BLCK (06-0516)P.O. BOX 1504
78=495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
t BUILDING & SAFETY DEPARTMENT
�• BUILDING PERMIT
s
Application Number: 06-00006516.
Property Address: 52050 MERIWETHER WY
o- APN: 767 -200 -998 -72 -330761 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 58250
Applicant: s�. Architect or Engineer:
A
Owner.
EAST OF MADISON LLC
PO BOX 1482.
LA QUINTA, CA 92247
Contractor:
MCD CONSTRUCTION, -
49881 29 PALMS HIGHWAY
MORONGO VALLEY, CA 92256-.
(760)363-7740.
VOICE (760) 777-7012
FAX (760)'777-7011
INSPECTIONS (760) 777-7153
Date: 2/02/06
D Q �
FEB 0 2 2006
CITY OF LA QUINTA
FINANCE DEPT.
Lic. No.: 820821
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LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed 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 Business and Professionals Code, and my License is in full force and effect.
- _ Fhave and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B License No.: 820821
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
�ate.a Q, b(o actor:
issued.
Al have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
_
' r
Code, for the performance of the work for which this permit is issued. My workers' compensation
• OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penaltyof perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 174857005 .
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the 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 manner so as to become 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 should become subject 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 Code, I shall forthwith compl with ions.
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).:
e: OW7.&G Ap : _7
(_ 1 I, as owner of the property, or my employees with wages as their sole.compensation, will do the work, and
'
• the structure is riot intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 PENALTIES AND 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.).
APPLICANT ACKNOWLEDGEMENT
(_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
'IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application. -
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). .. -
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
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.
Date: Owner:
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
- CONSTRUCTION LENDING AGENCY
permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lendirig agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and natives
of this county to enter upon the above-mentioned property for inspection purposes.
- � Lender's Name:
-- -
ate: rgnature (Applicant or Agent):
Lender's Address:
,
LQPERMIT
1 `
Application Number 06-00000516
Permit . . . WALL/FENCE PERMIT ;
Additional desc .
Permit Fee• 455.00 Plan Check
Fee
00
Issue Date . . . . Valuation
. . .
. 58250
ti Expiration.Date 8/01/06
Qty Unit Charge Per.
Extension
BASE FEE
414.50
9.00 4.5000 THOU BLDG 50,001-100,000
40.50
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k
f Special Notes and Comments
2330 L.F. 6' PERIMETER WALL, ORCO
SYSTEM.
Fee summary Charged Paid Credited
Due
.------------ - -. ------- - - -- ------ - - - - ------ - - -
----
--- - - - --- T
Permit -Fee Total 455.00 .00
.00
455.00
Plan Check Total .00 .00
.00
.00
Grand Total 455.00' .00
.00
•455.00
t
LQPERMII'
Bin #'
Permit #
Project Address: ,*
A. P. Number: -
Legal Description:
Contractor:
Address:
City. ST, Zip: Y- N(71'��101
Telephone: K ZOO 363
State Lic. # : k° C q1A IQ
Arch., Engr;, Designer:
Address:
City, ST, Zip:
Telephone: LIMI
49
3-n
State to Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
�S School Fees
v
Bu
7
'74-0
MA City Lic. #:
City of La Quo
nta
Building &r Safety Division .
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Permit
Application and Tracking Sheet .
Owner's Name: X C� J
Address: X PO + s
Telephone: S Z
Project Description: X
22s6
v,4l 1.3 3,0
1 1 Construction a
on T e
Y P: Occupancy
P ancy
Project (circ
type le one): New A dd'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Isis Estimated Value of Project: x
APPLICANT: DO NOT WRITE BELOW THIS LINE
'd
Rec'd
TRACKING
Plan Check submitted
PERMIT FEES
Item
Amount
Reviewed, ready for corrections
Called Contact Person
Plan Check Deposit
Plan Check Balance
Plans picked up
Construction
Plans resubmitted
Mechanical
2nd Review, ready for corrections/issue
Electrical
Called Contact Person
Plumbing
S 111.1.
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