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10-1309 (BLCK)P.O. BOX 1504 :78-495 CALLE TAMPICO. LA QUINTA, CALIFORNIA .92253 -Tit�4.4Q" BUILDING & SAFETY DEPARTMENT BUILDING, PERMIT .VOICE (760) 777-7012 FAX (760) 177-7011 INSPECTIONS (760) 777-7153 one year of completion, the owner -budder will have the burden of provingthat he or she did not build or - 'improve for the purpose of sale.). l _ I 1, 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' St 'ens Zsemo ( • 1 I am exempt under Sec._71, B.&P r n fDate/ l � Ow I hereby affirm under penalty of perjury that there is a co) work for which'this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERN11T LENDING AGENCY to lending agency for the performance of the APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director 6f 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 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, in 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 permZcessat,n of work for 180 days will subject permit to cancellation. I certify that I have read this application and to that abo 'correct. I agree to comply with all cityand court ordinances and state laws lacingwilding hereby authorize representatives of this coup to a er upon the above -m tion insses. . r`Dat gc ignature (Applicant Date: 12/01/10 Application Number: `10 0-0"00130 C52285 Owner: ' Property. Address: WHI-SPERING WY DESERT CHEYENNE, INC. APN: 767--740-016- - - 78401 HIGHWAY 111, SUITE -G Application description: WALL/FENCE ' LA QUINTA, CA 92253 PrnrartyJnnino: LOW DENSITY RESIDENTIAL ( Application valuation: 4625 Contractor:Applicant: tt Architect or Engineer: PULLIAM MASONRY, JOHN 2010 1535 NANDINA AVENUE PERRIS, CA 92571 CITY OFlA©LgNTA (951) 940-4441 FII�lA��.EQ£0t Lic. No.: 370756 ---- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business, and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided license Cl6ss: C29 License No.: 370756 - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: Contractor: _ 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 - . OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that l am exempt from the.Contractor's State License Law for the Carrier OAK RIVER INS Policy Number . 2200056668101 following *reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the a of th or ich this permit is issued, I shall not employ any " construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any ;ansous t cam tile to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree th , if I should b ome s lett the workers' compensation provisions of Section ' License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotle) or 37 0 of the abor Cod shalt wit comply with those provisions. 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).: Applicant: �r / Dat�G:: 1 _ ! '1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and -' l_ - the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARLURE TO SEC RE WORK S' C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL - Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES,UP TO ONE HUNDRED THOUSAND . ' and who does the work himself or herself through his or'her own employees, provided that the. , DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. .. one year of completion, the owner -budder will have the burden of provingthat he or she did not build or - 'improve for the purpose of sale.). l _ I 1, 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' St 'ens Zsemo ( • 1 I am exempt under Sec._71, B.&P r n fDate/ l � Ow I hereby affirm under penalty of perjury that there is a co) work for which'this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERN11T LENDING AGENCY to lending agency for the performance of the APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director 6f 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 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, in 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 permZcessat,n of work for 180 days will subject permit to cancellation. I certify that I have read this application and to that abo 'correct. I agree to comply with all cityand court ordinances and state laws lacingwilding hereby authorize representatives of this coup to a er upon the above -m tion insses. . r`Dat gc ignature (Applicant Application Number 10-00001309 'Permit . . . . . WALL/FENCE PERMIT Additional desc . Permit Fee 72.00 Plan Check Fee .00 Issue Date Valuation 4625, Expiration Date 5"/30/11 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 27.00. Special Notes and Comments r 185 LN FT X 6 HT BLK WALL PER ORCO STANDARDS & APPROVED PLANS. Other Fees BLDG.STDS ADMIN (SB1413) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 72.00 .00 .00 72.00 Plan Check Total 00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 7,3.00 00 .00 73.00 f LQPERMIT .. , 29 m- -- - - - - - - - - - - - - - - IW 489.50 F 483.30 L .. - _ .. • 15' 42 19" R-500 137. �G+ OD 80.09 484.80 483.90 Noo -p- � 4. TW 490.80 FG . FG = in o 00 TF 483.30 N _� 0.5096 o o- G 484.80 51 N .. -_ -- 484.92' 0;090 � I I FS --_ - - - � � O N r to `D r „� I� °°N I I T mfr w jo p m�. -81, 00 D�\\ I I-n � �o /rl No�1 O �W� V V O O CA u c 031 CA Ln chi cn _ 9 0 AtOD 0 2.09' to I J !�, O w I �2" o:o W Z I 2. �G 5 rte' r &O O WI to L0 9 8 COD COD 0 CA 0 to 6 o cn o I^ •v` GF= ro� 490.190 ° 9 G 4 484 80 tO v N TF 483.30 � 1 ° ;► V�� J m00, I o $.990 . °Li GF=484.80 n I� C) 4196 �9 l ° . ° 0 ° ° oo N i� 484.14 484.39 rr $0 v I N aoCMD° N O o0 O Ilio O A 1. 0 0i �9 �, FS �/ G1 co4 0 v, . c °� m v 04 0 v P3 to to 0Oo \ 80 0' OD O CD OD 80.00 0 ----- - -...--------....._ _..._. __ TC 482.61 TC 483.43 TC 483.08 TC 482.86 TC 483.54 TC 483. TC 483.10 TC 483.48 TC 482.72 TC 482.63 83.68 TC 483.50 m TC 483.08 TC 482.67 _ L 4 2.13 TC 483.49 --- ---------- 0.515 TC 482.65 ` - ... ._-- - - - ----}--- - - _"-T 482.66 Bin # Qty QI La Quint-a Building 8I' Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking S_eet . Permit # ��� Project Address: Owner's Name: Address: A. P. Number: Legal Description: City, ST, Zip: Contractor: G ez Telephone Address: Project Description: City, ST, Zip. Telephone: I O State Lic. # : City Lic. #.: O 0 Arch., Engr., Designer: / Address: City, ST, Zip: Telephone: ;.; Construction Type: Occupancy: . State ic . #• t L Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 13kalance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue 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 Pub. Wks. Appr Date of permit issue School Fees Total Permi` Fees n, Is