BLCK (06-1365)54840 Avenida Madero
06-1365
4`!t
Q"- P.O. BOX 1504VOICE (760) 777-7012
78-495 CALLE TAMPICOFAX (760)777-7011'
LA QUINTA, CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
• BUILDING PERMIT
r - Date:" 4/04/06
Application Number. 06-00001365_.—. — .( Owner:
Property Address: 54840 AVENIDA MADERO SACUY TIM
APN: 774-265-.027-20 -000000- 199.MESA DRIVE
Application description:' WALL/FENCE COSTA MESA, CA 92627
Property Zoning: COVE RESIDENTIAL -
Application valuation:.1.875
Contractor:
Applicant:. Architect or Engineer: SAC7Y, TEMIR
P.O. BOX 611 APR 0 L1 2006 .
CORONA DEL MAR, CA 926
(949)874-6309
OF LA 9!Ll I
Lic. No.: 689484 CIQU
F AaiCEDEPT.A
LICENSED CONTRACTOR'S DECLARATION
1 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 Professionals Code, and my License is in full force and effect.
License Clas : B nse No.: 689484
Date: Contractor:
ER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I ar ex mpt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and P fes ions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any ructure, 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.).
(_) 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.).
(_ 1 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 thispermit is issued. My workers' compensation
insurance carrier and policy. number are: '
Carrier CLAREDON Policy Number 04KR0027033
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 laws of California,
nd agree that, if I show {come subject to the workers' compensation provisions of Section
700 of the Labor C e, sft orthwit ply with those provisions.
Date: Applicant: YY/ `
WARNING: FAILURE TO SECURE WORKERS'O ENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA ?I AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE T 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 th ve information is correct. I agree to comply with all
city and county ordinances and state laws relating .t ' i onstruction, an hereby authorize representatives
of this counX
to enter upon the above-mentioned rop y 4inspection poses.
Date:' T' Signature (Applicant or Agenq: _ -
Applicatibn•Number . . . . 06-00001365
Permit WALL/FENCE PERMIT
-
-
' - Additional desc.
Permit Fee . . . . 43.00
Plan Check
Fee
.00
Issue Date . . .
Valuation
1875
Expiration Date 10/0'1/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
14.00. 2.0000 HND BLDG 501-2,000
.28.00
------------------------- ---------------------------------------
Special Notes and Comments
75 LF COMBO 3' RETAINING WALL WITH 5'
GARDEN WALL PER CITY STANDARD ALONG
SIDE P/L.
Fee 'summary Charged Paid
Credited'
Due
y Permit Fee Total 43.00
.00
.00
43.00
Plan Check Total .00
.00
..00
.00
Grand Total 43.00
.00
.00
43.00
LQPERMIT
Bin #
City of La Quinta
Building & 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:
Owner's Name: ,4C- v
A. P. Number: '7.74- —`L(p 6 ti 7 TZ)
Address: O c ptc
Legal Description:
City, ST, Zip:
Contractor:Dv✓ (, Y) .ht G vL
Telephone:
Project Description:
Address: i (
City, ST, Zip: 11/DV k-
o- c- l t'bti
( VAVV vk-,-ov LAI
.Telephone:i{ T i '10 1
1
>
State Lie. # 9
City Lic. #:
Arch., Engr., Designer:
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 Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
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
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd 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
r