09-0361 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09 OA -0:0036
Property Address:
52330^-AVENIDA HERRERA
APN:
773-264-004-19 '-000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
7269
Applicant: Architect or Engineer:
I
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT U
Owner:
APR 2.8 2009
CORON ENT
��Pp
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of pe u that I a licensed un r provisions Chapter 9 (commencing with
Section 7000) of Division 3 of the usi ess an Profession s ode, an n provision"
is in full force and effect.
License ass: B -C13 icense Nor: 34981
ate: 4 2� ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec.
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.).
(_) F 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Contractor:
CORONEL CONSTRUCTION
P.O. BOX 389
LA QUINTA, CA 92247
(760)564-4604
Lic. No.: 634981
VOICE (760) 777-7012
FAX (760) 777-7011
PECTIONS (760) 777-7153
Date: 4/28/09
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 AMER INS Policy Number 2385X7h7
I certify that, in the performance of the work for which this ermit is issued, I shall not employ any
person in any manne so as to become subjUworker
compensation laws of California,
and agree that, if Iso beta a subject tpensation provisions of Section
3700of the Labor C de, I shall forthwith crovisions.
0'ate: �\-1 14! i pplicant:
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 (5100,000). 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 th t e above infarmat0hereb
ee to comply with all
city and county ordinances and state laws relating to ui ing co structiorize representatives
ofthi aunty to enter upon the above-mentioned pro e y for in pection
ate: y Sjgfiature (Applicant or Agentl:
Application Number . . . . 09-00000361
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 99.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 7269
Expiration Date . . 10/20/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
6.00 9.0000 THOU BLDG 2,001-25,000
54.00
---------------------------'-------------------------------------------------
Special Notes and Comments
50 LF COMBO WALL (314" RETAINING, 6'
GARDEN), 200 LF COMBO WALL (114"
RETAINING, 6' GARDEN), 36 LF 5'
COURTYARD WALL & 15 LF 4' PROPANE
ENCLOSURE, ALL CITY STANDARD
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
- 1.00
Fee summary Charged Paid
-------------------------------------
Credited
---------- r ----------
Due ,
Permit Fee Total 99.00
.00 .00
99.00
Plan Check Total .00.
.00 .00
.00
Other Fee Total 1.00
.00• .00
1.00
Grand Total 100.00
.00 .00
100.00
LQPERMIT