06-3292 (BLCK)P.O. BOX 1504,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 '
Application Number: 06-00003292
Property Address: 54420 AVENIDA RUBIO
APN:. 774-235-008-17 -000000-
Application description: WALL/FENCE.
Property Zoning: COVE RESIDENTIAL
Application valuation: 650
Applicant:
C1
Architect o
SEP, O8 2006
VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/08/06
Owner:
ANDERSON RHONDA RAE
54420 AVENIDA RUBIO
LA QUINTA, CA 92253
---------------------------------
- -1�� of La o IWIA
' LICEN ED CONTR RATION
I hereby affirm under penalty of perjury that I a keens under provisions of Chapter 9 (commencing with
Section. 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: _ Contractor:
e OWNER+BUILDER 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 Coritractor'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 '
an applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($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 notapply 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 pr 'ng that he or she did not build or
improve for the purpose of sale.). '
(_ 1 I, as owner of the property, am exclusively contracting with licensed ontra rs to construct the project (Sec.
7044, Business and Professio e: The rectors' State L cense La does not apply to an owner of
property who builds or i lives thereon, and wh contracts foj the prof is with a contractor(s) licensed
pursuant to the Contra rs' State License Law.).
�(_ 1 1I am exempt under Sec. B.&P.C. for this r ,as
j Date: ZJ— I3y T Owner.
1 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
Contractor:
Owner
------------------
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 mai n workers' c nsation insurance, s r quired by Section 3700 of the Labor
Code, far th erformance of the work r which this rmit is issued. My workers' compensation
insurance arrier and policy number are:
Carrier Policy Nu bar
I certify t at, in the performance of the wo his per it is issued, I shall not employ any
perso in any manner so as to beco e s ject to t w s' compensation laws of California,
and ree that, if I should become u ' ct to the w rkers' pensation provisions of Section
p O 37000 f the labor de, I shall with comply ith o p ovisions.
Date: / O —�4oApp
4M bd1Q_—
WARNING: FAILURE TO SECURE WOR RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES 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 r est and for
whose benefit work is performed under or pursuant to any permit issued as a r ult this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and old he less the City
of La Quinta, its officers, agents an oyees or an r omission relate to the ork being
performed under or following i ance of this permit.
2. Any permit issued as a resul f this application becomes null and oid if wor is not c mmenced
within 180 days from da of issuance of such permit, or cessatio of work or 180 ays will subject
permit to cancellation.
I certify that I have read this applicati nand state that the above information is orr comply with all
city and county ordinances and state I ws relating to building construction, a reby au horiz resentatives
of this county to enter upon the above- entioned property for inspection r ses.
-Date:"'ESignature (Applicant o ent):
..Application Number 06-00003292
Permit WALL/FENCE PERMIT
' Additional desc .
Permit Fee 19.00
Plan Check
Fee
.00
Issue Date.
Valuation
. . .
. 650
Expiration Date 3/07/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
.2.00 2.0000 HND BLDG 501-2,000
4.00 '
Special Notes And Comments
30 LF 5' BLOCK WALL PER CITY STANDARD.
Fee summary Charged. Paid
Credited
Due
Permit Fee Total. 19.00
.00
..00
19.00
Plan Check Total 00
.00.
.00
.00
Grand Total 19.00
.00
.00
19.00
Bin #
City of La nuinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
to Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # /)
(
Project Address:
Owner's Name: / ( 0
A. P. Number:
Address:
Legal Description:
City, ST, Zip: - —
Contractor:Telephone:.
'-
Project Description:
Address:
City, ST, Zip:
,.
Telephone:
g
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): - New Ad(Tn Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal.
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Chec a Balance
Energy Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready for correctionsrissue
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 PersonA:I.P.P.
Pub. Wks. Appr
Date of permit issue
.School Fees
Total.•Permit Fees "