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04-5679 (BLCK)TA 4 t1ft�Gv BUILDING & SAFETY DEPARTMENT m -w� P.O. Box 1504 (760).777-7012 OF 9 78-495 CALLE TAMPICOFAX (760) 777'7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 04,_9000-56.7-9 -Date 7/26/04 Property.Address . . 78510'TVIA PALOMINO APN: 604 -03.2 -999 -98 -3.05212 - Application description WALL/FENCE- Property Zoning.. LOW DENSITY RESIDENTIAL Application valuation . . . 2625 Owner Contractor LENNAR HOMES OF CALIFORNIA LENNAR HOMES OF CALIFORNIA INC 78401 HIGHWAY 111, STE C 78401 HIGHWAY 111, SUITE -C LA..QUINTA, CA `LA QUINTA CA 92253 LA, QUINTA _ _,CA 92253 WCC: OLD REPUBLIC IN WC: MWC.10877600 11/01/04 CSLB: 728102 09/30/04 CCC: B' Permit . . . WALL/FENCE'PERMIT Additional desc Permit Fee . . . 54.00 Plan Check Fee .00 Issue Date Valuation 2625 Qty. 'Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 Special Notes and Comments 10 L.F.6' GARDEN WALL, 95 L.F. COMBO WALL, 21.RETAINING, 6' GARDEN, BOTH ORCO SYSTEM Fee summary Charged Paid Credited Due Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00. .00 Grand Total 54.00 00 .00 54.00 ^q?dIG 12EP, F. - P.O. BOX 1504 " VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY.DEPARTMENT Application Number: 0 4- 560 7q— I Date: Applicant: Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: AMA Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed unde rovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals ode, and my License ' in full force and effect. �J q License Class__ License No. /rT?10 a / Date S -l& 2?� ----Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U I, 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: t 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. YI have and will maintain workers' compensatioh insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is X uNo ors= compensation ins!uj3 a carnigr�nd �pti�c r�u-m�gr re: �Ga er OI / I k9l7C icy Number!/I/G(.1/�1�C3!"/[�Qlid _ I— certify h t, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall /forthwith comply with those provisions. A ate �' I �' nt WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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. 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 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 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, 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. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 100 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 above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. ate tf `� 4j ' Signature (Applicant or Agent): _ "r rfj Southwest Inspection and Testing, Inc. 10826 South Norwalk Blvd., Santa Fe Springs, CA 90670 Arw-A 1 AAA '1 f xA1 12 -9 A i \ T'%� n d a w T' _ _ _ I r r w % - — a n - - — - 11LZ 1D OSr JLV-VTC 0 9 qN ,JVL) JTV-V VLV - � r Z SWIT Job N REGISTERED INSI`E ORS'S DAILY REPORT '- G' 'l Date TYPE OF cp4einforced Concrete ❑ Structural Steel Assembly ❑ Quality Control INSPECTION ❑ Post Tensioned Concrete ❑ Fire Proofing ❑ Other REQUIRED ❑ Reinforced Masonry ❑ Asphalt Job Address / / City 3� Job Name I& Permit No. Issued By Type of Structure Architect G - 'q Nil Material Description (type, grade, source) �) / Engineer gaz if Z'/ Contractor / `Lig4 Inspector(s) Narne ,� Subcontractor TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY INSET ADDITIONAL REMARKS ON SAMPLES INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC. i-0 Tt- P • 6o4, S� �C 7`� ' " G G -C lt:� W 17 -6 Y Ca qG d W(-. ' v - 6i fir, CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATION , AND APPLICAELE S CTIONS OF TH GOVERNING BUILDING LAWS. �f SIGNATURE OF REGISTERE SPECTOR TSG ,�.--� 9 V- � f�G� SPECIALTY N0. AGENCY CONTINUED ON NEXT PAGE ❑ PAGE OF TIME IN TIME OUT REG. HOURS O.T. HOURS CYLINDERS I L q c L i0o I _ All inspections based on a minimum of 4 hours and over 4 hour - 8 hour minimum. In ddition, any ins ion exte ding p st noon hour vvill be an 8 hour minimu Approved byL. Project Superintendent WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR'S COPY, GOLDENROD - JOB SITE COPY