12-0310 (BLCK)P.O.•BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO } �FAX`(760) 777=70:11
LA QUINTA, CALIFORNIA 92,253 BUILDING & SAFETY DEPARTMENT . � INSPECTIONS (760) 777,-7153 ' t
° BUILDING PERMIT
Application Number: �1--2-OOOD0310 Y y Date: 3/26/12
A
PP '� . `: Owner:
'
Property Address: 80120. VIA VALEROSA SAPETTO LIONEL & MARIA
APN: 777-230-012- - 80120 VIA VALEROS��
'i
Application description: WALL/FENCE LA QUINTA, CA 922 (rt1 11 4
Property Zoning: LOW DENSITY -RESIDENTIAL _ (�q° ( E
Application valuation: 704 ��' VAR�. 2012' E
Contractor:
Applicant:. Architect or Engineer: i+ + - JBM, CONSTRUCTION DEV N OF i A 1o, INTA
+ : 35670 ABELIA STRE Flil!ANICC ;'EPT '
MURRIETA, CA 92562
t (95.1)698-8782
Lic. 'No. 906786
t
i- - - - - _ _ - -. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ _ _ - _ _ _ - _ _ _ _ _ _ _ ,- - _ _ - _ - _ _ - _ - _ - - _ - _ - - - - - - -. - - - - - - _ _ -
• - LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION • .� ,
hereby affirm under penalty of perjury that I -am licensed under provisions of Chapter 9 (commencing with' - I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the,Business and Professionals Code, and my License is in, full force and. effect. i _ I`have and will maintain atertificate of consent to self -insure for workers' compensation,.as provided
a License Class:. B - License No:: 906786 - - r for by Section 3700 of the tabor Code, for the performance of the work for which this permit is ,
issued.
. Date: ontractor: . - - �1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
a � - + Code, for the performance of the work for which. this permit is issued. My workers' compensation -
f + OWNER -BUILDER DECLARATION - - insurance carrier and policy number are:
_ I hereby affirm under penalty of perjury.that I am exempt from the Contractor's State License Law for the Carrier ULLICO ,CAS CO - Policy Number LTWHA48600003910
following reason (Sec. 7031.5; Business and Professions Code: Any city. or county that requires a permit to r 0, - _ - 1 certify that,.in the performance of the work for which thispermitis issued, I shall not employ any ,
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become.subject to the workers' compensation laws of California, '
permit to file a signed statement that he or she isficensed pursuant to the provisions of the Contractor's State' _ and agree that, if I should become subject to the workers' compensation provisions of Section -
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel or - . 3700 oftheLabor Cod sA�withly with those provisions. ti
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
• any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.: e: A 'ant:. -
_ (_ ) 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 - - - == WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL' - - ��-• - - • -
r _ Contractors' State License Law does not apply to an owner ofproperty who builds or improves thereon,. SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the ., DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS. PROVIDED FOR IN -
improvements are not intended or offered for sale. If, however, the building or improvement is sold within - SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.' - -
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improveforthe purpose of sale.). - - - ,, - APPLICANT ACKNOWLEDGEMENT '
r (_) 1, as owner of the property, am exclusively contractingwith licensed contractors to construct the project (Sec.,' • IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the r
• 7044, Business and Professions Code: 'The Contractors' State License Law does not'apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.), • - :whose benefit work is performed under or pursuant to any permit issued as a result of this application, -
(_) I am exempt under Sec. , BAP.C. for this reason 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.' • . ' . - . . -.- , . ' - r
f Date: Owner,, 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 `
S + CONSTRUCTION LENDING AGENCY " - permit to cancellation. -
a - I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the' + _ I certify that.I have read this application and state that the above information is correct. I agree to comply with all' t r
work for which this permit is issued (Sec. 3097, Civ. C,)• - city and county ordinances and state laws relating to building construed , and hereby, authorize representatives '
of this county to enter upon the above-mentioned propertyr inspeSXXh purposes.
' Lender's Name:(A
• - ate: 1 Signatyyypplicant or Agent): o
. ;Lender's Address: `
/ f
LQPERMIT
_.Application Number12-00000310
Permit WALL/FENCE PERMIT
Additional desc .
Permit-Fee 21.00 Plan Check
Fee
.00
Issue Date Valuation
704
Expiration Date '9/22/12
Qty Unit Charge Per
Extension.
BASE FEE
-15.00 .
3.00 2.0000 'HND.- BLDG 501-2,000
6.00•.
--------------------------------
Special Notes and Comments
-----------------
36 L.F. 4211 GARDEN WALL WITH, (2) 24"
PILASTERS,, ORCO SYSTEM AT FRONT ATRIUM
AREA. 201CODES..
-------------
Other Fees ',,BLDG STDS ADMIN (SB1413)
-------
---- - - - - -- -
1.00
Fee summary Charged Paid Credited.
Due,
Permit Fee Total 21.00. .00
OQ
21.00
Plan CheckTotal..00', .DO
:00
.00
Other Fee Total 1.00 .00
00
1.00
Grand Total 22:00 .00
.0,0.
22.00
LQPERMIT
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Bin .#
Cly}/ Of Quinta.-
-Building 9. Safety Division
P.O. Box 1504,78495. Caile Tampico,
La.Qulnta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking She' et
Pemut #
ProjectAddcess: Oj,?fj tl
'4
Owner's Name..
A. P. Number
Address: . 001 2,0 C/,k V
Legal Description:.
City, ST, Zip:
Contractor. T
J /�
Telephone:
Address'. .Z • 9
Project Description:
City, ST, Zip:
/I.Gi✓ GOON G YZy �o'��
Telephone: Qa j G� �%�Z.
State Lie. # : City Lic. #;
Arch., &W, Designer-
esignerAddress:
Address:
City., ST, Zip: '
Telephone: ` • o
State Lia #:iy r
Name of Contact Person:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal •
. Req'd
Reed
TRACIGNG
PERMiT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cabs.
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Cafes.
Called Contact Person
Plan Check Balance.-
alance•Title
Title24 Calci.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mecharilcal
Grading plan
2'' Review, ready for corrections issue
Electrical
Subcontactor List .
Called Contact Person
Plumbing
Grant Deed
Pians picked up
SALL
&O A Approval
Plans resubmitted
Grading
IN HOUSE:-
'"d Review; ready for correctionslissue
Developer Impact Fee
Planaing Approval.
Called Contact Person
A:%P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees