06-2133 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application .Number:
k06-00002133
Property Address:
531`90'AVE14151C UBIO
-APN:
774-043-010- -
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL '
Application valuation:
4505
Applicant: . ' Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
/ � A
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby_affirm.under penalty, of perjury that -I am'licensed under provisions of Ct6pter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and•my'License is in.full force and effect.
License'Classi License No.:.
Date:. z.' : Contractor:
O W NER-BUILDER' DECLARATION
1 hereby affirm under penalty of perjury that. l•am exempt from the Contr'actor's State License Law forthe
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repak any structure, prior to its issuance, also requires the applicant for the
permit.to file assigned -statement that he or sfie is 9icensed 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 stie is'exe'mpt therefrom and the basis for the alleged exemption. Any violation of Section 7031-.5 by
�_any ap cent for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.:.
1,<as owner of,ihe 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"Sta'te License Law does`Aot 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.). -• - •- �. -
(_ 1 1, 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.l.
1 1 I am exempt under Sec. B.&P.C. for this reason
CONSTRUCTION LENDING AGENCY
I hereby affirm under p 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:
JOHN & LAURIE,MOORE
53190. AVENIDA RUBIO
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5 / 23J 06
WORKER'S COMPENSATION DECLARATION
I hereby affirm.under penalty.of perju yonii of the.following declarations:
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. '
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor-`
Code;°for the performance of the work for which thispermitis issued. 'My workers' compensation
insurance carrier and policy number are:: ..
Carrier Policy Number -
__ certify that, in the performance of the work for. which this permit is issued, I shall not employ any
Lam -person in any manner so as to become
subject to the workers' compensation laws of California, . .
and agree that, if I should become subject.to the workers' compensation provisions of Section
37001of the Labor Code, ha]�Arthwith comply with those provisions. _
Elate
WARNING: ECURE WORKERS'COMPEN$ATION-COVERAGE IS UNLAWFUL, AND SHALL ,
SUBJECT. AlN YER 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 uction, and hereby authorize representatives
of this county to enter upon the above-mentioned property fo ctign pulses.
Application Number . . . . . 06-00002133
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee 72.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. .
. 4505
Expiration Date 11/19/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001-25,000
27.0.0
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Special Notes and Comments
5' BLOCK WALL IN FRONT YARD & 1ST 10'
OF SIDE P/L. 90 LF 6' BLOCK WALL ALONG
SIDE P/L.40 LF GATES(NON-ELECTRIC). PER
CITY.STANDARD.
Fee summary Charged Paid Credited
----
Due -
----------------------- ---------- ----------
Permit Fee Total 72.00 .00
----------
.00
72.00
Plan Check Total .00 .00
.00
.00
Grand Total 72.00 .00
.00
72.00
LQPERMIT
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:aigned;by property owners unless they'are personally performing their
own work. If your work is bemg.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,aw to put their license. number pn 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 thamyour'immediate family, andzthe 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 tak,withholding, -federal. social :security taxes, worker's
compensation insurance, disability insurance.costs•°and unentployment,-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 orsubcontractor, 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, toy 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 95.814.
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) 777-7011
ER'S SIGNATURE/DATE.
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PROPERTY ADDRESS
PERMIT NUMBER(S)_
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A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROV�D
PLANS AND JOB CARD ARE NOT 4N
THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
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A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROV�D
PLANS AND JOB CARD ARE NOT 4N
THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
-------------
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BUILDING & SAFETY DEPT.
APPR®VES®
FOR CONSTRON
DATE—BY
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BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE�_BY
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BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE�_BY
Bin #
City .of La Quinta
Building U Safety Division
P.O. -Box 1504, 78-495-Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building,Permii Application and Tracking Sheet
Permit #
Project Address: ��i go�
Owner's Name:
0
A. P. Number: _5-- A
Address: _
e' a
Legal Description:
City; ST, Zip: 3
Contractor: w e c„�
Telephone:. _
Project Description:
Address:
City, ST, Zip:
_
C- pe ett
Telephone:f
.,, yz> 64�Q
State Lic. # :
City Lic. #:
s L..
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type:. Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: o
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: Q
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
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading, plan
tad 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:-
3rd 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