BLCK (08-0909)78110 Masters Cir
08-0909
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08=00000909,
Property Address:
78110 MASTERS CIR
APN:
770-350-004- -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
5381
T4ht 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
JACK DANFORTH
78110 MASTERS CIRCLE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/19/08
Contractor: v
Applicant: Architect or Engineer: CAL -TECH DEVELOPMENT J P
78150 CALLE TAMPICO S A ` P 4J\Q,\.
LA QUINTA, CA 92253
(760)771-3738
/L Lic. No.: 683969
-----------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed u er provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business anifess: al ode, and my License is in full force and effect.
License Class: B ansa No.: 683969
ate: OWNER-'U'LDER
-BUILDER DECLARATION
I hereby affirm under penexempt from the Contractor's State License Law for the
following reason (Sec. 70essions Code: Any city or county that requires a permit to
construct, alter, improve,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,
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , BAP.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
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.
_ 1 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 1768839
I certify that, in the performance of thework f r which this permit is issued, I shall not employ any
s person in any manner so as to become su to the workers' compensation laws of California,
and agree that, if I should becom subje t he workers' compensation provisions of Section
370,0 of the Labor Code,,/shaj< hw' iply with those provisions.
WARNfNG: FAILURE TO SECURftWCOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER MI NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). I DITTO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE BOR 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'1 have read this application and state that the above information i c r ect. I agree to comply with all
city and county ordinances and state laws relating to building nsttarc tf' d eby authorize representatives
of this county is entyr upon the above-mentioned property r msec ' p
or
Application Number . . . . . 08-00000909
Permit . . . WALL/FENCE
PERMIT
Additional desc . .
Permit Fee . . . . 81.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 5381
Expiration Date 11/15/08
Qty Unit Charge Per
Extension
BASE
FEE
45.00
4.00 9.0000 THOU BLDG
2,001-25,000
36.00
---------=------------------------------------------------------------------
Special Notes and Comments
68 L.F. 6- GARDEN WALL, 105 L.F.
5 -
RETAINING WALL & 88 L.F. 3' RETAINING
WALL, ALL CITY STANDARD
Fee summary Charged
--------------- —--------------------
Paid
Credited
Due
Permit.Fee Total 81.00
----------
.00
----------
.00
81.00
Plan Check Total .00
.00
.00
.00
Grand Total 81.00
.00
.00
81.00
LQPERMIT
11
Bin P
Permit #
ao 1
Project Address: Q
A. P. Number:
Legal Description:
Contractor:
Address:7A
City, ST, Zip:
Telephone:
State Lic. # :6S—"96? -
Arch.,
S gArch. Designer:
L
Address:
City, ST, Zip:
Telephone:4 _— = =
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Energy Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
School Fees
City of La Quinta
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
rAddress:
's Name:
•
T, Zip: ,0V J M I AwL
Description:
City Lic. #: w
• n •
Construction Type:
Project type (circle one): Ne
!7—!7
Sq. Ft.. op # Stories:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING
Pla Ch k
Occupancy:
Alter Repair Demo
# Units:
PERMIT FEES
Total Permit Fees
Amount
n ec submitted
Reviewed, ready for corrections
Item
Plan Check Deposit
Called Contact Person
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2°" Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
Plans picked up
S.M.I.
Plans resubmitted
Grading
M Review, ready for corrections/issue
Developer Impact Fee
Called Contact Person
A.I.P.P.
Date of permit issue
Total Permit Fees
Amount