07-1185 (BLCK)A - -
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
i!
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
BUILDING.& SAFETY -DEPARTMENT
BUILDING PERMIT
7--0 0 0-0-1-1 _85= Owner:
52916 AVENIDA OBREGON HFFMAN WILLIAM B
773-315-015-8 -000000- 52952 AVENIDA OBREGON D
WALL/FENCE LA QUINTA, CA 92253 -
COVE RESIDENTIAL ----=------------------
224
_ .. Contractor'
Architect o�'Engineer' Owner
-
VOICE (760) 777-.7012 .
FAX (760) 777-7011
INSPECTIONS'(760) 777-7153
Date: 4/19/07
APS .19 2007. _ ..
V CONSTR1-4
UCTIO ING AGENCY .
I hereby affirm under penalty of perjury that there is a constructionlending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
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 hereby authorize representatives "
of this county to enter upon the above-mentioned prdp yy for,
iinsplec4lloonn purposes.
—Date: f!'Signature-IAppI� i rAgent): 17 ►'f,/l 1 / —.
1j�T'�.
--------.--.------------.---------- -`'–� __'"�►�,'
= — — - — — — — — — — — — — — '
-.
7— - —— — — — — — — — — — — — — — — — — —
,'LICENSED'CONTRACTOR S DECLARATION
—
— — — — — — - = — — — — — — — — — — — — —
, WORKER S COMPENSATION DECLARATION
Thereby affirm ur der.penalty of-perlury that I am-.licensed'under;piovisions of;Ch'apter. 9 (commencing with
f hereby affirm under penalty of perjury one of.$he following declarations '
- Section:J000) of; Division.3'of.;the,Business and.P.rofii sionals Code, and my License is in full force and effecfI.. ;: 4'..'.
. _ ..-, . F - _.
..%'
::. ' ': I have and will.maintain.a ceitifi ate.of:consenfto self -insure fir work i Y✓ m n i'n r 4i
o e s co sato , as p, o ded
; .. .-- ,.:.. *
License Class. • .' ; : " License N6.'.�. � .;_ i+- �-
' -
_ :pe
foi'by-Section 3700 of the Labor Cot:14 " e:the performance of the,work for, which this permit is
+issued
;;Wu .,, ..
Date: Contractor: -
- I.have and will mamtain:workers'. compensation insurance; as required. by Section 3700,of the Labor'
- - - - -
- 'Code, for -the performance . -of thii woik for' wkich.this permit is'issued. My workers' compensation
OWNER -BUILDER DECLARATION'
I -hereby affirm under penalty of perjury that I am exempt from"the Contractor's State License:.Law. for'the.
insurance cairier and poky-numberare:
Carrier- . "Policy Number ,
" following reason (Sec. 7031.5, Business andProfessionsCode:�Any.cjty of county -that requir'es.a permit to
'JW_ I certify that, in theperformance of the work for which.this permit is issued, I'shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any 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 the workers' compensation provisions of Section
License Law (Chapter,,9-lcommen6ng with Section 7000) of Division 3 of the. Business and Professions -Code) or
'Any
3700 of the Labor Code I shallforth ith comply with those provisions.
this he or she is exempt therefrom and the basis for the alleged.exemption violation of Section'7031.5 by
:�-
.any applicant for a permit subjects the applicant to'a civil penalty'of not more-thanfive hundred dollars ($500) >
Date: Applicant - -
.. (� 1 I as owner. of the, property,. or my employees with wages'as, their sole compensation, will, do the work and
�� ► :. - - -+- -. ..
{_tithe structure is'notintended or offered for sale (Sea�7044 Business and Professions Code. The' -
-apply
-WARNING: FAILURE TO ;SECURE,WORKERS"COMPEN AT.ION COVERAGE IS UNLAWFUL, AND SHALL-
., . Contractori'.State;License Law does not to an owner of property who Guildsrorimproves,thereon,
" SUBJECT -AN EMPLOYER TO CRIMINAL PENALTIES AND -CIVIL FINES uP.;TO.ONE�HUNDRED THOUSAND '
:and who does the work himself or"herselfahrough his"ot her own employees, provided,that ,the ..
"
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR -IN
improvements arenot'intended or offered,forsale. 1f, however, the building or'improvement isaoldwithin
SECTION 3706 OF THE LABOR CODE, INTEREST; AND ATTORNEY'S FEES. -
' one year, of,completion,.the owner -builder will have.the burden of proving that he or.she did not build or
- ..
improve'for'thepurpose of sale.)._
APPLICANT ACKNOWLEDGEMENT '
(_ 1 I,'as�owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application1s.hereby made to the Director of. Building and Safety for a permit subject to the . .
- 7044Business and Professions Code: The•Contractors' State:License Law doesnot apply to'anowner of
conditions and restrictionsset forth on thisapplication. -
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed
, 1 } Each person upon wliose behalf this application is.made, each person at whose request and for
pursuant to the Contractors' State License Law:).
whose benefit work ,is.perfarmed under or pursuant. to any permit issued as a result of this application,
(_ 1 I am exempt under Sec'. ; B.&P.C. for this r son
the owner'; and the applicant; each agrees to, and shall defend, indemnify and hold harmless the City
0
of La'ouinia,'its officers, agents and employees for.any actor omission related,to the work being
performed under or following issuance of this permit. '
Dater Owner: -
2. Any permit issued as a result of this application becomes null and void if work is not commenced
V CONSTR1-4
UCTIO ING AGENCY .
I hereby affirm under penalty of perjury that there is a constructionlending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
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 hereby authorize representatives "
of this county to enter upon the above-mentioned prdp yy for,
iinsplec4lloonn purposes.
—Date: f!'Signature-IAppI� i rAgent): 17 ►'f,/l 1 / —.
Application Number
. . . . . 07-00001185
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee . . .
. 15.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 224
Expiration Date
10/16/07
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and
Comments
14 LF 4' BLOCK WALL
PROPANE ENLOSURE
.PER CITY STANDARD.
Fee summary
-----------------
Charged Paid
Credited
Due
Permit Fee Total
--------------------
15.00
----------
.00
----------
.00
15.00
Plan Check Total
.00
.00
.00
.00
Grand Total
15.00
.00
.00
15.00
LQPERMIT
Bin #
City of La Quinta
Building. BL Safety Division
P.O. Box 1'504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building. Permit Application and Tracking Sheet
Permit #
Project Address:' �2.
Owner's Name:.
A. P. Number:
Address: 2
Legal Description:
Contractor:Telephon
City, ST, Zip:IA2
Address:
Project. Description:
_.
City, ST, Zip:
IPa G
Telephone:
State Lic. #:
City Lic. #:
Arch_ Engr., Designer:
Address: .
City., ST, Zip:
Telephone:Construction
State Lid.. #:
Name of Contact Person:
Type'. Occupancy:
Project type (circle one): New Add'n . Alter _ Repair Demo:
Sq: Ft.:
#Stories:,
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT<WRITE BELOW THIS LINE .
N
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 CalAplan,
Called Contact Person
Plan Check Balance
Energy C
Plans picked up
Construction
Flood plai
Plans resubmitted
Mechanical
Grading.plan
2"".Review, ready for. correctionsfissue
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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
OWNE"UILDER INFORMATION,
Dear Property Owner:
An application for a building permit hasbeen 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 re uired,;to be si ned.b ro er owners unless the are' ersonall performing their
P gP. q g YP. P tyY ,P YP g
own work. If your work;is being performed 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 l y. 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 infortnation for youi: benefit and'protection.
If you employ or otherwise engage any persons other than your 'immediate family, ' and the work (including materials
and other costs) is $200.00 or. more for the entire project, andsuch persons are notglicensed 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 include State' and Federal: income tax.' withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemploymentcompensation 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 Federal'Law; 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 Department of Benefit Payments and the Division, of Industrial Accidents.
If the structure is intended for sale, property owners who are',not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contra' .f6r'6r.subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is 'to secure an,"OwnerBuilder" building
permit, erroneously implying that the property owner is providing his or her own' lab or 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 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-rewrned.
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) 777-701; e
OWNER'S SIGNAL. RE/DATE
ffiwao
P P R ADDRE S
PERMIT NUMBER(S)