07-0109 (BLCK)jH P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:07-0_0000109 y
Property Address: 79124 HIGHWAY 111
APN: 649 -820 -021 -
Application description: WALL/FENCE
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 875
c&-ty/ 4 4 Q"
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am lic sed under provisions of Chapter 9 (commencing with '
Section 7000) of Division 3 of the Business and fessionals Code, and m License is in full force and effect.
License Class: B Licens 5 578
Oat 6 % Coontractor:
OWNER -BUILDER 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 ($500).:
(_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for.sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.). .
I—) I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: '
Lender's Address: '
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/11/07
Owner:
THOMAS ENTERPRISES
2385 SHELTER ISLAND DR
SAN DIEGO, CA 9210_6
Con tractor: 1 2001
PACIFIC WEST GE ERAL'CONTR NC
75153 MERLE DRiIV$,_S_E—E
PALM DESERT, .CA 922i*2�pF�QUINTA
(760)340-7590 1.�
Lic. No.: 857578
-----------------------------------------------
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 andpolicy number are:
Carrier STATE FUND Policy Number 0029778-2006
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should be subject to the workers' compensation provisions of Section
e
3700ofthe Labor C all forthwith compl os provisions. -
CDate: - ►` f9 fApplicant: -
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.
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 above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building co truction, and hereby author)'ze representatives
of this county to enter upon the above-mentioned propeqyJAKnsc peaes-� /
(Applicant or
Application Number . . . . . 07-00000109
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 23.00 Plan Check
Fee..
.00
Issue Date . . . . Valuation
875
Expiration Date 7/10/07
Qty Unit Charge. Per
Extension
BASE FEE
15.00
4.00 2.0000 HND BLDG -501-2,000
8.00
----------------------------------------------------------------------------
Special Notes and Comments
35 LF 6' BLOCK WALL TRASH ENCLOSURE PER
ORCO DETAIL & APPROVED PLAN.
Fee summary Charged Paid Credited
Due
----------------- ------ - --- ---------- ----------
Permit Fee Total 23.00 .00
----------
.00
23.00
Plan Check Total .00 .00
.00
.00
Grand Total 23.00 .00
.00
23.00
- • LQPERMIT . -
-
a
Din #
.%-,UY V1 Ld %4U11 t
Building &r Safety Division
P.O. Box.1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Q 7 (0
Project Address:
Owner's
Owner's Name:
A. P. Number:
Address:
ZOZ
Legal Description: ar, Mttp 0 ��',
City, ST, Zip:
Contractor:% )P -y /V
rAc- I --P-1; 1, 1,0
11 (",h 1� ,
Telephone: g
0
Address: -75-�--IS-3 tfkir- L( s �L-
Project Description:
C9 c- (c),stkx
City, ST, Zip: Z21 I
-
35- U on. C (f),
Telephone: 0
'€:',r=BN=;
State Lic. City Lic. #.. OW)U 7S11
Arch., Engr., Designer:
Address:
City., ST, Zip:
..........
Telephone'Construction
State Lic. #:
Name of Contact Person: Xe. r) 0,6 X
Type: Occupancy:
rojectty pe (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Storie*s:-#Units:
.Telephone # of Contact Person: (-7& 0) 48C;5-C&Ji
Estimated Value of Project: 0146fb-o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
4eq'd
Rec!d
TRACKING
PERMIT FEES
Plan Seti
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cilcs.
Called Contact Pe'rson
Plan Check Balance.
-Tflre-24-Ma Ts-.
Plans PlWd 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:-
7rd Review, ready for correcti s/issue
O
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P,
Pub. Wks. Appr
Date of permit issue
School Fees
[Tot., Permit Fees
:Bin #
�y
c
�
%1 � City of La Quints
I F,D Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permitfl
0.7
Project Address:
J ^p
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: (
City, ST, Zip:
Telephone: >, t
Address:(j 3 (W C} S, - fX E ^
Project Description: r —
Cj_y, ST, Zi rr
Telephone:
State Lic. # :
City Lic. #:rn
O�
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
V� .YMt
�•' + -A
Construction Type: ccupanc :
State Lic. #:
Project type (circle one): Ne Add 1 er Repair mo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:L s7(t g ,5- C a
I Estimated Value of Project:
T. APPLICANT: DO NOT WRITE BELOW THIS LINE
P
Submittal
Req'd
Recd
TRACKING ,
PERMIT FEES
Plan Sets
Z
Plan Check submitted
U
Item
Amount
2.
Structural Cates.
Z-.}-
Reviewed, ready for correctio
3
Plan Check Deposit
Truss Calcs.
Called Contact Person
`
Plan Check Balance
Energy Calcs.
Plans bicked up
0
Construction
Flood plain plan
r
Plans resubmitted /tA4 `;ET
Mechanical
Grading, plan
2" Review, ready for corrections/issue
Z
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
r
Plans resubmitted
Grading
IN HOUSE:-
'nd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Cq
Schobl Fees
Total Permit Fees
o • �O
3 114 M` .BQt>JZ. POE* 3 2-11 11T7
,511+1' 0-7 -COLD (w/Aa.r9 ¢ 6 )
3122.107 5TR_ fZ- C-
.3121 07 COO APPROVED
-t/4-107 oRONz 90€. +11-7107
'F 17107 5T2 APPRovED