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BLCK (06-2626)53210 Avenida Madero 06-2626 TAt!t 4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT • Date: 7/11/06, Application Number: -06-00002626 Owner: Property Address: 53210 AVENIDA MADERO CRAWFORD APN: + 774-032-010-13 -,000000- 53210 AVENIDA MADERO Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: COVE RESIDENTIAL ' Application valuation: .1147 - Contractor: y PFINANCEI),cpT, Applicant: Architect or Engineer: HENRY'S MASONRY, INC. P.O. BOR 526111006LA QUINTA, CA 9224 (760)775-68D7 Lic. No.: 704270 l.q ( U1NT/ ' ------------------.------------------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions. of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the fallowing declarations: Section 7000) of Division 3 of the Business an Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: C29 seNo.: 704270 for by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. Date: ontractor:, 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 _ OWNER-BUILDE LARATION insurance carrier and policy number are: ' - I hereby affirm under penalty of perjury that I am exempt from the ontractor's State License Law for the Carrier STATE FUND Policy Number 046001530605 - following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to - _ I certify that, in the performance of twork h 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 t b me 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 c e subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Cod o hwith comply 7th those provisions. 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).: ate: ^ //—(J A ant: - - (_ 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, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C ERAG I AWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP ONE HUNDRED THOUSAND and who does the work himself or 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 intended 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 -builder will have the burden of proving that he or she did not build or _ improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT (_) I, as owner of the property, am exclusively 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, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves 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. , BAP.C. for this reason 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. Date: Owner. 2. Any permit issued as a result of this apAaboi e null and void if work is not commenced within 180 days from date of issuanc' , or ssation of work for 180 days will subject CONSTRUCTION LENDING AGENCY. permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that 1 have read this application and state trmation is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and linty ordinances and state laws relating ton, and hereby authorize representatives _oft ' county to enter upon the above-mentioned ption urposes. Lender's Name:Date: ! gnature (Applicant or Agent) Lender's Address: V - LQPERMIT Application Number . . . . . 06-00002626 Permit . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 29.00, Plan Check Fee ." .00 Issue Date Valuation . . . . 1147 Expiration Date 1/07/07. Qty Unit Charge Per Extension BASE FEE 15.00 7.00 2.0000.HND BLDG 501-2,000 : 14.00 ------------ ----------------------------------------------- Special Notes and Comments ----------------- .53 L.F. 5' GARDEN WALL WITH STUCCO TO MATCH.HOUSE, CITY STANDARD Fee summary Charged Paid Credited Due 1 Permit Fee Total 29.00 .00 .00 29.00. _ Plan Check Total .00 .00 .00 .00 Grand Total 29.00 .00 00 29.00 Bin # City of La Quinta. Building a Safety Division P.O. Box 1504, 78-495 Calle Tampito La Quinta, CA 92253 = (760) 777-7012 Building Permit Application and Tracking Sheet Permit.# a Project Address: 5 — (fe WIA 0(f A() Owner's Name: C,g yJ A. P. Number: Address: -53a/c) `o -J,0 /qWe/- 0 Legal Description: City, ST, Zip: t U IGtJ' Contractor: AF—t/qSO k.i l2 y Address: O Q U S f/8 Telephone: Project Description: City, ST, Zip: /. 1' 3 X J zvl %4.S 6 w Alt. Telephone: State Lic. # :C O yoi % 0' City Lic. #: AIILC L4.0 U Arch., Engr., Designer: i ► / Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction 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 # Submittal Req'd Recd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood lain plan'. P P f Plans resubmitted Mechanical Grading, plan 2°d 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 correctionsrissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees _....-- ............... .... ........ _...... --- Total Permit Fees