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BWFE2015-0116I.1 78-495 CALLE TAMPICO C� 0 D Qum& LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2015-0116 Property Address: 59685 SEVILLE APN: 764710010 -. Application Description: ANDALUSIA TM 31681-3 LOT 184 / BLOCK WALL 276 LF Property Zoning: Application Valuation: $6,900.00 Applicant: T.D. DESERT DEVELOPMENT, L.P. 81-570 CARBON ERAS LA QUINTA, CA 92253 Contractor: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the -Business and Professions Code, and my License is in full force and effect. 7 License Clas : _ 'cense No.: AEC212 Date:c/ Contrac 11 Li . OWNER -BUILDER D RATION I hereby affirm under penalty of perjury that I am exempt from the Conactor'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 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 Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Llc. No.: AEC212 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 a or h this permit is issued. ave a d will maintain workers' compensation insurance, as required by on 3700 of th Labor Code, for the performance of the work for which this permit is issued. My wor ers' 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 3700 of th or ode, I shall forthwith comply wi those rovisions. Date Z� b� Applicant: / WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS NLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI ES 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 and state law ting to building construction, and hereby authorize representatives of this cit enter on the above mentionedrope y for inspection purposes. Date: Signature (Applica �Antl. Date: 5/14/2015 Owner: T D DESERT DEV 81570 CARBONERAS LA QUINTA, CA 0 w Un d Q W O C==32 Contractor: T.D. DESERT DEVELOPMENT, L.P I 81-570 CARBONERAS y I LA QUINTA, CA 92253 Q Q Llc. No.: AEC212 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 a or h this permit is issued. ave a d will maintain workers' compensation insurance, as required by on 3700 of th Labor Code, for the performance of the work for which this permit is issued. My wor ers' 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 3700 of th or ode, I shall forthwith comply wi those rovisions. Date Z� b� Applicant: / WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS NLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI ES 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 and state law ting to building construction, and hereby authorize representatives of this cit enter on the above mentionedrope y for inspection purposes. Date: Signature (Applica �Antl. EI DESCRIPTION FINANCIAL INFORMATION 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 , 101-000042404 0 $58.00 $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 for FENCE OR FREESTANDING WALL TOTALS:•• $166.77 $0.00 s� G Permit Details PERMIT NUMBER... City of La Quinta BWFE-201�5�01: 6 a,r - Description: ANDALUSIA TM 31681-3 LOT 184 / BLOCK WALL 276 LF Type: WALL/FENCE Subtype: Status: UNDER REVIEW Applied: 5/12/2015 MFA Approved: Parcel No: 764710010 Site Address: 59685 SEVILLE LA QUINTA,CA 92253 Subdivision: TR 31681-3 Block: Lot: 184 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $6,900.00 Occupancy Type: Construction Type:. Expired: No. Buildings: 0 No. Stories:.O No. Unites: 0 - Details: 276 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. ADDITIONAL SITES Printed: Thursday, May 14, 2015 5:47:54 PM 1 of 2 CPR" SYSTEMS CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI 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 5:47:54 PM 1 of 2 CPR" SYSTEMS PARENT PROJECTS ATTACHMENTS Printed: Thursday, May 14, 2015 5:47:54 PM 2 of 2 g?SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: WALL/FENCE - EA 101-0000-42404 0 $58.00 $0.00 ADDITIONAL 50 LF 'vVALL/FEtiCE - 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 forFENCE OR FREESTANDING WALL- $166.77 $0.00 TOTALS:00 PARENT PROJECTS ATTACHMENTS Printed: Thursday, May 14, 2015 5:47:54 PM 2 of 2 g?SYSTEMS