07-1606 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,.CALIFORNIA 92253 .
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
07-0000016.06
5269-5`AV'ENIDA RUBIO
773-282-022-9 -000000-
WALL/FENCE
COVE RESIDENTIAL
1750.
Architect or Engineer:
P,
4 4t4�7 VOICE —
(60) 777 7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/30/07
Owner:
SOLIS MANUEL
52695 AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
Owner
. D
---=----------- -.---- --moi 3
12001
CITY OF.Li4.QUTAIPeeD
LICENSED CONTRACTOR'S. DECLARATION,
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury thatI am licensed under'provisions -of Chapter 9 (commencing with
I hereby affirm under penalty otperjury 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' compensatiominsurance, as required by'Section 3700 of the Labor
- -
Code, for the performance of, the work for which this permit is issued.. My workers' compensation
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
certify that, in the -performance of the work for which this 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 td become subject to the workers' compensation laws of California,
{permit to file s signed statement that he or she is licensed pursuant to the provisions of the Contractor's state
and agree that, if I should become subject to the workers' compensation. provisions of Section.'
License Law (Chapter 9 (commencing with Section 7000),of Division 3 of the Business'and Professions Code) or
he or she is exempt therefrom and'the basis for the alleged exemption. Any violation of Section 7031.5 by
3706 of the Labor Cale, I shall forthwith comply with ose provisions. • r
,;that
.any applicant for a:permit subjects the to.a: penalty not more than five hundred dollars (55001.:
applicant civil of
f. / •1 I, as owner of.the property, or my employees with wages as. theirsole compensation, will do the work, and
.
ate:
V the structure is not intendedor offered for. sale (Sec. 7044, Business and Professions Code: The
L-
WARNING: FAIL RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
,
Contractors' State License Law does itot apply to an owner of property who builds or improves thereon,
.
SUBJECT AN EMPLOYER TOCRIMINAL 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 (5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAG&AS PROVIDED FOR IN-'
-. improvements are not intended or offered for sale. 'If, however, the building or improyemenfis sold within.
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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, as owner 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 fora permit subject to the
7044; Business and Professions Code: The Contractors' State License Law 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 projects with a contractors) licensed .
1 . Each person upon whose behalf this application is made,'each person at whose request 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 am exempt under Sec. ,.B.&P.C. for this reason
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
/ ? O ;cA4 %� nA, ('�„/ h r !
Performed under or following issuance of this permit. -
'Any
. f!
Da(: ,� IO Owner: /", i'�lLi f {-d y
2. 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
CONSTRUCTION LENDING AGENCY
permit to cancellation. -
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
Lender's Name:
•
of this c u ty t enter upon , e above-mentioned property for inspection purjps�es.
//p L U_ � L 0
te: _/ �W � ' nature (Applicant or Agent):
Lender's Address:
LQPERMIT
4�
Application Number . . . . . 07-00001606
Permit ... . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 41.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 1750
Expiration Date 11/26/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
13.00 2.0000 HND ' BLDG 501-2.,000
26.00
----------------------------------------------------------------------------
:., Special Notes and. Comments
70 L. F. 6': GARDEN WALL,' 18.L.F.<3'
GARDEN WALL, BOTH CITY STANDARD'
Fee summary: Charged Paid Credited
Due
- Permi"t Fee. Total .. 41.00 00'
00-.
41.-00
Plan. Check- Total= 00 .00,.
.0.0
.00
Grand Total 41.00 00
.00
4"1_°:00
LQPERMIT - "
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OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing y6urself as the budder 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 requited to be.. signed by property owners unless they are personally performing their
, , — -
own work. Ifyourwork ls'bt,ing— per orme.
"if d;:by's&r�e6he otherthah yourseff. you may protect yourself from possible
_
liability if that person applies forihe proper permitin or -46r. name.
Contractors are required by law to be licensed and bonded, by.:the State 6VC'afifornia and to have a business license
from the City or County. They are also required"by lav�v't'o put I their, licensenumber 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' pro
' iection:
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,hot licensed as contractors or
subcontractors, then -You maybe an employer.
If yow. are an employer, yq'y must register with the State,and Federal' Government aslan employer and you are subject
to. several obligations. -include State and Federal income. tax withholding, federal socialJ'secu'Aty taxes, worker's
compensation insurance, disability insurance costs and-upemployment compensation' contributions.
There may be financial risks for you if you do riot carry out these obligation s,' And these risks are especially serious with
respect to worker's compensation insurance.
For more specific informati 'on about your obligations.underfederal Law, contact the'Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration): Forl'more.speci ic i o
information about your obligations under State
Law, contact the Department of Be. nefit Payments andA I e� Division of industrial Accidents. I
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 alicensed contractor or su'bco'htractor, only under limited
conditions.
A frequent practice of unlicensed -pe't'so'ns professing, to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying tfiat,.they-owner
r pert ' s) to' material personally.
, ilv,�ovid
' ing his or her own labbr":a
0 , .
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-build6r verification form so that we can confirm that you are aware of
these matters. The buil'd'ing permit will'not be issued untiLthe verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 C m ico
La Q i ta, CA 2253
;
(7 '777-700
0
F �360) 7-7011 / /
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS
PERMIT NUMBER(S)
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