State Lic. #:
Project tYPa circle one): New Add'n Alter Repair Demo
Name of Contact Person: ✓�� �l?OS%
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 602 IZO 7M3
Estimated Value of Project:
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 Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
LJ
Total Permit Fees
.2o2