06-0029 (BLCK)c&t!t4-4Q"
Applicant: Architect or Engineer:
ut
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
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 P essionals Code, and my License is in full force and effect.
License Class: B is
yontractor: -
•/ OWNER-BUI R DECLARATION
I hereby affirm under penalty of perjury that I am exempt f m 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any 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 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 contractors) licensed
pursuant to the Contractors' State License Law.). -
(_) 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
Owner:
WATERMARK GRANITE LA QUINTA LL
200 E WASHINGTON AVE #100
ESCONDIDO, CA 92025
Contractor:
INNOVATIVE COMMUNITES,
200 E. WASHINGTON AVE,
ESCONDIDO, CA 92025
(760)839-8238
Lic. No.: 763187
Date: 1/05/06
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION '
I hrrrhy 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 wil'ma intain 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 STATE FUND ' Policy Number 1688263-2005
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 lawsalifornia,
and agree that, if I should becomawbiect to the workers' compensation pr ions of SI ction
3%j7]�0/0 of the Labo Code, sh orthwith comp ith those division
D /`v scant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION Co RAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL ES 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 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 info arson is corre t. I agree to comply all
city and county ordinances and state laws relating to building co uction, and h y au th resentatives
of this cou y to nter upon the above-mentioned propert or ' spection pur es.
D ( AO _(Si ure (Applicant or Agentl'
IIIIIII VIII III VIII IIII 18 j
IE
P.O. BOX 1504
--
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00000029
Property Address:
79860 AVENUE 52
APN:
772 -220 -010 -
Application description:
WALL/FENCE
Property Zoning:
NEIGHBORHOOD COMMERCIAL
Application valuation:
41175
c&t!t4-4Q"
Applicant: Architect or Engineer:
ut
� IiA
w
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
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 P essionals Code, and my License is in full force and effect.
License Class: B is
yontractor: -
•/ OWNER-BUI R DECLARATION
I hereby affirm under penalty of perjury that I am exempt f m 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any 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 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 contractors) licensed
pursuant to the Contractors' State License Law.). -
(_) 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
Owner:
WATERMARK GRANITE LA QUINTA LL
200 E WASHINGTON AVE #100
ESCONDIDO, CA 92025
Contractor:
INNOVATIVE COMMUNITES,
200 E. WASHINGTON AVE,
ESCONDIDO, CA 92025
(760)839-8238
Lic. No.: 763187
Date: 1/05/06
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION '
I hrrrhy 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 wil'ma intain 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 STATE FUND ' Policy Number 1688263-2005
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 lawsalifornia,
and agree that, if I should becomawbiect to the workers' compensation pr ions of SI ction
3%j7]�0/0 of the Labo Code, sh orthwith comp ith those division
D /`v scant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION Co RAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL ES 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 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 info arson is corre t. I agree to comply all
city and county ordinances and state laws relating to building co uction, and h y au th resentatives
of this cou y to nter upon the above-mentioned propert or ' spection pur es.
D ( AO _(Si ure (Applicant or Agentl'
Application Number 06-00000029
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 362.50
Plan Check
Fee
00
Issue Date . . . .
Valuation
. . .
. 41175'
Expiration Date 7/04/06
Qty Unit Charge Per
Extension
BASE
FEE
252.00
17.00 6.5000 THOU BLDG
25,001-50,000
110.50
-----------------------------------------_-----------------------------------
Special Notes and Comments
1647 L.F. 6' BLOCK WALL WITH 43
18"x18"
COLUMNS, CITY STANDARD
Fee summary Charged
Paid Credited
Due
Permit Fee Total 362.50
---------
.00
----------
.00
362.50
Plan Check Total .00
.00
.00
.00
Grand•Total 362.50
.00
00
362.50
LQPERMIT
... 08:29 7608398246 IC PAGE 01/02
(lilll 111 it II 1 I li''`
FACSIMILE COVER SHEET
DATE: \ 16 (oto # OF PAGES (including cover): Z
HARD COPY TO FOLLOW:
TO: NAME: Kny
COWANY: C.x'ry or -
PHONE: r'PHONE:
FAX: 7 fa a "-77--7k%2_
FROM: %wmo
RE: t.Ja-�-�rLurg.1� v•\\4S
FOR yOVR INFORMATION - NO SPONSE NECESSARY
PLEASE CALL AT 760-839-8238 x SSS -IF THERE ARE ANY
PROBLEMS WITH TRANSMISSION. ,
MESSAGE:
.a.-rr*AW�h i4' Twe �P Avto" V%ori
p-1.1- `' Env
a4A4"
,�yv !l922oL�c, �
P
200 E. WASHINGTON AVE., SUITE 100 ESCONDIDO, CA. 92025 760.839-8238 )'AX_760.839-8246
01/05/2006 08:29 7608398246 IC PAGE 02/02
Bin #
Qty of LaQuinta
Bui(dingar Safety division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
^�
Project Address: •- %. SZ
Owner's Name: U42VAWfe ae*) IT t-
A. P. Number, rl 7� -Z, ,BO r
Address-. z[�U (,(If�SN/�% 7D)% A,) -Am a
`4(7 T •
Legal Desai tion: / J- �J s.L 3 Fxic U
Contractor �Ai�G�%i l lli�. />?kA% %� n?5
City, ST, Zip: �j �!)C%tidij GaZU� S
Telephone:
Address: 1106 �� / �j,J U�
ProjeetDescription: C
City, ST, Zip:6c Md
Telephone:/00 �9• j1 < a
State Lie. A : 6 % y
City Lie. #: /#V z_�
a ♦t
. Engr•' nesiper i K� le; s JrX ...
. .
Address: 7p5,0 KP#%JL'ka /A4 A :,4,-5 iff- K-2
City, ST, Zips l�i �, lam,?LZO
Telephone: 4- 7? �/ 75/ s;<:
State Lic. #:
Construction Type: Occupancy:
Project type (circle One): New Add'n Alter Repair Demo
Name of Coatott Peravn: p p/�i u ��,
Sq. PL: # Stvn es:
# (faits:
Telephone # of Contact Peicsott:D'447- Z96
EsGtnated Value of Project
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Iteq'd
Recd
TRACKING
PERMIT FEES
Play Stts
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Tress Cala.
Called Contact Person
Plan Check Balance
Title 24 Calcs•
Plans picked up
Coosvuedon '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for correctionsIbsue
Fdoct[ica!
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
5.11711.
H.O.A. Approval
Plana resubmitted
Grading
IN MUM-
"° Review, ready for eorrectlonvInue
Developer Impact Fee
Pianaing Approval
Called Contact Person
AXF.P.
Pub. Wks. Appr
Date of permit Issue
Scholl Pecs
Total Permit Fees
�Q
1
R.
AD D
c®R']I�R1Cb�l�llll�les
TRANSMITTAL SHEET
TO: JOHN QUICK DATE: JANUARY 10, 2006
.Company: City of La Qwnta From: Jane Mc8roy for Brad Fomon
i
CC: DD i
i
URGENT FOR REVIEW FOR APPROVAL FOR SIGNATURE 4FOR YOUR USE
SENT VIA: HAND DELIVERED
Message: Permit for Block Wall —Watermark Villas
List of information sent_
Copies
Date Pages I Description
1
1 Check #328 in the amount of $362.50
1
1 Application for Permit
1
2 Plans fro Block Wall
i
t
To confirm the receipt of the above listed items, please sign below and fax back to
the attention of Jane McElroy Fax 760-839-8246 Thank you.
Documents received by. Date: