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11-0263 (BLCK)s P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. r..— _ Application Number: V11-00000263 ` Property Address: 52805 HUMBOLDT BLVD APN: 767-880-015- - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: ' 7700 T d-tt 4 4 Q" Applicant: Architect or Engineer: p A BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- LIC SED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I liced under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business i Prof ssi als Code, and my License is in full force and effect. License CI s: icense No.: 915336 Date: ;F1 Contra NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that Itee..sions empt from the Contractor's State License Law for the following reason ISec. 7031.5, Business and 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 ISec. 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 ISec. 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 ISec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: EAST OF MADISON LLC PO BOX 1482 LA QUINTA, CA 92247 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/17/11 Contractor: DBCA INC P.O. BOX 1482 q LA QUINTA, CA 92247�� )g (760)393-5271 Lic. No.. 915336 Ilk – – – – – – – – – – – – – – – – – – 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 _ I certify that, in the performance f the work for which this permit is issued, I shall not employ any person in any manner so as t come subject to the workers' compensation laws of California, and agree that, if I should be aeL workers' compensation provisions of Section 3700 of the laborCode,Is foy with those provisions. Dater/ / II Applic WARNING: AILURE TO SECURE WORKERS OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000) IN ADDITION TO T 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 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 staLproperty ov or is correct. I agree to comply with all city and county ordinances and state laws relatic n ruc ion, an ereby authorize representatives of this co ty o enter upon the above-mentionr i s cti n purpose Date:Ift Signature (Applicant or Ag Application Number . . . . 11-00000263 Permit WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 99.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 7700 Expiration Date 9/13/11 Qty Unit Charge Per' Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 ---------------------------------------------------------------------------- Special Notes and Comments 308 L.F. 6' GARDEN WALLS AT SEVERAL LOCATIONS AT VILLA 11, CITY STANDARD. 2010 CODES. -------------------------------------- Other.Fees . . . . . . . BLDG STDS ADMIN (SB14.73) 1.00 Fee summary ------------------ Charged Paid -------------------- Credited -------------------- Due Permit Fee Total 99.00 .00 .00 99.00 Plan Check Total .00 .0.0 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 100.00 .00 .00 100.00 LQPERMIT Bin # City of La Quinta Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # may, PIP- Project Address: 2+ 80 A004oP7 Owner's Name: i9w QFAW t5�0 A. P. Number: Address: Legal Description: City, ST, Zip: %1*7* • f�N60 `t- 4 �� !/i' , =Telephone -Contractor: + Address: gQ � � rj Z Project Description: owiwv City, ST, Zip: i""66pk (N/t �� T' 94 E1%z-f �^ Telephone: Z -/ 4(J / ?:?4, :.:..,. xs, >: ',• :. " .::.:+ State Lic. # : City Lic. #.- Arch., Engr., Designer: Address: / City., ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal . Req'd Rec'd 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 Tide 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 correctionstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees ws� a �z6' + i 1 s /�'j rz 3f1d ZZ d j .4 za r d _.V d _ 1 11 0 fs"ss AL Af dO 11-9 SJ wip go LIM tL f ... ✓` �J 9£` GATB d L9 SJ -z vitmg --u _. i!1 A i. =.7i;• [� I __ Fo e 99 Sj 6-90 FT 4 1 i I I SAy f rsi} f dfs —� YZ.. S AL 014 ifj DA Cv CA t CP I or,'j iJ7 R! i . g 9699 �N3WSV3 Oil 4 + and ,ZZ "~ ggna cc 3-3S 3NI� �`� r. •l.7 1 s _ Ci. d _ LL �� c