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06-3989 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 . I Application Number:06-000 03899 _ — Property Address: 52600 AVENIDA OBREGON APN: 773-285-005-4 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 1624 T-vy 4 4 Q" Applicant: Architect or Engineer: ----------------- 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.: Date: 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 th he or she it exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by a 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 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.). (_ 1 I am exempt under Sec. , B.&P.C. for this reason 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) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/15/06 Owner: JAVIER RUVALCABA 52600 AVENIDA OBREGON LA QUINTA, CA 92253 --------------------------------- Contractor: D Owner NOV 151006 ------------------- 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 Policy Number 41- 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 shout become subject to the workers' compensation provisions of Section 3700 of the Labor Cod I shall forthwith corn w h tho provisions. . Date:(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 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 underor' 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 h authorize representatives of county upon the above-mentioned pro- perty or inspection purp es. I r Date: 06 Signature -(Applicant -or Agen[I: O/ y lr / / sV n re A Application Number . . . . . 06-00003989 Permit . . . WALL/FENCE PERMIT Additional desc . Permit -Fee . . . . 39.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1624 Expiration Date . . 5/14/07 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 2.0000_HND BLDG 501-2,000 24.00 ---------------------------------------------------------------------------- Special Notes and Comments 75 LF 5' BLOCK WALL IN FRONT YARD & INTERIOR SIDEYARD (INSIDE EXISTING 2' RETAINING WALL). CITY STANDARD. Fee summary Charged Paid ------------------------------------- Credited -------------------- Due Permit Fee Total 39.00 .00 .00 39.00 Plan Check Total .00 .00 .00 .00 9: Grand Total 39.00 .00 .00 39.00 LQPERMIT Bin ff Permit ff Project Address: City..;ofla Quinta Building u Safety Division P.O. Box 1504 78-05 Calle Tampico La Qdinta, CA 9225.3 - (760) 777-7011 Building Permit Application and Tracking Sheet Owner's Name:** 6 A. P. Number. Address- 57 Qity, ST, Zip:, . I �L a n a q 2 Legal Dekription: Contractor: Telephone; (7e 0 re CY L7 72- IS Address: Prbject Description: r City, ST, Zip: Telephone: State Lic. # City Lic.i . I.Clion Type, Oceupancy: Arch., Engr-, Designer: Address: City, ST, Zip: Telephone: State Lic. Name of Contact Person: on type (circle one) :(EeDw Add'n Alter Repair Demo Sqt FL: Stories: # Units: Estimated Valdeqf Project. Telephone # of Contact Person: APPLICANT: *DO NOT W' PJTE.BELOW THIS LJNF.� N Submittal Plan Sets Req!a:: Recd TRA ., Plan Check submitted PERMIT FEES Item Amount Structural Caics. Reviewed,,.ready for."rrections Plan Check Deposit Truss Calcs. Called Contact Person' Pian"Clieck Balance Energy .Gales. us picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plau, 24 Review, ready for correctio*Wissue 'Electrical Subcontactor List Called Contact Person 'Plumbing Grant Deed Plans picked tip H.O.A. Approval 'Plans resubmitted.. Grading IN HOUSE:- Rivieyr; ready for co6 fi, rec ionsrissue Developer impact Fet� JPlanning ApprovalC ailed Contact Person A.I.P.P. ..Pub. Wks. Appr Date of permit,issue School Fees Tgtal.Permit Fees tz- ----- ----- __-_ _..... ..... p • - ---- ---'- --... - --- ...--= =-- ---- - - -- --- - - ...... i' INT Ll 1143 - i - I `f Z..�_.__.�Q��.�.�. �.._...� 9 2.2 5�... •-• _� ..rte-�.�,.,...._.,_ _ _-__,..__ 1 .. U f i. f OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as `!Owner/Builder" you are the responsible party of record on such a permit. Building permits are not required. to be signe&by property owners unless they are p mersonally performing their own work. If your work is, being perfored' 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 by law to be licensed and bonded, by the State of California and to have a business license from the City or County.They are also required by law to put 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 otherwise eingage any persons other than your immediate family, and the work (including materials and other costs) is $200:00 or more, for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you,must register with the State and Federal Government as an employer and you are subject to several obligations. inciude State Wand. 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 respect to worker's compensation insurance. ; For more specific information about your obligations.under Tederal taw, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration)..For more specific`information about your obligations under State Law, contact the Departrrient.of'Benefit Payments and the Division of Industrial Accidents. If the structure is intended foesale, property owners who are not licensed contractors are allowed to perform their work personally or through their owd employees; without; a'licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors isto 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 they are performing their own work personally. Information about licensed. contractors maybe `obtained by confacting°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 pe'rmirwill not be issued until the verification'is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND.SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (7,60) 777-7011 �1 / e e O R'S SIGNATURE/DATE PROPERTY ADDRESS d6-�q�� PERMIT NUMBER(S)