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BWFE2017-018078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: M CASTILLO'S CONCRETE CO P0BOX S COACHELLA, CA 92236 i haw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT WALL/FENCE/CITY STANDARD/PRE-APPROVED BWFE2017-0180 80742 VIA PESSARO, 777160005 ALBERS / 83 LF OF 6' HIGH GARDEN WALL $8,500.00 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: ALBERSINC 49855 RANCHO SAN FELIPE LA QUINTA, CA 0 Contractor: M CASTILLO'S CONCRETE CO P0BOX 5 COACHELLA, CA 92236 (760)398-9227 Llc. No.: 881611 Date: 9/28/2017 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter.9 I hereby affirm under penalty of perjury one of the following declarations: {commencing with Section 7000) of Division 3 of the Business and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers' my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: C-8, C29 License No.: 881611 of the ork for which this permit is issued. Date: %I1 �I / Cont C 4�/�i/eS C/ //-li � 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: OWNER -BUILDER DECLARATION Carrier: MIDWEST EMPLOYERS CASUALTY COMPANY ' Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Cont'ractor's State BNUWC0134789 License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any _ I certify that in the performance of the work for which this permit is issued, I city or county that requires a permit to construct, alter, improve, demolish, or repair any shall not employ any person in any manner so as to become subject to the workers' structure, prior to its issuance, also requires the applicant for the permit to file a signed compensation laws of California, and agree that, if 1 should become subject to the statement that he or she is licensed pursuant to the provisions of the Contractor's State workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business comply with those provisions. 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 '. Da .f zb l Appli� cant:' subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: r (_) I, as owner of the property, or my employees with wages as their sole WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, compensation, will do the work, and the structure is not intended or offered for sale. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO.THE COST OF apply to an owner of property who builds or improves thereon, and who does the work COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, himself or herself through his or her own employees, provided that the improvements INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT or she did not build or improve for the purpose of sale.). IMPORTANT: Application is hereby made to the Building Official for a permit subject to (� I, as owner of the property, am exclusively contracting with licensed contractors to the conditions and restrictions set forth on this application. construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State 1. Each person upon whose behalf this application is made, each person at whose License Law does not apply Loan owner of property who builds or improves thereon, request and for whose benefit work is performed under or pursuant to any permit issued and who contracts for the projects with a contractors) licensed pursuant to the es a result of this application , the owner, and the applicant, each agrees to, and shall Contractors' State License Law.). defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and (_) I am exempt under Sec. B,&P.C. for this reason 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 Date: Owner: commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. CONSTRUCTION LENDING AGENCY - I hereby affirm under penalty of perjury that there is a construction lending agency for I certify that I have read this application and state that the above information is correct. the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above - Lender's Name: mentioned property for inspection purposes. Lender's Address:5ienat�r ra IannGi"ra P�rt-�'�� DESCRIPTION FINANCIAON FORMATION ACCOUNT QTY. AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $50.67 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - FIRST 100 LF PC. 101-0000-42600 0 $63.33 Total Paid for BLOCK WALL: $114.00 DESCRIPTION `' _. ACCOUNT • QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT ' TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: TOTALS:00 $5.00 Bin# City of La Quinta Building & Safey Division. 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 o Building Permit Application and Tracking* Sheet Permit# - cc", Project Address: / / i / i # V Owner's Name: A.P. Number w Address: Legal Description: ` City, ST, Zip: L;( Contractor: /'. S. /s �• Telephone: Address: !' Project Descriptio •G City, ST, Zip: C� t .11i'&1/ Telephone: /� J1 �� J- 1 - yy l , H , bf-� A 6 /.,Of State Lic. #: 99/1"1 Cit e . -1 / % t f �/ (/-i lf 6-'12(,d— I12(,1—Arch, Arch,Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: L/ f„ A Occupancy: State Lic. #: Prej. Typeew Add'n Alter Repair Demo Name of Contact: SgFt: #Stories # Units: Telephone of Contact: Estimated Value of Project:] 00 �,Piv APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit: Truss Calcs Called Contact Person Plan Check Balance: Title 24 Calcs Plans Picked Up Construction: Flood Plain Plan . Plans Resubmitted Mechanical: Grading Plan 2nd Rev, Ready for corrections / Electrical: Subcontractor List Called Contact Person Plumbing: . Grant Deed Plans Picked Up S.M.I. HOA Approval' Plans Resubmitted Grading IN-HOUSE 3rd Rev, Ready for corrections / Developer Impact Fee Planning Approval Called Contact. Person A.I.P.P. Pub. Wks. Apps Date of permit issue School Fees Total Permit Fees - 683AAy Ryp��tfl 1igsyy y3$j3j 9'a �s8a9" I ...i I nCO& •Yf0 fIPp6,44{EJ I(IH1J I I I I(00&33FLJJ rCg6-]Rl II I I DII > fl 6 > $ it n g Fn r� fU I$ o D D ei ALBERS RESIDENCE FUTURE z 17 I I I I4 I f CONSTRUCTION LOT 163 VIA PESSARO landscape Design Services iK PLAN � LA QWNTA, CALIFORNIA 92253 V.O. Bo, 57¢3 !� alma caUfamia 92346 z HIDEAWAY �= Z wnaB: Cualaro6Guf"�,ura0»Ipnv.can TEL 7603157473 w+••GMFu lureDesigns.com TEL 760-3157473 •- ••� ••••• �••N•�w ......ur,c0 u. nn, ,unm �rt mprvrven n,ulaOn,'nn nllnVUl"I'nE rW —SEO -MEN CONSENT OF GM FOl.l. 0„ijn, �9p $�17ya. V'rR E�Ssf�20 Ji IVI: QIN GNI y > fl 6 > $ it n g Fn r� fU I$ o D D ei ALBERS RESIDENCE FUTURE z 17 I I I I4 I f CONSTRUCTION LOT 163 VIA PESSARO landscape Design Services iK PLAN � LA QWNTA, CALIFORNIA 92253 V.O. 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