The URL can be used to link to this page

12-0256 (BLCK)P.O. BOX 1504^' VOICE (760) 777-7012 78-495 CALLS TAMPICO 4 FAX (760) 777-7011 LA QUINTA,'CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 3/20/12 Application Number: 1;�12-00000256 Owner: Property Address: 52705 HUMBOLDT BLVD EAST OF MADISON LLC APN: 767-200-091-15 -34968= PO BOX 1482_ Application description: WALL/FENCE LA QUINTA, CA. 92247 4 Property Zoning: LOW DENSITY RESIDENTIAL D 1 Application valuation: 10050 - Contractor: MAR 2 0 2012 ` Applicant: Architect or Engineer: DBCA INC C1 P.O. BOX 1482 F1 -A EoEPrT� LA QUINTA, CA 92247 - / (760)393=5271 L/ Lic. No.: 915336 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 Professionals Code, and my License is in full force and effect. License Class: B License No.: 915336 /Date: Co actor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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.). (_ 1 1, 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 o contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License L (_) I am exempt under Sec. , B.&P.C. for h reaon Date: !W7,_ Owner: CONSTRUION LENDING AGENCY I hereby affirm under penalty of perjury that there is a cor&tuction 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 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain acertificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labvi 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 YEUB282D779711 I 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 ecome bject to the workers' compensation laws of California, and agree that, if I should b e su)ea he workers' compensation provisions of Section 3700ofthe Labor Code, I to ith com y with those provisions. Date- c t ✓ pli WARNING: FAILURE TO SECURE WORKER OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO T OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTI I ST, 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 state that the a info a ' n is correct. I agree to comply with all city and county ordinances and state laws relating to buildi onstru tion, a hereby authorize representatives of this county to enter upon the above-mentioned property n n purpo s. &Signa e (Applicant or'R§2i�fT^� LQPERMIT Application Number. 12-00000256 Permit . . WALL/FENCE PERMIT_ Additional desc . Permit Fee . . . . 126.00 Plan Check Fee .00 Issue Date . . . . Valuation 10050 Expiration Date 9/16/12 Qty Unit Charge Per Extension BASE FEE 45.00 9.00 9.0000 THOU BLDG 2,001-25,000 81.00 ---------------------------------------------------------------------------- Special Notes and Comments 402 L..F.6' PERIMETER GARDEN WALL, ORCO SYSTEM. ----------------------------------------------------------- 7 ------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- --7 Permit Fee Total .126.00 .00 .00 ------- 126.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 'Grand Total 127.00 .00 .00 127.00 LQPERMIT Bin.# QtY of La c.urnta Buidng 8T Safety Dw6n . P.O. Box 1504,78-495 Calle T'amplco La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #. Project Address:. Owner's Name:. % A?" A P. Number Address:' Legal Description:. City, ST, Zip: v� / of G' 09 3 p� Contractor. Telephone: ash Project Description: Address: City, ST, Zip: t 2'.25 C . a c Telephone: _ <''$. -� �' /� �_2� X25 BoT �- .l7 �F U Z^%� l��— �j _ State Lic. # : City Lie. #-) - �5✓' Arch, Eng r., Designer Address: City, ST, Zip: Telephone: � State Lic. #: ��» Name of Contact Person: �% Construction Type: Occu an p cy: Project type (circle on N Add'n Alter Repair Demo Sq, Ft.; # Stories: #Units: Telephone # of Contact Person �}�� %�j Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # SubmIttal Req'd Rec'd TRACMG PERMIT FEES Plpn Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit. . Trw Calcs. Called Contact Person Pian Check Balance Title 24 Cafes. Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2' Review, ready for correctionsfissue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees M