07-2609 (BLCK)P.O. BOX .1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T-4bf 4 4 a, "
Application Number: 07-00002609
Property Address: 52404 AVENIDA RUBIO
APN: 773-253-026-16 -000000-
Application description: WALL/FENCE
Property. Zoning: COVE RESIDENTIAL
Application valuation: 1125
Applicant: ' Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ESMERALDA NELDA
52404 AVENIDA RUBIO
LA QUINTA, CA 92253
(
Contractor:'::
HUGHES DEVELQ�
43380 WARNER
+PALM- DESERT., -
(7,60)346 8793"
Lic..-No 8076
--------- - - - - -- --- --------------'--:-.---
UCENSED CONTRACTOR'S DECLARATION
I herebY affirm under, penalty of perjury that I am licensed under provisions of Chapter 9 (commencing. with
Section 1000) of Division 3 of the Business and'Professionals Code, and my License is in full force and effect.
License Classi 5ti License.No 807682
A
Date -on ra`ctoryY�i
OER BUILDER DECLARATION"^
1 hereby affirm uriderpenalty.of. perjury that I'am.exempt from the Contractor's State Licerise„La`w for the
following,reason'ISec. 7031.5, Business and Professions'Code: Any city or,county that requires.a'permit to
construc4alter, improve, demolish, or repair any structure; prior to its issuance, also requires the applicant for the
- permit'to file. a signedstatement that he or -she is licensedpursuant to the provisions of the Contracfor.-'s State
License Li,,;(Chaptei;9,(commencing with Sectidn'7000) of.Division,3. of the Business and Profe'ssioris'Code) or ?
that he or -she, is exenipttherefrom and the basis for the -alleged exemption Any, violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civilpenalty of not more than five hundred dollars ($560j.:
1 _) I as owner of the property, or my employees with wages as then sole compensation; will do the work, and
- the structure is not intended or offered for sale (Sec. 7044, Business .and'ProfessionsCode: The
Contractors ',State;License, Lawdoes 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 iniended.oroffered'forlsale:-'If, however, the building 6r,improvement is sold within
one year0
1o
m Pet'on,
,he owner -budder will have the burden of proving that hear she did not build or
- improve or_thepurpose of;salea-
(_ 1 I;.as owner ofahe property, am exclusivelycontracting with licensed tontractors.to construct the project (Sec.
7044, Business'anC Professions Code: TIie;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 Caw.).
1—) .1 am exempt under Sec. B.&P.C. for this reasoh
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
211 �oo�
WORKER'S COMPENSATION DECLARATION
1 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
x for by Section 3700.of the Labor Code, for the performance of the. work for which this permit is
issued.-
- I have and willmaintain workers compensation insurance, as required by Section 3700 of the.Labor
.Code for theperformance of therwork-for which this permit is issued My workers' compensation
insurance carrier and policy number are: -
Carrier STATE, FUND Policy.Number' 04420623i,29
- Lcertify 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 agTe,that, if I should become subject tothe, workers compensation provisions'of Section
3700 of the Labor Code . I shall - rthwith comply with those provisions. • - - -
Qat 9A li
PPcan
WARNING: FAILURE TO SECURE WOR RS'.COMPENSATION COVERAGE'IS UNLAWFUL, AND SHALL
SUBJECT AN.EMPLOYER TO CIR" 1NACPENALTIES AND CIVIL FINES UP TO'-0NE HUNDRED THOUSAND
DOLLARS Is106,000). jN ADDITION;TO THE COST DF CONIPENSATION,'DAMAGES AS PROVIDED FOR IN
SECTION 37oebO .THE LABOR CODE, INTEREST, AND ATTORNEY'S, FEES.
APPLICANT. ACKNOWLEDGEMENT -
IMPORTANT Application is hereby made to the Director' f,Building and*Safety for a permit subject to the
conditions and restrict ons�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 Ouinta; 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 6rdinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for 'ns tion purposes.
Dam-
e: -Signature (li a t-or.Agentl:
LQPERMIT .
Bin #
City of La Quinta
.:Building U Safety Division
P.O.. Box 1504, .78-.495 Calle Tampico
La Qulnta, CA 92253 --(760) 777-7012
Building .Permit Appiication.-and Tracking Sheet
Permit .#
'
Project Address:*n
s' (�
U�. b
Rct t7 !..
Owner shame: A/ ,cam
14le L.S�t'•-a a .
A. P. Number:
Address: S
Legal Description:
City, ST, Zip:.
Contractor: { eS nS
Telephone:, (
Project Description:
Address:
33 go 0 --A e -f, fil
City, ST, Zip:
D�
Telephone: 7 7,Z -O
State Lie. # : • O %(o . City Lie.
Arch., Engr., Designer: S
Address: — CL
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person: q ✓ .LLAY. 4,C�
Construction Type:. Occu an
S DEW P cy:
Project type (circle one): New Add'n Alter Repair . Demo.
Sq. FG:
#Stories:.; .
#Units:
Telephone # of Contact Person: '7:4 (9 . �'% r� 7
Estimated Value of Project: j�
APPLICANT: DO NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd.
Recd
TRACKING _ • .
PERMTT 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
Floodplain plan.
Plans resubmitted
Mechanical
Grading. plan
2°" Review, ready for correctionstissueElectrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed.
Plans picked•up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Review, ready for -i
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
WALKWAY
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