BWFE2015-010778-495 CALLE TAMPICO D �IUCl/
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT'
BUILDING PERMIT
Application Number: BWFE2015-0107 Owner:
Property Address: 59175 SEVILLE T D DESERT DEV
APN: 764700002 81570 CARBON[
Application Description: ANDALUSIA TM 31681-3 LOT 167/ BLOCK WALL 207 LF LA QUINTA,
Property Zoning:
Application Valuation: $5,175.00
Applicant:
T.D. DESERT DEVELOPMENT, L.P.
81-570 CARBON ERAS
LA QUINTA, CA 92253
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 Clas ense No.: AE
C212
De �/'�i Contract
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.).
(_) 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 Addres
Contractor:
T.D. DESER-
81-570 CAR
LA QUINTA,
Llc. No.: AEC2
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/14/2015
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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'
co ation, as provided for by Section 3700 of the Labor Code, for the performance
theork which this permit is issued.
I h ve and will maintain workers' compensation insurance, as required by
Se n]1700 f 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: _ Policy Number: _
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 to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 370 the or Code, I shall forthwith
comply with ose pro ' ions.
Date: Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA E IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND C4 IL 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 Building Official 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 above information is correct.
I agree to comply with all city and county ordinances a state laws relating to building
construction, and hereby authorize representativ of this c to enter upon the above-
mentio�n•-ed 'rope for inspection purposes.
Date: J ua Signature (Appli nt or A nt):
DESCRIPTION
FINANCIAL ,•
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
$43.50
$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
$152.27
$0.00
TOTALS:00
PermiS PERMIT NUMBER
City of La Qunta BWFE�201f5-0107
a
Description: ANDALUSIA TM 31681-3 LOT 167/ BLOCK WALL 207 LF
Type: WALL/FENCE Subtype: Status: UNDER REVIEW
Applied: 5/12/2015 MFA
Approved:
Parcel No: 764700002 Site Address: 59175 SEVILLE LA QUINTA,CA 92253
Subdivision: TR 31681-3 Block: Lot: 167
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,175.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 207 LF GARDEN WALL [ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
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777, 77 77T
NAME TYPE
NAME
ADDRESS1
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
T.D. DESERT DEVELOPMENT, L.P.
81-570 CARBONERAS
LA QUINTA
CA
92253
NSPARKS@RANCHOLA
QUINTA.COM
CONTRACTOR
T.D. DESERT DEVELOPMENT, L.P.
81-570 CARBONERAS
LA QUINTA
CA
92253
NSPARKS@RANCHOLA
QUINTA.COM
OWNER
T D DESERT DEV
81570 CARBONERAS
LA QUINTA
CA
0
Printed: Thursday, May 14, 2015 11:10:36 AM 1 of 2
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BY
13SAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
WALL/FENCE - EA
101-0 . 000-42404
0
$43.50
$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- $152.27 $0.00
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Printed: Thursday, May 14, 2015 11:10:36 AM 2 of 2 CRWYSTEMS
71
Printed: Thursday, May 14, 2015 11:10:36 AM 2 of 2 CRWYSTEMS