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: