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11-0103 (BLCK)P.O. BOX 1504 78-495 CALLE TAMP ICO LA QUINTA, CALIFORNIA 92253 Application Number: X1-1-0000010'3 Property Address: 53475 VIA MALLORCA APN: 772-420-999747 -298943- Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2500 Ap�plic%a�nt: �'� Architect or Engineer: CD k V iL I \1 [:�- 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 Prssionals Code, and my License is in full force and effect., License Classs�s:: /C27 ptLicense No.: 857801 Date: ? W -(I Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of pe ry that I am exempt from the Contractor's State License Law for the • • . following reason (Sec. 70 31.5, siness and Professions Code: Any city or county that requires a permit to construct, alter, improve, de' ish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed state ent that he or she, is licensed pursuant to the provisions of the Contractor's State I License Law (Chapter 9 (c 'mencing 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 155001.: I I 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 0 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 (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. , 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.I. Lender's Name: Lender's Address: LQPEPNIIT Owner: GREEK RESIDENCE 22187 SERENADE RIDGE MURRIETA, CA 92562 ( Contractor: WESTLAKE LANDSCAPE INC, P.O. BOX 5175 LA QUINTA, CA 92248 . ...(760)399-1506 Lic. No.: 857801 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/28/11 6 D� JA►4 2 3- 2011 l BRILiLV T �,(71T'l or S A 4.UINTA Hq.f Jit Wx4 W WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations: 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 forwhich 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 NATIONAL ANION Policy Number WCOS8343827 _ 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 a workers' compensation provisions of Section 1 3700 of the Labor/Cl0�d9frhall forthw' co ly with those provisions. ."Pate: 1 - Applicant: / 6__: WARNING: FAILURE TO I? ORKERS' C�1 PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLP%9 CRIMINAL PE 'LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION T HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,'ANO 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 Quints, 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 specti urposes. --� Date:- Signature (Applicant or Agent r� Application.Number- 11-00000103 Permit WALL/FENCE PERMIT Additional desc . Permit Fee 54.00 Plan Check Fee'. .00 Issue Date . . . . Valuation . . . . 2500 Expiration Date .. 7/27/11 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9:00 -- ----------------------------------------------------.------------ Special Notes and Comments 100 LN FT X 6 FT HT BLOCK WALL PER CITY STANDARDS AND APPROVED PLANS. Other Fees . . . . . . .. BLDG STDS ADMIN (SB1473) - ---1-00---'-- Fee summary Charged Paid Credited Due •Permit Fee Total 54.00 .00 .00 5.4.00' Plan Check Total .00 .00 .00 .00 Other Fee Total _ 1..00 .00 .00 1.00 Grand Total 55.00 .00 .00 55.00 LQPERMIT - - - Bin # City of La Quinta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: L u �- 1-1 7C,- l Pe a c-a Owner's Name:�(�� - e 1G 4,P w � be/ J V j� /� (u t L 0 C (-G\, Address: 2-7 l 0 7 E e (,,2 Y-c-, Legal Description: City, ST, Zip: jVlL/ CCt Z (e Z Contractor: (-1Gr-n eSf/Q�'Q Q/l/��0� W � telephone: � P ,ijJ:4' :i.4X.•r:yN��:. •: >:f'?:H Address: q — I qC) /`e 0 L.) rim Project Description: 1jv% D 14 %IOC &C City, ST, Zip: &,r SMV T), (f u ql Z 2d rc-) 10 e a Telephone•760 Z State Lic. # : ' City Lic. #: Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. # A:k•:Ok 4:•:i'y`::(ii:�ti.'fi'v^'v(:�ii:fy..'.a'.iiini': ^Tl:;r^:` < k::'•}y:4Ai;fV^(;�>C'ix •:�•'y F:'f� M..:;' �.�':::> ` ' Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: 6(I` weE I lGr� Q Sq. Ft.: #Stories: # Units: Telephone ,# of Contact Person: 76 r) Z !;C) Z41 Z Estimated Value of Project: UvU �— APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Reed 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 2od Review, ready for correctionstissue 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 correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees