09-0320 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -. 09-00000320
Property Address: 81940 EAGLE CLAW DR
APN: 764-280-999-24 -300235-
Application description: WALL/FENCE.
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 160
(r�-,�'4 4 QW4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: �
Architect or Engineer:
------------------
-
CONTRACTO ' DECLARATION
I hereby -affirm under penalty ofperjury
I m licensed under° ov ions of Chapter9 (commencing with
Section 7000) of Division 3 of the Busi
and Professionals C e, d my License is:in full fordo and effect.
License.Cla : jC53
Li se N .: 866518
Date: Contractor•
GARY & SONS
BUILDER DECLARATION
1 hereby affirm under penalty of perjury that Lame _ pt from.the Contractor's State. License Law for the,
following reason (Sec. 7031.5, Business and Pro ions Cods: Any city or county that requires a permit to
construct, alter, improve, demolish, orrepair 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) ofDivision3 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 -18500)•:
( _,) 1, as,owner of the property, or my employees -with wages as their sale 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:f.
(_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project.(Sec.
7044, Business and Professions Code: The:Contrectors' State License Law does not apply town owner of
property who builds.orimproves :thereon, and who contracts for the:projects with a contractor(s) licensed
pursuant to the Contractors' Stene License Law.l:
(_ 1 I am exempt under Sec. , B:&P:C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury thatthere 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:-
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/09/09
Owner:
MELLIN RESIDENCE
81940 EAGLE CLAW
LA QUINTA, CA 92253I-W41FIII��
I
pp� iContractor: HPf1 �
t
GARY & SONS
67621 CACTUS APPLE
C1I YOF �A
DESERT HOT SPRINGS,?;;wE
QL11W1A
P-,�
(760) 251-8945
-�--..
.Lic. NO,.: 8'66518
WORKER'S COMPENSATION DECLARATION
I hereby affirm underpenalty 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,performarice of the,work for which this: permit is
issued.
1 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 DELOS INS CO Policy Number OZDKRM220010101
I certify that, n the performan of the work for whi his permit is issued, I shall not,employ any
person in any manner so a to becomYwn, t workers' compensation lawsofCalifornia,
agree that, if I should oma suorkers' compensation provisionsof Section
700 of the. Labor C ,.I all forththose: provisions.
Date: Applicant:
WAR IN FAILURE'TO SEC RE WORKERS' MPENSATION COVERAGE'IS.UNLAWFUL, AND SHALL
'SUB IN
AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES.UP TO ONE HUNDRED THOUSAND
DOLLARS 15100;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 thisapplication 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, agentsand employees for any actor omission related 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 o °isnot commenced
within 780 days from date of issuance of suchpe it, or cessatiorrof t for 180 days will subject
permit.to cancellation.
I certify that ha .read this and state that to elnformation is c ec . I agree.to comply with all
cityanrl c ty dinances and state laws relating to b ii in onstruction, and reb authorize representatives
of this c t enter upon the above-mentioned pro r inspection,pur s.
Date: Signature (Applice gent):_
Application Number . . 09-0000.0320
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 15.00 Plan Check
Fee
-00
Issue.Date
Valuation
. .
. 160
Expiration Date .
. 10/06/09
Qty Unit Charge
Per
Extension
BASE FEE
15.00
Special Notes and
Comments
10 IN FT X 4 FT HT
GAPDEN BLOCK WALL PER
CITY STANDARDS.AND
APPROVED PLANS.
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
Charged Paid Credited
Due.
Permit Fee Total
15.00 .00
.00
15.00
Plain Check. Total
.00 .00
.00
.00
Other Fee Total
1.00 .00
.00
1.00
Grand Total
16:.00 .0.0
.00
16.00
LQPERMn'
0
•
u
1
., t� (n
►j,
_ u
I s,
Existing Concrete
to Remain
Pool/Spa
Equip. -
MELL I N
RESIDENCE
E?/- qy0 Eacl, cj"
NOTE:
I. Low Voltage Landscape Lighting.
All trees shall receive (1) one low.
voltage landscape uptight. Lighting
Fixtures to be selected at later
date nnel nrnr)rnvPA kv jhnmon.nor
C
134 'V1w
New Colored
Cil. 922
PLAN KEY NOTES: s3
Concrete Vacking .
Q Concrete Decking - (1100 sq. ft.)
Color shall be Standard Grey
3'w X 3' w X s' L
Stacked Stone
with Salt Finish.
" Fountain .
. ..
�., Decomposed__ 6ranite AI'L
landscape areas and sidegards
shall receive 2" min. depth of
301 minus Omaha DG or
approved equal.
NOTE:
I. Low Voltage Landscape Lighting.
All trees shall receive (1) one low.
voltage landscape uptight. Lighting
Fixtures to be selected at later
date nnel nrnr)rnvPA kv jhnmon.nor
C
Bin #
Qty of La Quinta
Building ar Safety Dh4slon
P:O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit•#
Project Address: ���
Owner's Name: H.
A. P. Number:
Address: _ a
Legal Description:
City, ST, Zip. +1 I;Y S^
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip: CA, 2AY/
Telephon:"? 6
City Lic. #:
State Lie. # :
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #: �l
Construction Type: Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo
Name of Contact Person: Sq. FL:
# Stories: Tvnits:
Telephone'# of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRiTEMELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMITTEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Pian Check Balance
Tide 24 Cafes.
\
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for correctiouslissue
Electrical
Subcontector List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.l).A. Approval
Plana resubmitted
Grading
IN HOUSE:-
7nd Review, ready for correction tissue
Developer Impact Fee
Planning Apptoval
Called ContactPerson
A.I.P.P.
Pub. Wks. Appr
Date4of permit issue
School Fees
Total Permit Fees