05-4957 (BWFE)54685 Avenida Alvarado
MIN 70
IE
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
05-00004957
54685 AVENIDA ALVARADO
774-272-021-9 -000000-
WALL/FENCE
COVE RESIDENTIAL
160
4 4 auliffai
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
DiP
Owner:
TATRO JESS EUGENE
54685 AVENIDA ALVARADO
LA QUINTA, CA 92253
Contractor:
A & R COMPLETE POOL SERVICE
P.O. BOX 103
LA QUINTA, CA 92247
(760)772-0752
Lic. No.: 841981
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/07/05
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I . licensed under pro .ions of Ch pter 9 (commencing with
• Section 7000) of Division 3 of the Business . d Professional Code, .nd my Li.-nse is in full force and effect.
License Class: C53 cense o.: 84; 981
Contractor
rt.-
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
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 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.).
() 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
WORKER'S COMPENSATION DECLARATION
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 YOUNGBLOND INS Policy Number 229003025105
_ I certify that, in the performance of the work for which t s permit issued, I shall not employ any
person in any manner so as to ecome subject to the orkers' c pensation laws of California,
and agree that, if should be •file subject to the w. ers' co nsation provisions of Section
00,of the La.•r Code, I - all f; rthwith omply ovisions.
65
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 (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 37.06 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 work1r. not commenced
within 180 days from date of issuance of such permit, or cessation of wor .r 180 days will subject
permit to cancellation.
1 certify that I have read this application and state t•: the above information is correct I agree t• omply with all
city and county ordinances and state laws relatin• to building c1 struction, an• hereb authoriz: -presentatives
of this coupty tenter upon the above -mention• property fo.dsp-; tion pur:'.ses.
gnature (Applicant or Age
Application Number 05-00004957
Permit 'WALL/FENCE PERMIT
Additional desc
Permit Fee . . 15:00. Plan Check Fee
Issue Date . . Valuation . .
Expiration Date 5/06/06.
Qty Unit Charge Per
BASE FEE
.00
160
Extension
• 15.00
Special Notes and Comments
10 L.F. 4' EQUIPMENT WALL, ORCO SYSTEM
Fee summary
Permit Fee Total
Plan Check Total
Grand Total
LQPERMIT
Charged Paid
15.00
.00
15.00
.00
.00
.00
Credited
.00
.00
.00
Due
15.00
.00
15.00
Bin# .
•
City of La Quinta
Building 8t Safety Division
Permit # /1
aQ\5
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-70.12
Building Permit Application and Tracking Sheet
Project Address: 5/46 $S l
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Owner's Name: bee S 1
A. P. Number:
Address: Sq. b%s A kli9A\ 1 •PA- N 1 l(aQ- O
Legal Description:
rI
City, ST, Zip:
LA DutMiFl OR-
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Contractor: - d-- R (n
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Telephone: - 3 c(
P S119-4439
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Address: e. D . Px»x I 0 3
Project Description:
City, ST, Zip: l4, G U\
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TeleP hone: 1 ala
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State Lic. # : $ \ VZ I
City Lic: #:c ) y 1 S
Por.p :. DYC-) L,LS t e I'\ -e,1 al
Arch., Engr., Designer:
...Ph OC
4 &t J _ mi Q'r,
Address:
City, ST, Zip:
10 W F±. y' ht k.-
?•
o �P i
N.A.TelePhone:
Construction Type: e: R-1\Occupancy •
State.Lic. Lic.
.............. ......
Project e type (circle one Add'n Alter Repair Demo
Name of Contact Person:
Dui
Lk) l=b ,
U
# Stories:
# Units:
Telephone # of Contact Person (AO - ai .-13(.9 .
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 Calcs.
Called Contact Person
Plan Check Balance
•
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for corrections/issue •
.
1 Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.
•
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
P.ub. Wks. Appr
Date of permit issue
School Fees
' Total Permit Fees