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09-0292 (BLCK)V '4 P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: 09-00000292 81670 DE SOTO 767-200-091-1 WALL/FENCE Tdy/ 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: AVE EAST OF MADISON LLC -34968 - PO BOX 1482 LA QUINTA, CA 92247 LOW DENSITY RESIDENTIAL 3704 Architect or 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 nd Professionals Code, and my License is in full force and effect. License Class: 13 C10 _License No.: 746198 /Date' `—© ontractor: 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).: (_ 1 1, 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 _ I 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.). 1 _ 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 (Sec. 3097, Civ. C.). Lender's Name: ,\ Lender's Address: N LQPERMIT Contractor: A & M CONSTRUCTION P.O. BOX 366 LA QUINTA, CA 92247 (760)564-4832 Lic. No.: 746198 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 7.77-7153 Date: 3/31/09 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. 1r 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor T� Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: - Carrier STATE FUND Policy Number 044-0028137-07 1 certify that, in the 4shouecome f the work for which this permit is issued, I shall not employ any person in any mbecome subject to the workers' compensation laws of California, and agree that, isubject to the workers' compensation provisions of Section 23700 of the Labl forthwith comply with those rovisions. 1te31-t Aunt: WARNING: FAILURERE TO SECURCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 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 avid 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 bove information is correct. I agree to comply with all city and county ordinances and state laws relating to buil ng construction, and hereby authorize representatives ofthis county` two enter upon the above-mentioned prope for inspection pu*ses. a6 te: �C v 1 �gnature (Applicant or Agent): Application Number . . . . .. 09-00000292 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation 3704 Expiration Date 9/27/09 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00 ---------------------------------------------------------------------------- Special Notes and Comments 120 L.F. 6' GARDEN WALL & 44 L.F. 4' GARDEN WALL, BOTH CITY STANDARD. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged ---------- Paid Credited Due ----------------- Permit Fee Total ---------- 63.00 -------------------- .00 .00 63.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 64.00 .00 .00 64.00 LQPERMIT 4X =44 1, CIVIL ENG. _.. I AS f-" Cc 14%6" P.A 5'-0" 61 -oil 1. Bin # City of La Quinta C �� Building a Safety Division 17 P.O. Box 1504, 78-495 Calle Tampico t La Quinta, CA 92253 - (760) 777-7012�l Building Permit Application and Tracking Sheet Permit # Project Address: — 40 VA " Owner's Name: �%��r D �%yj���� G LI/— A. P. Number: Address: -PO ( L( $'Z Legal Description: City, ST, Zip: L A 6Q j i v->-r,+Zoi ZZ t ( 7 Contractor: M CO-tA 57—. Telephone: Address: FO 3 (e 4? Project Description: `� LoGIL 7.4 CV- City, ST, Zip: p �T (�t1'L ► �. �% �D T 4 gl —(P -7o Dli J DSO Ave 02 ' LA— � Z Z �7 a Telephone: �lo �f L/ �37� -- �i C9 FT n Y q FT- Y State Lie. # City Lie. # - y [ —& q Q D.e �D i © V e- Q 4} Arch., Engr., Designer: t5,P,,—z- A,6+ V I %A- 00 F -, 6 FT -/,g?, [ i— � Y Fr Address: City, ST, Zip: Telephone: State Lie. #: �2 T� % Fr/ T7 Fr 4t Fr' 0 q' Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: (Z -Z G ate, Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: '- Estimated Value of Project: '070D r APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rce'd TRACKING PERMIT FEES Plan Sets Plan Check submitted ' Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"d Review, ready for correctionstiissue 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 corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue El I School Fees Total Permit Fees