BWFE2015-0282�' �►� + D �NMIA�iI/ VOICE (760) 777-7125
78-495 CALLE TAMPl'%CP' D FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/22/2015
Application Number: BWFE2015-0282 Owner:
Property Address: 81738tt�iNY 4AF L11`4 0i S R Vi l + CVWD
APN: 767800090 P 0 BOX 1058
Application Description: GRIFFIN RANCH TM32879 CVWD WELLSITE COACHELLA, CR 0
Property Zoning:
Application Valuation: $10,750.00 D +�
Applicant: SEP 2 Contractor:
LENNAR HOMES OF CALIFORNIA 1 C 3 2015 LENNAR HOMES OF CALIFORNIA INC
25 ENTERPRISE 25 ENTERPRISE
ALISO VIEJO, CA 92656 CITY OF LA OUINTA ALISO VIEJO, CA 92656
COMMUNITY DEVELOPMENT DEPARTMENT (949)349-8269
Llc. No.: 728102
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 Profess' ' ns Code,
and my License is in full force and effect.
License C ass- B7 License No.: 728102
Date: Contractor:
' OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Co
License Law for the following reason (Sec.. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing 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
($500).:
(_) 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 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.).
(_) I, 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.).
Lender's N
Lender's Ad
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one :)f the following declarations:
I 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 therk for which 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: Policy Number:
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 he workers'
compensation laws of California, and agree that, if I should become Abject to the
workers' co sensation provisions of Section 3, 00 of th bor. Co 1. 1 shall forthwith
comply w_�h hose rovisions.
Date: Applicant: /
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C VERAGE I UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESPND CIVI INES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITIO. TO COST OF
COMPENSATION, DAMAGES AS PROVIDED FCR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNC WLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on the application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is perforned 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 Quinta, 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 sate that the above information is correct.
I agree to co ply with all city and county ord nances and state ws relating to build' g
construction, nd hereby authorize representatives of this city o enter up he
above -me oned property for inspection purposes.
Date: Signature (Applicam or Agent):
FINANCIAL
.;.
DESCRIPTION " <
x; Q ACCOUNT
QTY
AMOUNT
PAID PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00'
s:PAfD BY
RECEIPT #
CHECK #, CLTD BY. .
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION,,
"ACCOUNTs,QTY
AMOUNT -
PAID
PAID DATE'
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$101.50
$0.00
PAID BY ,
. ` `METHOD "
` RECEIPT #._ "'
"" CHECK #
CLTD BY
aR DESCRIPTION ,
''ACCOUNT" �`
QTY
� `-'AMOUNT ` ��
f (;PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
r. PAID BY
IMETHOD
`vRECEIPT # "
CHECK #' '
uCLTD BY
a DESCRIPTION �, _
�_ ACCOUNT `;,
`QTY
AMOUNT =
PAID ' ..PAID
DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
; METHOD
RECEIPT # • ,' r
CHECK # g
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL: $210.27 $0.00
TOTALS: $211.17 00
u
e
Ri
,.
Description: GRIFFIN RANCH TM32879 CVWD WELLSITE
Type: WALL/FENCE Subtype: SPECIAL/ENGINEERED Status: APPROVED
Applied: 9/22/2015 MFA
DESIGN
Approved: 9/22/2015 BHA
Parcel No: 767800090 Site Address: 81738 HALFINGER WY LA QUINTA,CA 92253
Subdivision: TR 32879 Block: Lot: AR
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $10,750.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: CONSTRUCT 430 LF OF 8' BLOCK WALL (PROTOTYPE II SPECS) CVWD WELLSITE PERIMETER WALLS AND ENTRY GATE PER 2013
CALIFORNIA BUILDING CODE
Printed: Tuesday, September 22, 2015 9:25:48 AM 1 of 2 SYSTEMS
toNbMoNs
CONTACTS
NAME TYPE
" NAME ,'x
": ADDRES51
''.CITY .7"
STATE
ZIP .:µ PHONE" ` FAX
EMAIL
APPLICANT
LENNAR HOMES OF CALIFORNIA INC
25 ENTERPRISE
ALISO VIEJO
CA
92656
lennar@lennar.com
CONTRACTOR
LENNAR HOMES OF CALIFORNIA INC
25 ENTERPRISE
ALISO VIEJO
CA
92656
lennar@lennar.com
OWNER
CVWD
P O BOX 1058
COACHELLA
CA
0
Printed: Tuesday, September 22, 2015 9:25:48 AM 1 of 2 SYSTEMS
PARENT PROJECTS
�— --- -- - -- —- -- „ ....................
90IVi� (N�tRMATION
Printed: Tuesday, September 22, 2015 9:25:48 AM 2 of 2 srsieMS
C D I
DESCRIPTION
'ACCOUNT
--QTY,
`AMOUNT ' -
PAID
PAID DATE
''RECEIPT#
CHECK#
METHOD
PAID BY'
BY
WALL/FENCE - EA
101-0000-42404
0
$101.50
$0.00
ADDITIONAL 50 LF
WALL/FENCE - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
T
WALL1FENCE -FIRS00
101-0000-42600
0
$60.91
$0.00
1 LF PC
-
Total Paid for FENCE OR FREESTANDING WALL: $210.27 $0.00
TOTALS:$0.00
PARENT PROJECTS
�— --- -- - -- —- -- „ ....................
90IVi� (N�tRMATION
Printed: Tuesday, September 22, 2015 9:25:48 AM 2 of 2 srsieMS
qty of La Quin
2-CidldEng eZ $a ety D Wi h
� �� P.O. Box t 504,"7849'S CTlte Tams ko .
D La.QW 4 CA 92253 - (764) 777-7012
Building Permit Application and Tracking Sheets
Permit # c�
J -
'Pmj=Add!ew: 81_738 H tfin er Way-Griffin .
Owner'stvame Lennar Homes, Inc
A- Numb= 767-800-090 " •
�aa�� 980 Montecito Dr, Suite 302
Legg t?=drAion: _ TTM 32879
City, ST>z Corona, CA 92879
Contrwtir:Lennar HOM- eSjnc
Telephoto:. Q5,1 -817-26
A,dt : Same. as above
Desoiveion:
City, ST, Zip.
Construction of 430} f 81` high
Telephone:
CVWD Wellsite erP referWatls &
ctyU,-, ,- On File
Tc3Cgttt> c
a
eosuuvdion.Typ t7ecug Gy:
Fipjca Type(6rctc o.%): Nttty Ad&h Alta R,* it D---Ra
Namc;ofCont&�tPuson; Ulrich Sauertsrey
So. FL- r, StoriLti
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Toi pbonc 9 of Conma i;' rwn: 764-610=9410
€ iirtvtad ��oitvt aiYrvjtct:: $12,€00
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