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06-3996 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00003996 Property Address: 54420 AVENIDA RUBIO APN: 774-23.5-008-17 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 750 ,Tiht 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: ANDERSON RHONDA RAE 54420 AVENIDA RUBIO LA QUINTA, CA 92253 --------------------------------- Contractor: Owner Date: 11/16/06 D D NOV 16 2006 CITY OF LA QUINTA . FINANCE 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 (commencing 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 requi ed by ection 3700 of the Labor _ Code, for the perfo ance of the or which this permit is i sued. y 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 Numb 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 Contractor'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 anypplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and Y" the structure is not intended or offered for sale (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 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- have the burden of proving th a or s did not build or improve for the purpose of s . . (_ 1 I, as owner of the property, a exclusively contracting ith licensed contra ors to const ct the project (Sec. 7044, Business and Pr essions Code: The Contra ors' State License aw does n apply to an owner of property who builds or mproves thereon, and who ntracts for the pr jects wit contractor(s) licensed pursuant to the Contr ctors' State License Law.). (_ 1 I am exempt under Sec. B.&P.C. for this re son Date: — 1 0 r: \ CONS RUCTION 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: IP' LQPERMIT certify that, n the performance of the work for hich this permit is issu , I shall not employ any person in any manner so as to become a workers' ompe anon laws of California, and agre that, if I should become je o the worke ' com ns on provisions of Section 3700 of the Lgbor Code>-h�haf nh comply with [hos pr 'ions. WARNING: FAILURE TO SECURE WORKERS/ COMPENSATION COVERAGE IS bNLAWFUL, AND SHALL SUBJECT AN -EMPLOYER 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 is a -result of this application, the owner, and the applicant, each agrees to and shall defend, in mnify and hold harmless the City of La Quinta, its officers, agents a mployees o y act or o ssion related to the work being performed under or following i ance of this permit. 2. Any permit issued as a resu of this application becomes n I and void if work is not commenced within 180 days from d of issuance of such permit, or ce at n of work for 1 BO days will subject permit to cancellation. I certify that I have read this applica ion and state that the above informatio is correct. I ag e'to comply with all city and my ordinances and t laws relating to building constructi eby au orize representatives of thi ounty to enter upo a ab6 -mentioned property for ins purpos 11 //-/6 v ignature (Applicant Application Number 06-00003996 Permit . . . WALL.%FENCE PERMIT Additional desc.. Permit Fee 21.00 Plan Check Fee .00 Issue Date Valuation . . . 750 Expiration Date 5/15/07 Qty• Unit Charge Per Extension BASE FEE 15.00 3.00 2.0000 HND BLDG 501-2,000 6.00 . ----- --7------------------------------------------------------------------ Notes and Comments 'Special 30 L.F. 6' GARDEN WALL, CITY STANDARD Fee summary Charged Paid Credited Due Permit Fee Total 21.00 .00 .00 21.00 Plan Check Total .00 .00 .00 .00 Grand Total 21.00 .00 .00 21.00 Bin ff Permit # Project Address: A. P. Number. Legal Description: Contractor: Address: .City, ST, Zip: Telephone: State Lic. # :. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lie. #: Name of Contact Person: Telephone # of Contact Person: City of La Quinta Building 'u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Owner's Name: 9PA6 _ 01 Address: _- a City, ST, Lie. #: Project Description: Construction Type: Gccupancy: Project type {circle one): New Add'n Alter Repair Demo Sq: Ft: # Stories: #Units: Est6ated,Value of Proiect: APPLICANT: DO NOT WRITE BELOW" HIS UNE Submittal Req'd . Reed TRACKING . PERMIT FEES Plan Sets Plan Check submitted Fff Item Amount Structural Calcs. Truss Calcs. Reviewed,yeady for corrections Called Contact Person Plan Chec6.Deposit Plan Check Balance Energy Calcs. Plans picked up Constcucti+u Hood plain plan Plans resubmitted Mechanical Grading.plan' 2'° Review, ready for correctioWiissue Electrical • Subcontactor List Called Contact Person Plumbing Grant Deed .. Plans picked up S.M.I. H.O.A. Approval IN HOUSE:- Pians resubmitted . '''Review, ready for correctionstissue Grading Developer Impact Fee.. TELEPHONE (760) 777-7012 FAX (760) 777-7011 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•proteci 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 contractors 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 "OvnerBuilder" building permit, erroneously implying that the property owner is providing his or her own labor a -id 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, DEPT. OF BUILDINQ,. 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777 OWNER PROPERTY ADDRESS PERMIT NUMBER(S)