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07-2714 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 e. Application Number: 07-00002714 Property. Address: 52220_,AVENIDA OBREGON r APN:' 773-255-001-1 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 1040 Applicant: Architect or Engineer: V - LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: License No:: �Contract^, _ 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 '4igned statement that he or she. is licensed, pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 700%':of,.Division 3 of the Business and Professions Code) or that hear, she'is exempt therefrom and the basis for the alleged exemption. Any violation of Sectiori 7031.5 by .any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$5001.: 1 1 I; as owner of the property;, or myemployees-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 notapply to an owner. of, property who builds: or improves thereon, land 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 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' orimproves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law) 1 _ I I'am. exempt under Sec. B.&P.C. for this reason M k 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.I. Lender's Name: Lender's Address: . LQPERMIT Owner: HARMON GRACIE 52220 AVENIDA OBREGON LA QUINTA,.CA,92253 (.909)376-5296 ry Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/08/07 OCT 08:2 OQQ7 CITY OF LA QUINTA ------------------ 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 toself-insurefor workers' compensation, as provided for by Sectiom3700 of the Labor Code, for the performance. of the work for which'this' permitis issued.. - have and will maintain workers' compensation insurance; as required by Section 3700of-the Labor . Code, for the performance of.the work -for which this permit'is-issued. My workers' coinpensation 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 mannerlso as to become subject to.the.workers' compensation laws of California, . and agree that, if I shout ecome subject to the workers' compensation'provisions of Section 3700 of the Labor Codeshall forthwith compll th those provisions. ' .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 1$100,0001. 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 and1county ordinances and state laws relating to buildi,,YYYYyy,,,,,,,,,pppppp000Gtttttt{{ construction, and hereby authorize representatives of.this county to enter upon the above-mentioned propertinspection purp . mare• 15>D6=0 r.Sfrinar,�rc.rnr,r,ifrar,r-nr-nnonrt•. /{Y /l/fil Application Number . . . . . 07-00002714 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 27.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1040 • Expiration Date 4/05/08 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 2.0000 HIND BLDG 501-2,000 12.00 ---------------------------------------------------------------------------- Special Notes and Comments 4 X 65 IN FT GARDEN WALL PER CITY STANDARDS Fee summary Charged ----------------- Paid Credited Due -------------------- Permit Fee Total 27.00 ---------- .00 ---------- .00 27.00 Plan Check Total .00 .00 .00 .00 Grand Total 27.00 .00 .00 27.00 LQPEPJW1T Bin # 1 k Ci` of La Quinta ' Building UkSafety Division P.O. Boz::1504, 78-495 Calle'jTampico La Quinta, CA,.92253 - (760) 777-7012 BuiIding.. Permit Application and Tracking Sheet Permit # - I Project Address J (� J.� G Owner's Name:i ((GR c. A. P. Number: % - —off. y Address �� ZZ 1.l� "� x Legal Description: _ L$ : , N 1 ti Contractor: O W(� II City; ST Zip Telephone a37 Address: - Pr/o'ject Description: _ City, ST, Zip: Telephone: "J%— r _ e �' O State Lic. # : City Li #: Arch., Engr., Designer ^ Address: } AL. VT City, ST, Zip: Telephone: P ` ` ' Construction Type: Occupancy: State Lic. #: Project, type (circle one):. • New : Add'n Alter Repair Demo Name of Contact Person:=(� Sq. Ft.: # Stories: # Units - Telephone # of Contact Person: Esiimated Value of Project t 4 , APPLICANT: DO NOT'.WRITE--BELOW THIS.LINE # _Submittal Req'd Rec'.d' ' ^ -TRACKING PERMIT FEES ; Plan Sets ,.Plan Check submitted. •Item Amount Structural Calcs.A 11 Reviewed, ready f corrections 'Plan Check Deposit Truss Cates. 'Called, Contact Pers -ow,, Plan Check Balance Energy Cates. Tla,ns picked up Construction Flood plain plan.Plans resubmitted ��0 ;,Mechanics[ Grading plan 2"'.Review, re y fo `,correction issue WElectrical'-`" Subcontactor List 'Called Contact Person' 20f :Plumbing Grant Deed Plans.picked up rS.M.I. - H.O.A. Approval Plans resubmitted `.Grading IN HOUSE:- 7rd Review, ready for correctioris%i - Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr r Date of permit issue . School Fees Total Permit Fees . � \ , ; 3" � . �,�z � . �� "�/f� �/�,| i% �� . �