13-0542 (BLCK)A , •
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000542
Property Address:
51725 AVENIDA HERRERA
APN:
773-132-023-11 -000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
5250
Ta�/
��
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT
IX , U
F -APR 28 2013 D
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: C29 License No.: 472843
ADate: — Contractor: Oct ,4, 2;&O
OWNER -BUILDER CN
I hereby affirm under penalty of perjury 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).:
(_) 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.).
(_ ) 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:
Lender's Address:
LQPERMIT
LA QUINTA
Owner:
ROWE, ROBERT & RITA
51725 AVENIDA HERRERA
LA QUINTA, CA 92253
omracTor.
RECISION MASONRY
.O. BOX 3938
ALM DESERT, CA 92261
760)779-5100
ic. No.: 472843
WORKER'S COMPENSATION DECLARATION
Date: 4/26/13
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 GRANITE STATE Policy Number WC065255554-01
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, 1 shall forthwith comply with those provisions.
Date: %+} Applicant: 04k
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C ERAGE 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 the above-mentioned property for inspection purposes.
Date: �"' Signature (Applicant or Agent):
Application Number . . . . . 13-00000542
Permit . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 81.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 5250
Expiration Date 10/23/13
Qty Unit Charge Per
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
----------------------------------------------------------------------------
Special Notes and Comments
21OLF OF 6' HIGH BLOCK WALL (5' MAX AT
FIRST 10' OF PROPERTY) AROUND ENTIRE
PROPERTY AT PL [PROTO II SPEC) THIS
PERMIT DOES NOT INCLUDE ENTRY ARCH OR
ELECTRICAL INSTALLATIONS. PRECISION
CONCRETE BLOCK SHALL BE COVERED WITH
STUCCO, PAINT, OR TEXTURED COATING WHERE
VISIBLE FROM OUTSIDE THE PROPERTY. 2010
CALIFORNIA BUILDING CODES.
April 26, 2013 3:54:33 PM AORTEGA
-
---------------------------------------------------------
Other.Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
-------------------
1.00
Fee summary Charged Paid Credited
----------
Due
-------------------------------------
Permit Fee'Total 81.00 .00
----------
.00
81.00
Plan Check Total .00 00
.00
.00
Other Fee Total 1.00 .00
.00
1.00
Grand Total 82.00 .00
.00
82.00
LQPERMIT
P
Bin #
Qty Of U Quishtd
Buifding u Safety Division
P.O. Box 1504,78-495 Caffe Tampico
14 QLgnta, CA 92233 -'(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: Owner's Name: . b �Ic�WGff .
A. P. Number. i Address:
Legal Description: City. ST, Zip:
Contractor. r U r Telephone:
Address: C', 3 93 Project Description:
City, ST, Zip: / G 6 U Cj< Uj pg-
'¢Telephone:
Telephone:?(�U- -% l00 (, 140
State Lia # : '{7,q-g6f City Lit. #;
Arch, Eng., Designer.
Address:
City, ST, Zip:
Telephone: Construction Type:. Oxupa :
State Lia #: Project type (eirde one): New Add'n Alter Repair Demo
Name of Coozact Person: (/)/� u ! � Sq. FL: # Stories:. A Units
Telephone # of Contact person: — Estimated value of Project: 2 5-v C7, Oo
APPLICANT: DO NOT WRITE BELOW THIS UNE
N
Submittal
Plan Sets
Req'd
Recd
TRAgMG PERMIT FEES
Plan Check submitted Item Amount
Structural Cala.
Reviewed, ready for Correction Pian Check Deposit.
Trop Gla.
Called Contact Pecaoa Plan Cheek Balance.
Title 24 Gla.
Pians picked up Canstraetion
Flood plain plan
Plana resubmitted Mechariksl
Gmdimg plan
Z ! Review, ready for correctioneissue Electrical
Sabcoatactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S -M -L .
H -0 A- ApprovalPlans
resubmitted Grading
IN HOUSE:-
r" Review', ready for cormcdonvissue Developer Impact Fee
Planning Approval
Called Contact Person A-I-P.P.
Pub. Wks. Appr '
Date of permit Issue
Scholl Fees
Total Permit Fees
1�1
(3 ob
V'4
9F
C51 "+
CITY 0-rLAQUINTA
BUILDINE
APPROVED
FOR CONSTRUCTION
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