12-0286 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C,\12-60000286_
Property Address: 79625 VISTA CORALINA IN
APN: 600-020-054- - -
Application description: WALL/FENCE
Property Zoning: COMMERCIAL PARK
Application valuation: 40000
Applicant: Architect or Engineer:
11IN
^� VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/23/12
Owner:
LA QUINTA HOUSING AUTHORITY
78495 CALLE TAMPICO
LA QUINTA, CA 92253
Contractor: `
OPTIMUS CONSTRUCTION I C MAR 2 CJ 202 If
440 WESTERN AVE #202, p MAR it L
'LA QUINTA, CA 92253
(808) 550-8411 ` CITY r.A d rlFVTA
Lic. No.: 902939__-
' - LICENSED CONTRACTOR'S DECLARATION -
WORKER'SCOMPENSATION 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:B - License -No.: 902939
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. -
ate: '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 -
NER-BUILDER DECLARATION
- insurance carrier and policy number are: '
1 hereby affirm under penalty'of perjury that I.am exempt from the Contractor's State License Law for the -
Carrier STATE FUND Policy Number 0000506-2010 -
.. 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 as to become 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 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 Code) or
3700 ofthe Labor C I shall fo hwith comply with those provisions.
.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
'tlC�AppIicant:
any applicant for a permit subjects the applicant to a civil penalty'of not more than five hundred dollars ($500).:
Date: 3 -
(_ 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 SECURE 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 (5100,000)• 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
-
- improve for the purpose of sale.). -
APPLICANT ACKNOWLEDGEMENT
(_ 1 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,
(_) 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. -
_
Pate: .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 -
CONSTRUCTION LENDING AGENCY -
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for theperformance of the
I certify that I have read this application and state that the above information is correct. 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 to building construction, and hereby authorize representatives
-
' Lender's Name: -
-
of this county to enter upon the above-mentioned prope f inspection urposes. -
�•'� Agent): '
Lender's Address:
ate:3 nature (Applicant or
LQPERMIT
Application Number . . . 12-00000286
Permit ELEC-MISCELLANEOUS
Additional desc '
Permit Fee 53.85 Plan Check'Fee
13.46
- Issue Date Valuation . .
. 0
Expiration Date 9/19/12..
Qty Unit.Charge Per
Extension
BASE FEE
15.00
20.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
15.00
53.00 .4500 EA ELEC DEVICE/FIXTURE >20
23.85
Permit . .- WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 349.50 Plan Check Fee
.00
Issue Date Valuation . . .
. 40000
Expiration Date 9/19/12
Qty Unit Charge Per
Extension
BASE FEE:
252.00"'
'15. 00 6.5000 THOU "BLDG 25,001.-50;000
97.50
-----Special Notes and Comments
1600+ LIN FT "ORCO" DESIGN 6-8FT HGT
GARDEN, 12-16FT HGT SOUND WALLS ANDA
QTY TRASH ENCLOSURES. INCLUDES WALL ;
LIGHTING.20.10 CODES,.
-- - - - - - - - - - - - -- - - - -- -- --------.---------------.------------.-----------
Other Fees BLDG-STDS.ADMIN (SB1473)
2.00
Fee summary Charged Paid., Credited
Due
Permit"Fee Total 403.35 00 00
403.35
Plan Check Total 13.46 .00 .00..
13.46
'Other Fee Total 2.00. .00 .00
2.00
Grand Total 418..81 0.0 .00
418.81