BLCK (05-5266)78140 Masters Cir
05-5266
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
v4p
05-00005266
78140 MASTERS—COIR
770-350-006- -
WALL/FENCE
LOW DENSITY RESIDENTIAL
1920
Tit!t 4 4 a"
Architect or Engineer:
PIA -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
s
Owner:
BENTON DEV
78140 MASTERS CIRCLE
LA QUINTA, CA 92253
Contractor:
DRURY CONSTRUCTION, MARGARET
73807 MASSON STREET
PALM DESERT, CA 92260
(760)346-7227
Lic. No.: 463407
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
. Date:.. 12/01/05
---------------------------------------ivy -------------------------------------------=----------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury 'censed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations: '
Section 7000) of Division 3 of the ass and Pro ionals 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: B C29 License No.: 463407
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ate: -M40XCon'1ractor:Ve11 A
issued.
yI 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-BUIER ECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjur at I am exempt fro Contractor's State License Law for the
Carrier PREFERRED INS Policy Number WKNI157592
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
_ 1 certify that, in the perfor work 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 mann ,so as to becom 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 s o ecome subj ct 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 , I shall f nh th comply with ose 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).:
ataX 2505— Ap nt:
1 _ 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: FAILU TO SECURE KERS' COMP ION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE ND CIVIL FINES UP TO 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.).
(_ 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: n
Lender's Address: p
LQPERMIT
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 the Knns
ation is correct. I agree to comply with all
city and county ordinances and state laws relating to bull
ct) n, and hereby authorize representatives
of this count t enter nature
above-mentioned pr tio purposes.
e/ Applicant or Agent):
Application Number . . . . . 05-00005266
Permit WALL/FENCE
PERMIT
Additional desc ...
Permit Fee . . . . 45.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 1920
Expiration Date 5/30/06
Qty . Unit Charge Per
Extension
BASE
FEE
15.00
15.00 2.0000 HIND BLDG
501-2,000
30.00
----------------------------------------------------------------------------
Special Notes and Comments
100 L.F. 4' GARDEN WALL, 20 L.F.
3 -
RETAINING WALL, CITY STANDARD
Fee summary Charged
-----------------
Paid Credited
Due
----------•-=--------
Permit Fee Total 45.00
----------
.00
----------
.00
45.00
Plan Check Total .00
.00
.00
.00
Grand Total 45.00
.00
.00
45.00
LQPERMIT
Bin #
City La Q of uinta
Building U 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: '7
Owner's Name:
A. P. Number:
Address: -7,0-1110
Legal Description:
Contractor: fi/1liJ fi f_
lj,evp &006
City, ST, Zip: U c, i p -
Telephone:
Project Description:
22 5-3
4
Address: 73-007yU,15 O J 'S r
City, ST, Zip: {?!kL-VVL 1 cS 2 ( e/ Z f
/
00 I / /f
Telephone:
'
i
D TA ✓i ,lG-Gv - C.
State Lic. # :
Arch., Engr., Designer:
City Lic. #:
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
TRACIQNG .
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:-
''" 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