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13-0462 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-00000462 Property Address: 52903 ROSS AVE APN: 767-670-018--330761- Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: • 7200 Applicant: 0 �J Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 0 °D APR ;12013 ---------------------------------------------------- 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 Professionals Code, and my License is in full force and effect. License Class: C29 License No.: 678140 `Date:/ )) -13 Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State 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.). (_ 1 1, 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. , BAP.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 Name: _ Lender's Address: LQPERMIT Owner: LOTHENBACH RESIDENCE 52903 ROSS AVENUE LA QUINTA, CA 92253 Contractor: RAS MASONRY INC 16780 CRESCENT GLEN COURT RIVERSIDE, CA 92503 (760)774-0090 Lic:,No.: 678140 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/11/13 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of 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 the work 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 INS CO OF WEST Policy Number WSD502042501 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 the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section (0 of the Labor Code, :; shallfo�th comply with those provisions. Date: Y- Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed 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 state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned prope or inspe ion purposes. Date: � Signature (Applicant or Agent): Application Number.-. 13-00000462. Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 99.00 Plan Check Fee _00 Issue Date . Valuation . . . . 7200 Expiration Date 10/08/13 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 , ---------------------------------------------------------------------------- Special Notes and Comments 162 IN FT X 6 FT HT PROPERTY WALL; 162 LN FT X 2 FT HT RETAINING WALL; (2). PILASTERS 24" X 24" 8FT HT; 124 LN FT X 6 FT HT GARDEN WALL ALL ORCO DETAILS APPROVED PER AJ. --------------------_---------------------------------- Other Fees . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 99.00 :00 .00 99.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 100.00 .00 .00 100.00 LQPERMIT Bin. # Qty of Ld Quin: td Bullding U Safety Division P.O. Box 1504,78-495 Calle Tamplw La.Qulnta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:11"2153 .Owner's Name:. 1A L A. P. Number. / 7 2) Address:Rose �14 Legal Description: Contactor. City, ST, Zip: y Telephone: Address: 1'y ti°/1� Project Description: City, ST, Zip: Telephone:76 -oa z rd rS . +? State Lic. # : City Lic. C- Arch., Engr., Designer. f. Address: v � O City., ST, Zip: Telephone: Construction Type:. Occupancy: State Lic. #: Project type (circle one): Now Add'n Alter 'Repair Demo Name of Contact Person: Sq. Ft: #Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd'Rec'd TRACKNG PERMrPFEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Cake• Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Pians resubmitted.. Mechanical Grading plan V Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Great Deed Plans picked up S M.L H.O.A. Approval Plans resubmitted Grading DH HOUSE;- 3" Review; ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees M I �r VICINITY MAP NOT TO SCALE P n IE Mas •s NOR: m MMIRAEIDR• j� In the City of Lo Ouinto Precise Grading Plan Lothenbach Residence ,M"m lonasM AcsaBA.r D(Sw rOm snag x m (NpG OJ iml. MMPnON: mr x —. 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