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06-1699 (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: '51300 AVENIDA RAMIREZ 773-083-003-22 -000000- WALL/FENCE COVE RESIDENTIAL 3717. Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION VOICE (760) 777-7012 FAX (760) 777-7011 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/02/06 Owner: VICTOR ROMERO 51300 AVE RAMIREZ LA QUINTA, CA 92253 --------------------------------- I hereby affirm under penalty of perjury that I am licensed 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 N6.: Date: Contractor. 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 Contractor's State License Law (Chapter9 (commencing with Section 7060) 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 plicant for a permit subjects the applicant to a civil.perialty ofnot.more than five hundred, dollars ($500).: ( ) 1, 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 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 -builder will have the burden of proving that he or she did not build or irnprove,for the purpose of sale.). 1 _ 1 I, 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 contractors) licensed pursuant to the Contractors' State License Law.). I—) I am exempt under Sec. B.&P.C. for this reason Date• ��—�� Own - �%6r�yl f/ W � e1:ii 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.1. Lenders Name: Lender's Address: LQPERMIT Contractor: Owner MAY A WORKER'S COMPENSATION DERAT1910 I hereby'affirm under penalty of perjury one of the following declarations: ` • ®F I have and will maintain 'acertificate of consent to self -insure for wor bided for by. Section 3700 of the Labor Code; for the performance of the work for. whit _ - it is issued. ' I have and will maintain workers' compensation insurance, as required by Sectiori'3700 of.the Labor Code, for the performance -ofthe work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number I certify that, inShe 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 agree that, if I should become subject to the workers' compensation provisions of .Section 3700 of the Labor Code, I shall forthwithcomply with those provisions. WARNING:. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 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 construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. M Q y� Det -'C �Q Signature,lAoolicant*orrAaentl.: y V, 1 'f O3/ - el (/ Application Number . . 06-00001699 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 3717 Expiration Date 10/29/06 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18.00. ----------------------------------------------------------------------------- Special Notes and Comments 140 LF 6' BLOCK WALL ALONG REAR & SIDE PROPERTY LINE WITH LAST 10' OF SIDE WALL @ 5' ENDING 12' FROM FACE OF CURB.CITY STANDARD. Fee summary Charged Paid Credited Due ---------- - ------ ---------- ---------- Permit Fee Total 63.00 ---------- .00 ---------- .00 63.00 Plan Check Total .00 .00. .00 .00 Grand Total 63.00 .00 .00 63.00 LQPERMIT OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has-been submitted in your name listing' ourself as` the builder of the property improvements specified. For your protection you, should -be aware that as "Owner/Buildef" you-are-the:responsible party of record on such a permit. Building permits are'not required to be signed, by property owners unles's,theyare,ersonally performing their lr own work. If your work is being performed'by someone other than yourself, you --may protect yourself from possible liability if that person applies the proper permit in his or .her name. Contractors.are required by law to be licensed. and.borided_by'the State of Galifornia and -to. have a business. license from the City or County. They are ,alsorequired by law -to put their license number ori`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 otherwiseengage 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 obligation_ s' under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For. more specific information abouty"br 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 throtigh.tlieir 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 "Owner/Builder" building permit, erroneously Implying that the property owner -is providing his or her owd Iaboe and material personally. Building permits are. not required to be signed by property owners unless they .are. performing their own work personally. Information about licensed coritractors maybe obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street,,Sacrament", California 95814. Please complete and retufn the enclosed owner -builder. verifrcaiioii form- so' ihat;we-can•'confirm that you are aware of these matters: The building permh 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 �•I/r�Z� a� ���/Yll OWNER'S SIGNATURE/DATE ;bo PROPERTY ADDRESS NO�( PERMIT NUMBER(S)