06-3414 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
y
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00003414
Property Address:
78720 HIGHWAY
APN:
643-220-024-4
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY
Application valuation:
750
Applicant:
Ihereby affirm under penalty of pe ry thpf I a lice
Section 7000) of Division 3 of t4 BusinoEs a
License Class:
BB C8
Dat4 - W Contra r:
111
-000000 -
RES
Architect or Engineer:
I -
CONTRACTOR'S DECO
nsed under provisions of
maiaWls Code, and rIWI
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
ZION
pter 9 (commencing with
ense is in full force and effect.
.83
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of rju that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7037.5, B 'n ss and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, 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 _ 1 1, 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. , BA.P.C..for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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: 9/22/06
Owner:
ONE ELEVEN LA QUINTA
C/O SABBY JONATHAN
42620 CAROLINE CT STE 102
PALM DESERT, CA 92211
Contractor: G
CONSOLIDATED CONTRA G,
46753 ADAMS STREET
LA QUINTA, CA 92253
(760) 771-3345 Q�p.O�Q'�
Lic. No.: 824183 _.NVQ
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 whicf is issued. My workers' compensation
insurance carrier and policy num r a
Carrier STATE FUND icy Number 1770749
I certify that, in the performa a work for which this permit is is ed, I shall not employ any
person in any manner so s to come subject to the workers' co ensation laws of California,
and agree that, if I shou bec a subject to the workers' co nsatian provisions of Section
3700 of the Labor Cod I s forthwit with t provisions.
Date: Applicant:
WARNING: FAILURE TO SECURE RK RS' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIM AL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITIO E 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 applicantgw
grees to, an hef hold harmless the City
of La Quinta, its officers, agem es for any act or omission related a work being
performed under or followinof this per it.
2. Any permit issued as a resulapplication b comes null and void if work is not c menced
within 180 days from date nce of suc ermit, or cessation of work for 180 ays will subject
permit to cancellation.
I certify that I have read this application the ation is correct. ree to comply with all
city and county ordinances and state lawuildin constructio y authorize representatives
of this county to enter upon the above -mo e n urDaterSignature (Applicant
LQPERMIT
Application Number . . . . . 06-00003414
,
Permit WALL/FENCE PERMIT
Additional desc .
+. Permit Fee. . . 21.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. .
.'. 750
Expiration Date 3/21/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
3..00 2.0000 HND BLDG 501-2,000
6.00
-------------------------------------------------------------------'---------
Special Notes and Comments
30 LF 6' BLOCK WALL FOR TRASH ENCLOSURE
PER APPROVED PRECISE & CITY STANDARD.
Fee summary Charged Paid Credited
Due
Permit Fee Total 21.00 .00
.00
21.00'
Plan Check Total. .00 .00
.00
.00
Grand Total 21.00 .00
.00
2'1.00
� r t
Bin #
City of La Quinta
Building & 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:'—Z,!5--77,6
Owner's Name: /�j � f7tiT
A. P. Number: .•• �ZQ d 7i V
Address:
Legal Description:
Contractor:
City, ST, Zip:
Telephone:
Project Description:
Address: —%
City, ST, Zip:
' for.
Telephone:
State Lic. # : 3 .
City Lic, #:
(.
Arch., Engr., Designer:
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
TRACKING.
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°d 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