Loading...
BLCK (04-7287)1 BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760) •777-7012 '78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . . X04-00007287 Date 11/17/04 .Property Address . . . . . . 53105-AVENIDA MENDOZA APN: 774-062-018- - - Application description . . . WALL/FENCE Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation 7603 Owner Contractor CORONEL ENTERPRISES INC CORONEL CONSTRUCTION P 0 BOX 389 P.O. BOX 389 LA QUINTA CA 92253 LA QUINTA CA.92247 (760) 564-4604 WCC: STATE FUND WC: 1744453 01/01/05 CSLB: 634981 01/31/06 CCC: B -C13 ---------------------- ---------------------------------------- -------------- Permit . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 99.00 Plan Check Fee .00 .Issue Date Valuation 7603 Qty Unit Charge Per Extension BASE FEE 45.00 6.00 .9.0000 THOU BLDG 2,001-25,000 54,.00 ----------------------------------------------------------- Special Notes and Comments 250 L.F. 6' -BLOCK.WALL, 44 L.F. 5' BLOCK '77 oV� - pii WALL, 25 L .. F . 41 BLOCK WALL ALL CITY STANDARD qC IdQ :Fee summary Charged Paid Credited Due ----------------- ----- - - - - - - - - - E l9rs��`r 1 Permit Fee Total 99.00 .00 .00-� - 99-.=0=0 Plan Check Total .00 .00 .00 .00 Grand Total 99.00 .00 .0.0 99.00 P.O. BOX 1504 • , '��� 78-495 CALLE TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING, & SAFETY DEPARTMENT Application Number: X74' -7 7 Date: lJ-(2 Applicant: I Architect or Engineer: Applicant's Mailing Address: VA Architect or Engineer's Address: Lic. No.: t$UIL.LJINU PLKMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under pro visio f Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals C de, and my Li ense is in full force a effect. ense Class ?. -1 `> 8 1icense No. 4 `L,%( i ' /Date OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' 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 <. igsu d. Yorkers' compensation ins nce carrier and policy number are: �rrier 1, 1 icy Number _\� t�{4 S —I certify that, in the performf the work for which this pe • issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cal' mia, and agree that, if I shout a me subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos p visions. ,"6ate_ can WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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. 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 APPLICANT CKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Buildingand Safety A set forth on this application. 1. Each person upon whose behalf this application is made, each person atwhosfe request and for whose benefitwork st subject to the conditions and rnperformed 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 ab information is co I agree co ly with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this co nt to enter upon a above -men ' n roperty for inspection purposes. ate 1— c!1ignature (Applicant or Agent):