06-1991 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&ty/ 4 4 Q"
Application Number:
Y 06-00001991
Property Address:
51380 AVENIDA RUBIO
APN:
773-045-024-9 -000000-
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY RES
Application valuation:
24000
Applicant:.. Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
UC D CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury thaV am licenjO under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Busine and�rp s ionals Code, and my License is in full force and effect.
License Class: - - - - - - - - -- /'/ License : C61 -D28
'Date: (�� �� Contractor:
OWNEF10DER 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 1$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.).
(_) 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
Owner:
SMITH WILLIAM F
51380 AVE RUBIO
LA QUINTA, CA 92253
Contractor:
ALADDIN OVERHEAD DOOR/GATE CO
83764 AVENUE 45
INDIO, CA 92201
WCC: STATE FUND
Lic. No.: C61 -D28
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
5/12/06
*-4y 1 \
.,q,��
-----------------------------------------------
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 number are:
Carrier 0010272-2006 0
1/01/Ofioli6y Number 422978
I certify that, in the performance of a work for which this permit is issued, I shall not employ any
person in any manner so as t e me subject to the workers' compensation laws of California,
and agree that, if I should b o s ject to the war ' compensation provisions of Section
3700 of the Labor Code, h o ill comp) ith those provisions.
,Date:Applicant:
WARNING: FAILURE TO SECURE WORK ' COMPEATI N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN IL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 permi r cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the a ve i o ation is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi g c c on, and hereby a orize representatives -
of this count to nter upon the above-mentioned propert for a on purposes.
Date: % QCQlgnature (Applicant or Agent):
LQPERMIT .
,- Application Number 06-00001991
Permit . . . WALL/FENCE.PERMIT
Additional desc .
Permit Fee. . . . . 243.00
Plan Check
Fee
.00
Issue Date . . .
Valuation
. .
. 24000
Expiration Date— 11/08/06
-Qty Unit Charge Per
Extension
BASE FEE
45.00
' 22.00 9.0000 THOU BLDG 2,001-25,000
198.00
--------------------------------------------------
Special Notes and Comments
INSTALL LOW VOLTAGE ELECTRIC AUTO GATE
WITH WOOD PER CDD APPROVED PLAN/12 LF
5' ORNAMENTAL IRON FENCE.
Fee summary Charged Paid
Credited
Due
Permit Fee Total 243.00
.00
.00
243.00
Plan Check Total .00
.00
.00
.00 .
Grand Total 243.00
.00
.00
243.00
LQPERMIT .
APPRQYED BY COMMUNITY DEVELOPMENT DEPARTMENT
BY
(00, R s� DATES 5./ Z o 6
DA89:NO M4TOf Frr
x
opo
decorative stee
motm OVmv n00p Aw 6mCO,
65-764 M 95, M910, CA, 92201.,
PH: 160 5416405 FAX; 760 397.8961, LIC; 4922978
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
THE SITE FOR A SCHEDULED.
INSPECTION.
LST►ANSI
i
CITY OF LA QUINTA
BUILDING & SAFEW DEPT.
APPROVED
FOR CONSTRUCTION. .
DATE BY
-------- ----
},, r r r
M. x :�c x
raised panel western red cedar s,t,k,.
butt JoA, t in g,
2" x 8" 5,f,K, western red cedar
rough sawn 9 sides
L 2" sa, tu6e steel frame
I/ x 9" flat steel
around the enure gate,
Bin #
City of LQuinta a
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
Permit .#
Project Address:'
Owner's Name: UJ
A. P. Number:
Address:
Legal Description:
City, ST, Zip: Ct
Contractor:_
Telephone:
Address:
Project Description:
City, ST, Zip: 0 CA 9 Z'Z M
Telephone: ���'�
S'C C 'l-lLo C.
State Lic. # : 22"( 7 City Lic. 10 k C7
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: 451-0j L7,�pancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project: z
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°" 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:
"d 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
Desert Sands Unified School District
CERTIFICATION OF PAYMENT '
OF
SCHOOL FACILITY FEES
To: c�
.BUi NOTICE:
DATE:
THIS DC)MVIENT CANNOT
BE DUPLICATED&
5�-380
This is to certify that
developer of which is
located at within
this District, has paid school facility fees imp sed pursuant to the
authority generated by Government Code Sgrctioti 53080 in he amount -of
covering a total of 494&1 sq re feet of (X) residen al or
( ) industrial/commercial development and that building permits for
this footage in this development may now be issued by your jurisdiction.
6kf/2%�
for DESERTS^N DS UNIFIED SCHOOL DISTRICT
White - Building Department • • Yellow - Facilities Planning • Pink - Accounting • Gold - Developer
(10)-37