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06-3564 (BLCK)v. q P.O. BOX 1504 4�^' VOICE 760 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 10/06/06 Application Number: 06-00003564 Owner: Property Address: 52180 AVENIDA RUBIO VICTOR CORTES APN: 773-213-009-14 -000000- 52180 AVENIDA RUBIO Application description: WALL/FENCE LA QUINTA, CA .92253 Property Zoning: COVE RESIDENTIAL ------- ------------------------- Application valuation: 3441 r' Contractor: D u Applicant: Architect or Engineer: Owner �) 9 200C 00 [1 V IJ 1 a • - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1' 1 CITY QF LA ®UIPITA 1' FINAWCE DEPT. -------------------------------`------------------------------------------------------------------ LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (cdmmencing 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. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Date: - Contractor: _ 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 workerscompensation OWNER -BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number _ following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I c=at, in the performance of the work f r which is 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 becomes to a 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 s o th orkers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or + 7 efof the Labor. Code, with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: - plicant:. 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work,.and 01 the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WAR NG: FAILURE TO SECURE W.0 ( S' 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 CRIMI 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 ADDITI 0 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 DE, I TERf !EST, &ND'ATTORNEY'STEES. � 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 I, as owrier 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 L w 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 p. • acts with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whoserequest 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, I—) I am exempt under .Sec. , B.&P.C. for reaso the owner, and theapplicant, 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. . ate: wner: 2. Any permit issued as a result of this application becomes null and void if work i not commenced within 180 days from date of issuance of such permit, or cessation of work r 180 days will subject c0rLconstruction ON LEN/nng GENCY permit to cancellation. I hereby affirm under penalty of perjury that that i tegency for the performance of the I certify that I have read this application and state that the above informati i e . I agree to comply with all work for which this permit is issued (Sec. 3 Ccity and county ordinances and state laws relating to building constructi er y authorize representatives of this ounty t enter pon the bove-mentioned property for in Lender's Name: ate: ure (Applicant or Agent): / .17/i i :Lender's Address:Yr LQPERMIT Application Number . . . . . 06-00003564 .f Permit . . . WALL/FENCE PERMIT t s Application Number . . . . . 06-00003564 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee'. .00 Issue Date . . . . Valuation . . 3441 Expiration Date 4/04/07 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00 ---------------------------------------------------------------------------- Special Notes and Comments 90 L.F. 6' BLOCK WALL AT REAR & SIDE YARDS, 55 L.F. 5- BLOCK WALL AT FRONT & SIDE YARDS, CITY STANDARD Fee summary Charged Paid ------------- - --- ---------- ---------- Cred_ted ---------- ---------- Due Permit Fee Total 63.00. .00 .00 63.00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 .00 .00 63.00 LQPERAIIT OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-701/, ---..,/ OWNER'S GNATU ATE 5180 ' A�0 10 , PROPERTY ADDRESS Oen - .3504, PERMIT NUMBER(S) Bin # City. of La uinta Q Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico :. La Quinta, CA 92253 - (760) 777-7012 Building Permit Application d Tracki g Sheet Permit # Project Address: Owner's Name: A. P. Number: Address: CA Aim Legal Description: City, ST, Zip: U Contractor: Address: Project Description. City, ST, Zip: Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: ) J SS • Address: ,jL City, ST, Zip: Telephone: State Lic. #: Name of Contact Person:Sq. Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Ft.: 0 #Stories: #Units: Telephone # of Contact Person:7-1 Estimated Value of Prod t: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING . PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit- epositTruss TrussCalcs. 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 $.M.I. H.O.A. Approval Plans resubmitted. Grading IN HOUSE:- 7rd Review, ready for corrections/issue Developer Impact Fee.. ; Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date ofpermit issue School Fees Total Permit Fees :... ;...