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12-0930 (BLCK)P.O. BOX 1504SCAl41 VOICE (760) 777-7012 78-495 CALLE TAMPICO Ir® FAX (760),777-7011 LA.QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7.153 BUILDING PERMIT __• Date: 8/16/12 Application Number: -'12-00060930.1 Owner. Property Address: 53672 VIA PALACIO AME S . APN: 772-560-054- - - 53672 VIA PALACIO Application description: WALL/ FENCE., -LA QUINTA CA- 922-53. -- Property Zoning: LOW DENSITY RESIDENTIAL ` lJ Application valuation: 2750 Contractor: AUL J. t, 2 12 Applicant: Architect or Engineer. BOGART MASONRY INC ` P.O. BOX 2398' CIfY0FLA•4UINI YUCCA VALLEY, CA 92286 i7l.�flti DEPT. (760)363-7550 Lic. No.: 772387 - 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 Profession de, and my nse is in full force and effect. - _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Zl'ate-.! Class: C29 cense N 2387 - for by Section 3700 of the Labor Code, for. the performance of the work for which this permit is - issued. ��Z ontractor. .w. - .. I have and will maintain. workers' compensation insurance, as required by Section 3700 of. the LaborCode, for the performanceof the work for which this permit is issued. My workers'compensation insurance carrier and policy number are:I hereaffirm under penalty of perjur that I am exempt from.the Contractor's State License Law for the Carrier SECURITY NATL - Policy Number SWC1006841 - following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_ I certify that, in the performance of the work for which 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 manner so as to become subject to th 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 that, if I should become subject to tt wort rs' compensation provisions of.Section - License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or _ 3700 of the Labor _ hall forthwith c fSt h those rovi ' 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)•; • Date:C7 �% pplicant: let _ - (_ 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 offeredforsale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECUREORKERS' CO PENSATION-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•PENALT S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his ocher own employees, provided that the DOLLARS ($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 -builder will have the burden of proving that he or she did not build or - .improve for the purpose of sale.).'- y APPLICANT ACKNOWLEDGEMENT - 1 • . 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed -1. Each person upon whose behalf this application is made, each person at whose request and for pursuant to the Contractors' State License Law.). - ., whose benefit work is performed under or pursuant to any permit issued as a result of this application, I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant,"each agrees to; and shall defend, indemnity 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. - Date: Owner: 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 ' CONSTRUCTION LENDING AGENCY - permit to cancellation. . hereby affirm under penalty of perjury that there is a construction lending agencyfor the performance of the I certify that I have read this applicationand state that the above information is correct. I agree to comply with all - work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and 1 dY a orize representatives V Oil is county to enter upon the above-mentioned pro inspection - Lender's Name: Date lZ nature (ApplicantorAgentl:- _ Lender's Address: LQPERMIT Application Number . . . 121-00000930 :._ Permit . . . . . . WALL/FENCE PERMIT Additional desc'. Permit Fee 54.00 Plan Check Fee .00 Issue Date Valuation 2750 Expiration Date 2/12/13. Qty Unit Charge Per Extension -BASE FEE 4 5-0 .0 -= 1.00. 9.0000 THOU BLDG 2,001-25,000 9.00 -------------------------------------------------------------- Special. Notes and -Comments 110 L.F.. 6'"GARDEN WALL IN VARIOUS LOCATIONS ON PROPERTY, 24 L.F. -36" WALL @ BBQ AREA, ORCO 'SYSTEM. 2010 CODES. , -------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN.(SB1473) ----------- -- 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 54.00 .00 .00. 54.00 Plan Check Total .00 .00. :'00 00 Other Fee Total .1:00 .00 .00 Grand Total 55.00 .00 :00 55.00 ,LQPERMIT DIII ff Perna t # X Project Address: i A. P. Number: 5-% 72 Legal Description: Contractor: Igoe P Address: City. ST, Zip: Telephone: State Lic. # -Z97 723 LA,ddress: ngr., Designer: Zip: Telephone: State Lic. # Name of Contact Person: k F "ftLTelephone # of Contact Person: # Submittal. Plan Sets Structural Calcs. Truss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval CN HOUSE: - Planning Approval Pub. Wks. Appr School Fees City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit APPlication and Tracking Sheet 1° t`n wner's Name: 0 / �7 U` ST, Zip. 1_ Q(aw phone: :ct Description: IA-D� r� r _ l cid IC 1 I (-1t t Co (FI nceA- I .— m Construction T nn 5 e �Occ Occupancy: anc y•. ype r0 J ec t type (circle r c le one) New Ad ' o Alter Repair tp Demo 0M Sq. Ft.: # Stories: # Units: Sb J Estimated Value of ProjecA `� 7 =* ' APPLICANT: DO NOT WRITE BELOW. THIS LINE Reed TRACKING Plan Check submitted Reviewed, ready for corrections Called Contact Person Plans picked up Plans resubmitted 2°d Review, ready for corrections/issue Called Contact Person, Plans picked up Plans resubmitted Review, ready for corrections/issue Called Contact Person Date of permit issue PERMIT FEES Item Amount Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Plumbing S.M.1: Grading' Developer Impact Fee A.I.P.P. Total Permit Fees