12-1332 (BLCK)r -
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
12a00001332�
le_f52'2f5 ,WHISPERING WY
767-200-999-47 -312023-
WALL/FENCE
LOW DENSITY RESIDENTIAL
350
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
CENSED CONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury th -I m licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business Professionals Code, and my License is in full force and effect.
License Class: B License No.: 916227
ate.. 9 ontractor•
WNER-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, 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 _ 1 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—) 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:
t
LQPERMIT i�
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/091/12
Owner:
DESERT CHEYENNE, INC.
78401 HIGHWAY 111, SUITE G-
LA QUINTA, CA 92253
(760)777-9920
DF
GJH DEVELOPMENT INC C'�+ 2012
29207 RIDGELINE CT
TEMECULA, CA 92590 :',TY :)F!-AQUINTA
(760) 777-9520
Lic. No.: 916227
---------------------------------------
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. - z
I 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 EXEMPTPolicy Number EXEMPT
I certify that, in the perf, mance of the work for which this permit is issued, 1 shall not employ any
person in any manner o to become subject to the workers' compensation laws of California,
and agree that, if I sho d ecome subject to the workers' compensation provisions of Section
C/ 3700 of the Labor Cod shall forthwith comply with those provisions.
Ltete/// pplicant:
WARNING: FAILURE TO SECURE WORKRS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL' ENALTIES 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. I '
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 appli ation becomes null and void if work is not commenced
within 180 days from date of issuance Lich permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and statethat h above information is correct. I agree to comply with all
city and county ordinances and state laws relating to b it ng construction, and hereby authorize representatives
of this county to enter up n the above-mentioned prop ifor inspection purposes. ,
/ate:,///9 / ignature (Applicant or Agent):
Application Number 12-00001332
Permit_ WALL/FENCE PERMIT
' Additional desc
Permit Fee 15.00 Plan Check Fee '.
.00
Issue Date Valuation
350
Expiration Date 5/08/13
Qty Unit Charge Per
Extension
BASE FEE
15.00 -
----------------------------------------------------------------------------
Special Notes and Comments
14 L, F, 6' GARDEN WALL (2) RETURNS, ORCO
SYSTEM. 2010 CODES.
-------------------.-----------------------------
Other Fees . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
------
Permit Fee Total. 15.00 .00 .00'
15•:00
Plan Check Total 00 .00 .00
.00
Other Fee Total 1.00. .00 .00
'1.00.
Grand Total 16.00 .00 .00
16.00
LQPERMIT -
.
.
TW 490.33
O 483.67 -
E1 122.70
X484.60 1
FC 40
OD
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/ o
EXISTING WALL-
- -.__...._ ......... ... ...
/..iiN 489.90
TF 82.90 482G8
2 a 484.0.6__ 484.90 O�
111.88 v \ FLN
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:83.60 a s .Q 47 '� 5 1 1 �o 0
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FF -484.40 FS U 5 .
483.96 2.587--.
a PE -483.9 �i ~ 1 � 18'
84.20 I W . ,O
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o FS 00
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83.70 3.40%" / ~ L) I a TC 483.13
t ' M 1-` 82:85 6 76.02
00 (� .��
- S 00.50 ao 4 L-ra0.55%FL-GB' 2.0%o I -
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116.84' 7.16% FL 82.33
. U.509�_
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B;,r.#
•
Permit #
Project Address:
City of. La Quihta
Buil�ng 8z Safety Division
P.O. Box 1504,76-495 Calle Tampico
La.Quinta, CA 92253 -:(760) 777-7012
Building Permit Application and Tracking Sheet
/Owner's Name:. moo,
A P. Number.
Address: Ul 7111 X
Legal Description:
City, ST, Zip: / 3
Contractor r
14 T
Telephone:
0`3aag>r°'x:
:M_y
Address:
Project Description:
City, $T, Zip:
Telephone
r�
a ' C�?
., i1't''
i
State Lic. # :
City Lie.. #.:
Arca., Engr., Designer.
Address:
City., ST, Zip:
Tele hone:
P
State Lic. #:
`�`
Y
3"
—Alc' :?w �'»� - ,r
Construction Type: _ Occupancy:
Project type (circle one): New Add'a Alter Repair Demo
Name of Coamet Perso
—
Sq. Ft.: # Stories:
#Units:
Telephone # of Contact Person.
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
'Reed
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mecharilcal
Grading plan
2" Review, ready for correctionsrrssue
Electrical
Subcoatactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S,ALL
H.O.A. Approval
Plans resubmitted
Grading
IN fiOUSE:-
''' Review; ready for correctionsfissue
Developer Impact Fee
Planning Approval.
Called Contact Person
Ad.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees
1--t—Tot;ipermit
Fees