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10-0598 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 s BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 . BUILDING PERMIT Date: 7/01/10• Application Number:, 10-00000598 Owner: Property Address: 78500 VIA SEVILLA SMITH SCOTT APN: 604-211-030-32 -23971 78500 VIA SEVILLE Application description: WALL/FENCE LA QUINTA, CA 9225 D Property Zoning: LOW DENSITY RESIDENTIAL (818) 3,99-5771 Application valuation: 144 -----------=----------=--__------ -�— —._— ---_—_Contractor: Applicant: Architect or Engineer: VACATION POOLS INC 83900 AVE 45 STE C (;�'�Y INDIO, CA 92201 (760)775-.0468 Lic. No.: 856835 -- -- - LICENSED CONTRACTOR'S DECLARATION - • WORKER'S COMPENSATION DECLARATION I 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 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C53 y Li se No.: 856835 -for by Section 3700 of the -Labor Code, for the performance of the work for which this permit is ° issued. Date: `� / '��0 Contractor: - _ 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 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 PRAETORIAN INS Policy Number 194854842010 following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is 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 o beco subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I sho b com u act wor ' compensation provisions of Section . License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor C96e, ahall o i co ly ith ose provisions. 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).: Date: Z±__/`Applicant: (_ 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 WARNING: FAILURE TO SE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL .. Contractors' State License Law does not apply to an owner of property 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 15100,0001. 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 _ improve for the purpose of sale.). - APPLICANT ACKNOWLEDGEMENT (—) I, as owner of the property, am exclusively contracting with 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 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, (_ 1 I am exempt under Sec. , B.&P.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. • Date: Owner: 2. Any permit issued as a result of this applicationbecomes 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 CONSTRUCTION LENDING AGENCY - permit to cancellation. 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 thAdnstr or ati n is rect. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating tctio ,an ereby authorize representatives • of this county to enter upon the above-mentioned prctio' pu ses. Lender's Name: /+ • Date��/ /`Signature (Applicant or Agent): Lender's Address: -- p LQPERMIT Application Number 10-00000598 Permit WALL/FENCE PERMIT Additional.desc Permit Fee 15.00.• Plan Check Fee, . .00 Issue Date..' :, Valuation 144 Expiration Date 12/28/10 Qty Unit Chargee PerExtension BASE. FEE'. 15.00 Special Notes and Comments 9 LN FT X 4'FT HT BLOCK WALL TO CITY STANDARDS & APPROVED PLANS.. Other Fees BLDG STDS ADMIN (SB1473) 1.00 - Fee summary Charged Paid Credited Due - Permit Fee Total 15.00 .00 .00 15.00 Plan Check Total .00 .00 ..00 .00 ' Other Fee Total 1.00 .00 .00 1.00 Grand Total 16.00 .00 00 16.00 Bin # City of La Quinta Building &r Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico , �`'� 1 La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: 7 147 -ye-1)111(f Owner's Name: 60 S h A. P. Number: Address: 200-.570-0- v111 Legal Description: Ci ' City, ST, Zip: 441-A,r4 Contractor: N/V � Qr!, Telephone: °� h. Address: �//� v e / Project Description: City, ST, Zip:t?l Tel hone• P 2 7S 4/L/ `,S 'F�y{O�:•,+n State Lie. # : ��� ` City Lie. k: Arch., Engr., Designer: �G� OC/C -'(/ Address: City, ST, Zip: G " Telephone: Wo - ; Construction Type: Occupancy: State Lie. #• Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: e/G J 49 CSq. Ft.: # Stories: # Units: Telephone # of Contact Person: '7t,/ G a ?S —.7(V1144 Estimated Value of Project: APPLICANT: -.DO NOT WRITE BELQW THIS LINE # Submittal Req'd Recd TRACIUNG PERMIT FEES PlIIn Sets Plan Check submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Plan Check: Balanee Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontector List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE: Review, ready for correctionstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees' r VACATION POOLS, INC: 88900 Avenue 46, 8ufte C 4,• ,w �- Indio, CA,92201 ; =,e, m Ph. (780) 776-0468, Fax* (760) 776.8489 License # 0-684868856 Wall by f NOTE: Landscape elements (Trees, • ' Shrubs, Vines and Lawn) and Patio Furniture shown for illustration only. ' Unless by separate bid. CONTRACTOR cannot.assume responsibility for damage to -curbs, sidewalks, driveways, cement _ 51ab5, sewers, lawns, trees, fences, retaining walls, sprinklers, wires, valves, telephone or shrubs. Hhen access is made through a neighbor's property it is understood that you, the owner, have that neighbor's permission and assume full responsibility. v Df}TE 516NATURE DATE I REVI5ED 03/09/10 05/26/10 NAME: SMITH RE5IDENCE ADDRESS: "18-500 VIA 5EVILLA CITY: LA WINTA, CALIFORNIA 92255 TRACT: .. S '1. ' • Yip " . 1 • LOT: ' PHA5E: • S r VACATION POOLS, INC: 88900 Avenue 46, 8ufte C 4,• ,w �- Indio, CA,92201 ; =,e, m Ph. (780) 776-0468, Fax* (760) 776.8489 License # 0-684868856 Wall by f NOTE: Landscape elements (Trees, • ' Shrubs, Vines and Lawn) and Patio Furniture shown for illustration only. ' Unless by separate bid. CONTRACTOR cannot.assume responsibility for damage to -curbs, sidewalks, driveways, cement _ 51ab5, sewers, lawns, trees, fences, retaining walls, sprinklers, wires, valves, telephone or shrubs. Hhen access is made through a neighbor's property it is understood that you, the owner, have that neighbor's permission and assume full responsibility. v Df}TE 516NATURE DATE I REVI5ED 03/09/10 05/26/10 NAME: SMITH RE5IDENCE ADDRESS: "18-500 VIA 5EVILLA CITY: LA WINTA, CALIFORNIA 92255 TRACT: .. S '1. ' • Yip " . 1 • LOT: ' PHA5E: