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05-3974 (BLCK)P.O. BOX 1504 . 78-495 CALLE TAM'PICO LA QUINTA, CALIFORNIA 92253 T-iht 4 4 Q" Application Number: 05 0000�3987�;4� Property Address- 517 - - -- ENIDAJOBREGON APN: 773-1647002-2 -000000- Application description: WALL/FENCE . Property Zoning: COVE RESIDENTIAL Application valuation: 1.810 Applicant: Architect or Engineer BUILDING& SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION . I hereby affirm under penalty of perjury that I am licensed under provisions of Chaptei 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: License No.: Date: Contractor: " _. OWNER -BUILDER -DECLARATION I hereby affirm under penalty of perjury that I am'exempt*fioni the Contractor's State License Law for the - ,allowing reason (Sec..7031.5;;Business and Professions Code: Any cityor county that requires a permihto construmi iier imprrove, 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.(Chapfer 9 (commencing,with-Section 7000) of Division 3 o the Business andProfessions Code) or that he orshe is exempt therefrom and the basis for the alleged exemption. Any violation of'Section 7031.5 by a y applicant for a permit subjects the applicant to a civil penalty of not ;more than five hundred dollars ($500).: I 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'Piofbwions Code:. The Contractors: State License Law does not apply to an owner of property who builds or improves. thereon, ' and who doesthe woik himself or herself thFough his or hei own errmpl6yees;'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 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(sl licensed pursuant to the Contractors' State License Law). 1 _ 1 I am exempt under Sec. B.&P.C. for this reason Date: r 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 VOICE (760) 777-7012 FAX (760) 7-77-7011 INSPECTIONS. (760) 777-7153 Date: 9/13/05 -------------.----'C- Owner: GONZALEZ NACHO 51782 AVENI'DA OBREGON LA QUINTA, CA 92253 ------------------------------- Contractor: Owner ------------------------------ -----------------=------— 1f" WORKER'S OMPENSATION DECLARATION I hereby affirm under penalty of perjury one of th"e" 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 workforwhich 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 inanymanner so, as to become subject to the workers' compensation laws of California,' and agree th t, if I should become subject to the workers' compensation provisions of Section 3700 of, Labor C. I s all forth ith comply it those provis" WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C(5ERAGE I UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($1 1 00,000). IN ADDITION TO THE COST"OFCOMPENSATION, DAMAGES ASPROVIDED 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 Ouinta, 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 rdinances nd tate laws relating to building construction, a hereby authorize representatives of�thissccounty enter u �n//�e above-mentioned property for i ection p s. Date:: ignHl04Eplicant or Agent): LQPERMIT Application. Number . . . . . 05-00003974 Permit WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 43.00 Plan Check Fee .00 Issue Date Valuation . . . . 1810 Expiration Date 3/12/06 Qty Unit Charge Per Extension BASE FEE 15.00 14.00 2.0000 HND BLDG 501-2,000 28.00 ---------------------------------------------------------------------------- Special Notes and Comments 62 L.F. 6' BLOCK WALL & 12 L.F. 5' BLOCK WALL, BOTH CITY.STANDARD Fee summary Charged Paid Credited Due ------------------------------------- Permit Fee Total 43.00 ---------- .00 ---------- .00 43.00 Plan Check Total .00 .00 .00 .00 Grand Total 43.00 .00 .00 43.00 S! OWNER%BUILDER INFORMATION Dear Property Owner: An applicatiornfor a building permit.has b'een`submitted in your name listing yourself as the builder of the property improvements specified. " For your protection you should be aware that as "Owner/Budder" you are the responsible party.of record on such a permit. Building permits are'not re"quired.ao be signed by property owners unless they, are personally performing their F own, work. If your work is being 'p'erforn ed by someone other 'than yourself; you may protect yourself from possible liability if. that person applies for the proper permit in his or her name., Contractors are required :bylaw to -be licensed and bonded by the State of California an&to have a business license from the City or County. They are also required `by law to Out their license number on all permits for which they apply If you plan;to do your own work, with the exception of various trades -that you plan to subcontract, you should be aware of the following -information for your benefit and protection: If you employ or otherwisel a gage any persons other than your immediate family, and the work (including materials and,,other costs),is-'$200.00 or' mor"e for the entire project, and such persons are not licensed as contractors or subcontractor's, then you may be antemployer. If you are an employer, you must register with the State and Federal Government as an employer and you are.subject to several obligations include State,and Federal income tax'.withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respeet to worker's compensation- insurance. For more specific information about your obligations under Federal Law, contact. the Internal Revenue Service (and, if you wish,,the U S,§ all Business Administration):.•For °more specific information about your obligations under State Law,.contact the Department of Benefit Payments and the Division of Industrial Ac idents. r. •l If the structure is intended -for sale, property owners who are.notlicensed contracts are allowed to perform their work personally or through their own employees, without a licensed: contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed',personsi; professing to be contractors is to secure an "Owner/Builder" building .permit, erroneously implying that -'the property owner• is providing, his or her own• labor and material personally. Building permits are not required' to be signed by property owners .unless tliey` are performing their own work personally. Information about licensed contractors may be obtained; by contacting the Contractors' State License Board' in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and. return the enclosed owner -Builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification.is eturned. Very truly yours, CITY OF LA QUINTA, DEPT..OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011 OWNER'S SIGNAT9n/DA+K47/ 7 ,k ` 9 t G� a"A PR PERTY A15DRESS, PERMIT NUMBER(S)