10-0069 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10=00000069
Property Address: 80815 - VIA , PORTOFINO
APN: 777 -150 -022 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6600
Tiluf 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prof s .onals Code, and my License is in full force and effect.
License C ss: B License No.: 769229
te: ( ntractor:
OW ER -BUILDER DECLARATION
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Seo- 7031.5, Business and Professions Code: Any city or county that requires permit to - -
r- 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).:
(_) 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 town owner ofpropertywho 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.).
(_) 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.).
( - 1 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:
LQPERMIT
Owner:
JIM WEYMOUTH
P.O. BOX 238
LA QUINTA, CA 92247
VOICE. (760) 777-7012
FAX (760),777-7011
INSPECTIONS (760) 777-7153
Date: 1/27/10
Contractor:
ALBERS CONSTRUCTION CO, INC.
_78060 CALLE ESTADO, SUIT 11
LA QUINTA, CA 92253
(760)771-9954 D
Lic. No.: 769229 D
'JA IV
---------------------- ---� ------Q-- -_--
WORKER'S CO ATION CLA41 _
I hereby affirm under penalty of perjury one of the following dec a ' ;.;V, ,
_ I have and will maintain a certificate of consent to self -insure ter • sation, as provided
for by Section 3700 of the Labor Code, for the performance of the or which this ermit is
�issued. - -
I have and will maintain workers' compensation insurance, as required by Section 3700 o the Labor
Code, for the performance of the work for which this permit is issued. My workerscompensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 0004885-2009
I certify that, 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 th abor Cole, I h I forthwith comply with those provisions.
^1
at
T_16plicant:
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. - -
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, 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 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
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 ffie above-mentioned property
yffor
i/ins a ion purposes.
/e: i 1 V nature (Applicant or Agent):
Application Number . . . . . 10-00000069
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 90.00 Plan Check Fee
00
Issue Date . . . Valuation .
. 6600
Expiration Date 7/26/10
Qty Unit Charge' Per
Extension
BASE FEE _
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and Comments
190 L.F. COMBO WALL 2' RETAINING, 6'
GARDEN &'68 L.F.6' GARDEN WALLS WITH 4
16" PILASTERS, CITY STANDARD. 2007
CODES.
----------------------------------------------------------------------------
Other Fees . . . ... BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 90.00 .00 .00
90.00 „
Plan Check Total- 00 .00 .00
.00
Other'Fee Total 1.00 .00 .00
1.00
Grand Total 91.00 ;00 .00
91.00
LQPERMIT -
Bin #
Permit #
�b 1
Project Address: &OgIS7
Qty of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
VIA- P" ^' k o Owner's Name: -Jlk,H
A. P. Number:
_ (� -O ZZ
Address: % 239
Legal Description:p 1r L8g8 y "aZ `
Contractor: �&G�l C4vM& eo
City, ST, Zip: L_A Qvl�,,•�
Tele hone: t) - i?%,l 7 Irk
Address: QO (�
2 3
Project Description:
City, ST, Zip: �-F.�
Qtlltn �22 S 3
e -PTS! LW Elio1
Telephone: ^/
P (a�0 • �� t'( �� 7
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{��t�.: �:a:'i`^is<>�.'•}',<�.i<y✓;:t:.?::'tic'
CityLic: #:
1 Ej/� (1�/l Ll.�
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State Lic. # :
Q� ' ' t M,igLIvd-
Arch., Engr., Designer
! t.
Address:
/
City., ST, Zip:
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Telephone:
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Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Q,M A4�r5
Sq. FL:
# Stories:
# Units:
Telephone # of Contact Person: 'Z 1, p -1t,1-8 JR 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 Cates.
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
2i4 Review, ready for correctionstiissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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A.P.N. 777-150-023 DETAIL5 PER ARCHITECT
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' LEGEND
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O3 959 COMPACTED 5UBGRADE
O POOL BOND BEAM - REFER
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O5 BULL N05E 1/2 ROUND
O6 WATER LINE
O7 DRAINLINE TO OVERFLOW STORAGE
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O9 TILE - TO BE 5ELECTED
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A.P.At. 777-140-021
' LEGEND
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O2 7UNITE GUTTER
O3 959 COMPACTED 5UBGRADE
O POOL BOND BEAM - REFER
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O9 TILE - TO BE 5ELECTED
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