BLCK (06-2240)54470 Avenida Martinez
06-2240
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: ;06-00002240
Property Address: 54470 AVENIDA MARTINEZ
APN: 774 -254 -024 -ST -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 4330
Applicant:
Tjht 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BILLS RANDY C
4865 AVENIDA OBREGON
QUINTA, CA 92253
O
^OQ6 ntr ctor:
`\ l• GA HOMES
W.O. OX 696
QUINTA, CA 92253
O E (760)777-8317
Lic. No.: 778280
-----------------=--------------------------------
A
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 Professionals Code, and my License is in full force and effect.
Lice n a Class: 13 LiqgAW 78280
r
ontra
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).:
(_ 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
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
;s 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.
y 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:
LQPERA11T
VOICE -(760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/01/06
------------------------------------------
WORKER'S COMPENSATION DECLARATION
I 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 STATE FUND Policy Number 13302-2005
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 laws of California,
and agree that, if I should b ome subject to the k o pensation provisions of Section
3700 of the Labor Code s ('forthwith com Ii it l those rovons.
Date: " Applic
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEFIAM74 UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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 t he above infor tion is correct. I agree to comply with all
city and county ordinances and state laws relati to b ' m cons u n, and hereby authorize representatives
of thi county to enter upon the above-mentio e y for i io oses.
Dat§?' _/ Signature (Applic
Application Number . . . . 06-00002240
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 72.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 4330
Expiration Date 11/28/06
.
Qty Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
----------------------------------------------------------------------------
Special Notes and Comments
200 LF 5' GARDEN WALL PER CITY STANDARD.
Fee summary Charged
-------------------------------------
Paid
Credited
--------------------
Due
Permit Fee Total 72.00
.00
.00
72.00
Plan Check Total .00
.00
.00
.00
Grand Total 72.00
.00
.00
72.00
Cv
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LQPERMIT
Bin #S,
City of La Quinta
Building a Safety Division
Permit.# P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: t N(7 I ,, a t,l _1 'Owner's Name:
A. P. Number: Address: 4
Legal Description: City, ST, Zip:
Contractor: Cc t2 (OJ i Telephone:
Address: l L
VDfProject Description:
City, ST, Zip:C4 a )an
TelephoncMlo)
State Lic. # : —M al (
Arch.; Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Cates.
Truss Cates.
Energy Cates.
Flood plain plan
Grading. plan
Subcontactor.List
Grant Deed
H.O.A. Approval '
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Estimated. Value of Project: .
APPLICANT: DO NOT WRITE BELOW THIS LINE
c'd
TRACIMG
Plan Check submitted
PERMIT FEES
Item Amount
Reviewed, ready for corrections
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2"" Review, ready for correctionsrssue
Electrical .
Called Contact Person
Plumbing
S.M.I.
Plans picked up
Plans resubmitted
Grading
Developer Impact Fee
A.I.P.P.
Review, ready for corrections/issue
Called Contact Person
Date of permit issue
Total Permit Fees
Bin #
`
Permit.#
Project Address:' S y%DCa12T/A/6?,
A. P. Number:
Legal Description:
Contractor:
City of La Qu*=
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: 1l
Address: 4 z Q /l/U2
City, ST, Z Gt. 7"Ps Ci`t
Telephone: 003 1160
Address:
Project Description:
City, ST, Zip:
Telephone: g9D - .3 y
State Lie. #: 7% f 2Q
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:
Estimated-Value of Project:
Telephone # of Contact Person:
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 correctionsrssue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
S M L
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'nd 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