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09-1244 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 09-00001244 Property Address: 5262.5—AVENIDA OBREGON APN: 773-284-018-5 -000000- Application description: WALL/FENCE Property Zoning: COVE .RESIDENTIAL Application valuation: 350 Applicant: ✓`�/� .Architect or Engineer: ------------------- LICENSED CONTRACTOR'S DECLARATION :�� ? .,;moi•, BUILDING & SAFETYDEPARTMENT BUILDING PERMIT hereby affirm under penalty of perjury that I am -licensed under provisionsof-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: B' License No.: 717813 Date*2 Contractor: ontractor: f 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 ISec..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 Divisiom2l 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 fora permit subjects the applicant to a civil peoalty,of not more than five hundred dollars ($500).: ( 1 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, B'us'iness and Professions Code: The Contractors' State License Law, doesnotapply to an owner of property ,who builds or improves thereon, and who does the work himselPor 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 shedid 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 contracto.r(s) licensed pursuant to the Contractors' State License Law.). - 1 _ 1 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 Name: _ Lender's Address: LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 n! Date 12/07/09 Owner: CRAWFORD jOANNA & MARK 52625 AVENIDA OBREGON LA QUINTA, CA 92253r+- i+ f (626)536-6052 C67y Fla LA Contractor: NrEpp AERY CONSTRUCTION 52641 AVENIDA BERMUDAS LA QUINTA, CA 92253 (760)200-7910 Lic- No.: 717813 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 poli cy. are: Carrier UNITED .INS Policy Number 1890225-07 _ 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 3700 of the Labor Cod II forjgwitocom ly with those provisions. r Date��'��p Applic�nt:t , 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"Aet 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 construe ' n, and hereby authorize representatives of this county to enter upon -the -above-mentioned pro riyup! on purpos D e, G`—�\yP Signature (Applicant of A' l�r+.pl,L I' a Application Number . . . . . 09-00001244 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 350 Expiration Date 6/05/10 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 13'-10" LENGTH X 6 FT HT BLOCK WALL PER CITY STANDARDS & APPROVED PLANS WITH (2)RETURNS / (2) GATES.APPROVED BY PLANNING (D.S.) & A.J. ---------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary ----------------- Charged ---------- Paid Credited ------------------------------ Due Permit'Fee Total 15.00 .00 .00 15.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 16.00 .00 .00 16.00 LQPERMIT N r 0 D 00 tw m � n0 I I1 193. --------- It I �r N r 0 D 00 0 _h V 3 U.� BUILDING & SAFETY DEPARTMENT c� 9ti5 00 OF (760) 777-7012 Tl�' • FAX (760),777-7011 To: Greg Butler, Building & Safety Manager. To CDD: /.;2-'9-D y% From: Planning Building., Permit Release (This is an approval to issue a Building Permit) The Community Development Department has reviewed the following project: Description: / ✓ �'--� �/ L •10 G1G� (� Lc�. a? V - Address or genera 11 ocation: APN and or. description: • r The Community Development Department finds that: ❑ ...issuance of this Building Permit does not require Community Development" Department approval. r - �J,---.—" issuance of this Building Permit is approved by the Community Development Department. 2 Planner signature Date rcl-Ve DEC 7 2009 atv of La QLfta Manning Oapaft..D KAY'S GRN SHEET:doc 7/15/2004 Bin # C tTof La- Quinta Building Br Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application :and Tracking Sheet Permit # 1�y 0\ \` Project Address: 2_,&_`eA/LDk (-g QyV 0wner's Name: 'd'► l� A. P. Number: Address: �(ZA- AtAe m6a C&r Legal Description: Contractor. l `�:��2. City, ST, Zip: Telephone: t"' — � ;N:� ..::.v.:: •� ...s:.�>.;,;::;;«�:<r Address. Z (O q l AV,e L t)A t tJ�f�� Project Description: Odd- A. City, ST, Zip: 6,2\ ��% ('��t� G� r q2Z�9 3 C/ S Telephone: 2("J)ZQC-� ZvLd tis'><:::;.:3.>:>..;<.:::>;:::.:{..{:;.;.;;:r.::.;•j;:::.: / _/00 State Lic. # : City Lic. #.: Arch., Engr., Designer: 56UTM (P,051 t_5 C . Address: 7�� (, &4+t`eESi4,k_:>0 IA-e2k; City, ST, Zip: Telephone:.:: State Lic. #: ~ $ �' ' ^ ;::w>;:: �:;<.: rrr.> :".•:;?Fss a.{<:>:::<;_:+v>r?.?>.< .: Construction Type: �i/�l�li Occupancy: Project a circle one): New Add'n Alter Repair Demo Name of Contact Person: �`�/t, Sq. Ft: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cities. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2•" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for correctionstiissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees