06-3161 (BLCK)I t!e
P.O.* BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING &.SAFETY,DEPARTMENT
F
R1111 mIVC; PFRMIT
Application Number: 06-000031.61
`_Property Address: 529'16 AVENIDA OBREGON
at APN: 773-315-015-8 -00000.0-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 3125
Applicant; _ Architect or'Engineer:
Owner:
HOFFMAN WILLIAM B
52952 AVENIDA OBREGON
LA QUINTA, CA 92253
----------------------------
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/30/06
AUG s o Zoos L
Date: tea!/ 761 1116 f Owner:
CONSTRUCTIO 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
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, an here authorize representatives
of this county to enter upon the above-mentioned property for inspection etr ses.
i
Date: Signat pplicant_or Agent):
J
CITYQF i�4 QUINTA
-- _---—::--=------ =-- ------------ —------- -------
,
_ - LICENSED:CONTRACTOR'S DECLARATION
--- -----------------------------------—----—---
WORKER'S COMPENSATION DECLARATION
:1 hereby affirm under penalty of, perjury that-l;am!licensed`under provisions of Chapter 9 (commencing with ", -
I hereby affirm under penalty of perjury one of the following°declarations: -
' -:`�Section'7000) of Division 3'of the'Business and Professionals Code, and'my License is in full force and-effe'ct:�
I have and will maintain a certificate of consent to self -insure for workers' compensation,:as provided
License Class '` - License No.:,
_
.for.by'Section 3700 of the"Labor'Code, for the performance'of the work for which this.permit is
... issued. .
' Date:. - Contractor:-',:
I have and will maintain workers' compensation, insurance, as required by Sectibn 3700 of the Labor
' -
_
Code;-forahe performance of the work for which this permit is issued. My workers' compensation .
- OWNER -BUILDER DECLARATION' '
insurance.carrier and, policy number are: .
-,I hereby affjrm•under penalty of perjury,thatI am exempt fiom'the Contractor's State License Law for.the.
Carrier Policy Number
.,following reason'ISec. 7031.5; Business _pnd Professions Code: Any, city or county that requires a permit to
j�_ f certify that, `in the performance of the work for which this permit is issued, Lshall not employ any
construct�.alter;•iinprove, demolish, orriapair any, structure, prior to its issuance, also`requires the applicant for the
person imany manner so as to become'subject to the workers' compensation laws of California,
;.permit to file a signed statement that he or she.is licensed,pursuant to the, provisions of the Contractor's State
and agree that, if I should become subject to_t a workers' compensation provisions of Section
',License.Law -(Chapter 9 (commencing with`Section 7606) of -Division 3 Ail a Business and Professions Code) or
3700 of the Labor Code, I shal�fh�,i!h,c ply with ioseprovisions.•
ythat he or, she is exempt therefrom and the basis for the alleged'ezemption. Any'violation of Section7031.5 by
zany applicant fora -permit.subjects the applicant to'a civil penaltyof not more than five hundred dollars ($5001.:
Date: i Applicant:
(N) I, as ownerof'the property, or my`employees with wages as their sole compensation, will do the work, and
. .
.. the structure isnot intended or offered for sale (Se&.*7044,Business;ands Professions Code: The
WARNING: FAILURE TO,SECURE,WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' Stat6 License Law does not apply to an.owner of property 11 who builds or" improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES uP'TO ONE HUNDRED THOUSAND
._
and who does the work%hiniselfor herself -through his or her own employees,"provided, that the
DOLLARS.($ 100,000). IN ADDITION TO .THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
. Improvements are not intend6b or offered,for sale. If, however, the building or improvement is.sold within
SECTION 3706 OF THE.LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
' one year of completion, the: owner-builderwill -have the burden of proving that he or she did not build or
" improve for, the purpose'of sale.). -
APPLICANT ACKNOWLEDGEMENT
1 1 I, as owner of the property, amexclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Businessand Professions Code: The Cont actors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
. property who builds orimproves thereon, and who contracts for the projects with•a contractor(s) licensed
1. -,Each person upon whose behalf this application is made, each person at whose request and for
pursuant to:the contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , Bi&P.C. for this reasop
the owner, and the applicant, each agrees to, and iihall defend, indemnify and hold harmless the City
Date: tea!/ 761 1116 f Owner:
CONSTRUCTIO 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
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, an here authorize representatives
of this county to enter upon the above-mentioned property for inspection etr ses.
i
Date: Signat pplicant_or Agent):
J
t'!
LQPERMIT
Application Number . . . . . 06-00003161
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 63.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 3125
Expiration Date 2/26/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
2.00.. 9.0000 THOU BLDG 2,001-25,000
18.00
----------------------------------------------------------------------------
Special Notes and Comments
125 LF 2' RETAINING WITH 6' GARDEN -WALL
ALONG NORTH &.-REAR P/L'S PER CITY
STANDARD.
_Fee summary Charged Paid Credited
-------------------------------------
Due
----------
Permit Fee Total 63.00 .00
----------
.00
63.00
Plan Check Total .00 .00
.00
.00
-Grand Total 63.00 .00
.00
63.00
Bin#
City of ta Quinta
Building 81 Safety DIYISion
P O Box 1504, 78-495 Calle Tampico.
La Quinta, CA. 92253',(74Q)777-7012
Buildin �P.ermivA lication a:
, g , : •pp nd Tracking "Sheet
Perrin .#
�.
Project Address: /�
1 C% `0
O wner shame
A. P. Number:
Address:
Legal Description: -
Contractor:
, C.ST, Zip, ,
Telephone; r .
,Project Description:.
Address:
City, ST, Zip:
Telephone:
City Lic. #:
U.
.
State Lic. # :
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #: u>...
Name of Contact Person:
Construction Type -: Occupancy:
Project type.(dircle:one): {•New ' Add'n Alter Repair Demo
Sq:,Ft ;
.4 Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT:.D,O NOT WRIT9: BELOW THIS LINE .
#
Submittal
Req'.d
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections"
Plan Check Deposit
Truss Cates.
Called Contact Person -=
-Plan Check Balance
Energy,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.'
H.O.A. Approval
Plans•resubmitted
Grading
IN HOUSE:-
7rd Review,ready for.corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit,issue
School Fees
Total Permit Fees
{
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, awarethat as, "Owner/Buildet,", you are the responsible party'' of record on such a
permit. Building permits are not required'to be signed by.or6oerty,,bwrf-ers,uniess� they are personally performing their
own work. If youi work isperformed'by someone oifier, than -yourself, 'yq u may . 0 r6tect yourself- fro m possible
liability if that person applies for the proper "permit in'his ci'Ale , r, name. -
Contractors are required bylaw to be licensed and bonded.by th8'-Siat&, of California and to have a business license
from the City or County. They are also required by law to put their.ficerise, number on,,afl permits for which they
p
apply
If you plan to do your own, work, with the exception of various trades thai,you plan to subcontract, you should be
'benefit and p tim'.
aware of the following information for your rotec ion:
If you employ or otherwise engage any persons other than' --your immediai6,.fiimily, and the work (including materials
and other costs) is $200.00 or more, for,tfie 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 ariffederal Federal:
�Government as an employer and you are subject
to several obligations include:'State and Federal income'. , tax W'.4thiholdiiig;4' decal social security taxes, worker's
contributions.
compensation insurance, disability insurance costs.and unemployment
There may be financial risks for you if you do not carryout these;. obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations undek Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business.Adm'i ' ni * stiatiori). For more specific'-ffif6rination about. your obligations under State
Law, contact the Department- of Benefit.;P'a�yipents and thebivisicn of Indbi's"trii4! Accidents.
If the structure is intended for sale; property owners who are not. ficensedcontracis. are allowed to:perform their
work personally or through their own employees, withodia., c contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed. persons, professing to, be,contractors is to 'secu're, anfl "Owner/Builder" building
ly implying that the property owner i&-provi ing,
permit, erroneous 'his' ' of -her own lab&arid material personally.
Building permits -are not. required to be signed...by propeity owners:-unles's'--ihey are- performing their own work
personally.
Information about licensed contractors may, be -6btaifted, by. contacting,the Contractors' State,. License Board in your
community or at 1020 N. Street, Sacramento, Californik ' 95814.
Please complete and return the enclosed owner -builder verification fbrhi;so.that,we can confirm that you are aware of
p 1. _ '. " `returned.' - -
these matters. The building permit will; norbe issued until -the" verificati6ti'is
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 SIGNAPURJZ/DATE
PROPERTY ADDRESS
PERMIT NUMBER(S)