BWFE2015-012378.495 CALLE TAMPICO T t4
LA QUINTA', CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BWFE2015-0123 Owner:
Property Address: 59955 SEVILLE T D DESERT DEV
APN: 764710019 81570 CARBONERAS
Application Description: ANDALUSIA TM 31681-3 LOT 193 / BLOCK WALL 426 LF LA QUINTA, CA 0
Property Zoning:
Application Valuation: $10,650.00
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 Clasp: License No.:AEC212
Date: GAJ Contractor: /
G OWNER -BUILDER D ATION
I hereby affirm under penalty of perjury that I am exempt from the Conractor'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
thg 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 constriction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
T.D. DESERT DEVELOPM
81-570 CARBON ERAS
LA QUINTA, CA 92253
Llc. No.: AEC212
Date: 5/14/2015
r
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'
compe tion, as provided for by Section 3700 of the Labor Code, for the performance
of 'o k f hich this permit is issued.
1 h will maintain workers' compensation insurance, as required by
ection 3700 of the abor 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 the Labor Code, I shall forthwith
comply withpose pr inions.
Date: "" Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM NSATION COVERAGE IS U WFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COS 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 laws re - g to building
construction, and hereby authorize representatives of this city to er u n the above-
mentione prope rfo/r inspection purposes.
Date: � f/ Signature (Applican or Agent
DESCRIPTION
FINANCIAL •
ACCOUNT .
1•
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
CITY
AMOUNT
PAID
PAID DATE
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$101.50
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
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
CITY
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 $210.27 $0.00
TOTALS:6m 1 $0.00
Description: ANDALUSIA TM 31681-3 LOT 193 / BLOCK WALL 426 LF
Type: WALL/FENCE Subtype: Status: UNDER REVIEW
Applied: 5/12/2015 MFA
Approved:
Parcel No: 764710019 Site Address: 59955 SEVILLE LA QUINTA,CA 92253
Subdivision: TR 31681-3 Block: Lot: 193
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $10,650.00 Occupancy Type: Construction Type:
Expired:
No. fiuildings: 0 No. Stories: 0 No. Unites: 0
Details: 426 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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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
$101.50
$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 forFENCE OR FREESTANDING WA LL $210.27 $0.00
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