06-3924 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: l 06-00003924
Property Address: 77225 AVENIDA ARTEAGA
APN: 658-210-026- -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2750
Tityl 4 4& Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SIBERT SAM
77225'AVENIDA ARTEAGA
LA QUINTA, CA 92253
Contractor:
Architect or Engineer: SOUTHERN HILLS DEVE
78150 CALLE TAMPICO
LA QUINTA, CA 92253
(760)771-3497
Lic. No.: 838041
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I m licensed and rovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business d Profession Co and my License is in full force and effect.
License CI : B ense No.: 838041
ate: d� C ,actor.
OWNER -BUIL R 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,
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.).
(_ 1 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/08/06
_o
�C
1 Nov o g 2000
LA
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 num er are:
Carrier EXEMPT olicy Number EXEMPT•
I certify that, in the performance f the work for w c is permit is issued, I shall not employ any
person in any manner so as t become subject o the (kers' compensation laws of California, -
and agree that, if I should b mM ct to r ers' compensation provisions of Section
37 /0 of the Labor Code, all fh ly 'th those provisions.
6 A ant:
WARNING: AILURE 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.
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 bec es null and void if work is not commenced
within 180 days from date of issuance of such pe it, or cessation of work for 180 days will subject
permit to cancellation. �
I certify that read this application �d,state that the ab a information i correct. I agree to comply with all
city and my ordinances and state s relating to buildin struction, a y authorize representatives
of th' oun�y± to a/nter upon thea ve-mentioned propert r in p 'o ose
Kate- L b Sig re (Applicant or Agent IF
Application Number . . . . . 06-00003924
Permit . . . . .
. WALL/FENCE
PERMIT
Additional desc .
.
Permit Fee'
54.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. .
. . 2750
Expiration Date
5/07/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
1.00 9.0000
THOU BLDG
2,001-25,000
9.00
-------------------7--------------------------------------------------------
Special Notes and
Comments
110 L.F. 6' GARDEN
WALL, ORCO SYSTEM
Fee summary
--=--------------
Charged
------------=-------
Paid
Credited
----------
Due
----------
Permit Fee Total
54.00
.00
.00
X4.00
Plan Check Total
Grand Total
.00
54.00
.00
.00
.00
.00
, .00
54.00
LQPERMIT
Bin f
Permit �(.�
Project Address: �,22� t/( f�/
City of La Quinta-
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
(,� `fem Q Owner's Name: •f zk5 J`' 1h
A. P. Number:
Address: G
Legal Description• 22 of
1
Z-/l City, ST, Zip:
Contractor. sQ�( /'j ��
Address:�rf : /�� eajle, %
Q(/j/, Telephone.
116,0 Project Description:
City, ST, Zip: Get oul k Q f
_Tdophone: 771-,3Y97
7 ZZ /Q
0
State Lid. #: K3 S D
Arch., i3agr., Des4g -
Address:
City Lia C
City, ST, Zip: Z;4 d
Telephone 4 —Soo ?i Conshudion TAW. occupancy;,
State Lia #: Pvo cd type (cicde one): New Add'n Alter . Repair Dano
Name of Contact Person: Ft.: # Stories: # Units:
Tetcphone # of Contact Person: Yl`o9' G7�7 : Estimated Vatae of Pmjic�
"APPU M': DO NOT ftXM•BM0W THIS LINE
# Submittal - ReVd Reed TRACENG.• PFRMrrFEFS
Plan Sets ]tan iCk"k submitted Iters Amoast
Structural Gla.
Rerkw4 ready for corrections Pon Chedc Deposit'
Trois Career.
Called Contact Person Pbu Cbeck Balance
Uurgy Gla.
Plays iiidctd. ap Construction
now plain plan
Plans raabmttttd Mechanical
Grading, plan
2" Review, ready, for correctionsnaut Electrical
Subcontactor List
Called Contact Person Plumbing-
Grant Deed
Plans picked up &M I:
H.O.A. Approval
Plans resubmitted Gradift
IN HOUSE:
''' Review, ready for correctloastissae Developer Impact Fee
Planning Approval
Called Contact Perron A.l P.P.
Pub. Wks. Appr
Date of permit lase
School Fees
Total Permit Fres