12-0640 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
Application Number: 12-0000064 0
Property Address: 51365 A� HERRERA
APN: 773-084-018-6. -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 2000
Tiht 4 4 Q"
Architect or Engineer:
p(A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
-------------------------------------------------
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 Professionals Code, and my License is in full force and effect.
License Class: B ense No.: 937930
/ate: l �_'onlractor:
OWNER -BUILDER DECLARATION -
I hereby affirm under penalty of p ry that I am exempt from the Contractor's 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 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).:
(_ 1 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 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.).
(_ 1 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' State License Law.).
(_ 1 I am exempt under Sec. , BAP.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: I
Q
Lender's Address:
LQPERMIT
Owner:
DENISE FISHER
51365 AVENIDA HERRERA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/11/12
Contractor: i! )) W I J
TRI-KON GENERAL
CO
INru 4
31355 SAN ELJAY A
CATHEDRAL CITY, CAf 2 34 J'UN1 11 2012
(760)880-4085 LU
Lic. No.: 937930 CITY
S-A QUINTA.
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I 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.
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:
Carrier EXEMPT Policy Number EXEMPT
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 the Labor Code, I shalt rthwith com with those provisions.
te: //-/ plicant:
WARNING: FAILURE TO SECURE ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,0001. 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, 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 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 the above-mentioned property for inspection purposes.
DSte:����./ / f6ignature (Applicant or Agent):
LQPERMIT
Application Number . . . . 12-00000640
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee
.00
Issue Date .'. . . Valuation . . .
. 2000
Expiration Date 12/08/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
15.00 2.0000 HND BLDG 501-2,000
30.00
Special Notes and Comments
-80 L.F. 61, GARDEN WALL @ SIDE P/L, CITY
STANDARD. 2010 CODES.
:
-------------------------------------------------
Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
r Fee summary Charged Paid Credited
Due
---------------------------------------------------------
Permit Fee Total 45.00' .00 .00
-
45.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1:00
Grand Total 46.00 .00 .00
46.00
LQPERMIT
6XIlV IiAj �(G—
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Wu
CITY OF LA QUINTA
BUILDING & SAFETY DEFT.
APPROVE®
FOR CONSTRUCTION
DATE 12BY lib
E,pT1E2
S'
FAc6- eF
Lw
TRI-KON GENERAL CONTRACTING,
31355 San Cljay Cathedral city Ca 92234
lic#937930
760 -880 -4085 -
PROPOSAL & CONTRACT
This agreement is made this 5 day of june 2012 by and between Tri-kon contracting hereinafter
call the contractor and Dennise Fisher hereinafter call the owner.Witnesseth.that contractor and.
owner for the considerations named agrees as follow:
1 -SCOPE OF WORK:
-Build 6' high x 80' garden wall. Along north side of property.
-install splinkler in front yard
-install 200 sq ft floring tile on rear concrete patio —tile by owner
-paint 14'x8' wall in living area
2 -WORK TO BE PERFORMED ON PROPERTY AT:51365 Avenida Herrera,La Quinta
3 -THE CONTRACT PRICE: $4175.00 labor and material
4-TERMS:full payment due up on work completion
OWNER: X DATE P
Print nane 'D 15:�J/5 -FlSf/rK
CONTRACTOR ATE 7/
JOSE NUNEZ
N
#
City of b Quina
BAft a Safety Divtslon
P.O. Box 1504,78-495 Calle Tampico
[a.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Peml,t #
a'
ProjectAddtrss:s% G� ,/! 6 �1-i'C
OwneesNwne:. D.. , C 5 •e jl-
A P. Number.
Address03 65"4 ye641 -e,)- r vC
Legal Description:
City, ST, Zip. C j Q-
J /
Contractor. 7d Kar✓ Ceti � r u �m �) T v al^ I
Telephone:
Address: i .a I e ✓
Project Description:
City, ST, Zip: :G,t. PI-eo-veJ Ir A,
C / %:
Tele hone:
P %L!/"4WV
State Lit # : C U City Lic #;
Arch., Eng, Designer.
Address:
City., ST. Zip:
Telephone:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State L'rc, #:Pro
Name of Contact Persons t7 id
Sq: Ft.:
#Stories:
# Units:
Telephone # of Contact Person: fj = � t?- " U
Estimated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS UNE
p
Submittal
Req'd
Recd
TRACMG PERMIT FEES
Plan Sets
Plan Check submitted
Item Amoaat
Stmctural Caics.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cates.
Called Contact Person
Plan Check Balance.
Title 24 Calci.
Plans picked up
Construction
Flood plain plan
Plans resubmitted..
Mecharilcal
Grading plan.
2'! Review, ready for corrections/issue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Pians picked up
S.M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1n° Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr -
Date of permit issue
Scbodl Fees
Total Permit Fees