06-4147 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1-0-6=00004147
Property Address: 51596 AVENIDA'RAMIREZ
APN: 773-131-005-20 -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 1500
Applicant: Architect or Engineer:
Td4t 4 4v Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ADAN HERNADEZ
51596 AVENIDA RAMIREZ
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/30/06
---- Lrt1
DEC 01 2005
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 7060) of Division 3 of the Business and Professionals Code, and my License is in full forceandeffect. 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
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm undei penalty of -perjury that.l 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 apermit to
construct, alter, improve; demolish, or repairany 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
any applicant 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
the structure is not intended or offered for sale (Sec. 70.44, 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 isisold 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.)
(_) I, as owner of the property; am exclusively contracting with licensed contractors to. construct the project.(Sec.
7644, Business and- Professions Code: The Contractors' State License Law does not apply town owner of
property who builds orimproves , thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. ' , B.&P.C. for this reason
' D� ate:: 10/'O Owner:
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
issued.
I have and will maintain workers':compensation insurance, as. required by Section 3700 of the Labor
Code, for the performance. of the work for which this permit is issued. My workers' compensation
insurance carrier and. policy number are: "
Carrier Policy_Number
r I certify that; in the 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 shallforthwithcomply with.those provisions.
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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. �P
.Date/ Signature (Applicant-or-Agentl:"Z<4P701y L_ ` L
Application Number . . . . . 06-00004147
Permit WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 35.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 1500
Expiration Date 5/29/07
Qty Unit Charge Per Extension
BASE FEE 15.00
10.00 2.0000 HND BLDG 501-2,000 20.00
----------------------------------------------------------------------------
Special Notes and Comments
60 LF 6' BLOCK WALL PER CITY STANDARD @
SIDE YARD(NORTH).
Fee summary Charged
----------------- ----------
Permit Fee Total 35.00
Plan Check Total .00
Grand Total 35.00
LQPERMIT
Paid Credited Due
---------- ------ --- ----------
.00 .00 35.00
.00 .00 .00
.00 .00 35.00
Bin #
Crtyof La Qulnta
Building U. Safety Division
Permit ff
P.O-. 60x.1504, 78 495.Calle Tampico
14 y
La Quintar GA 192.253.- (760) 777-7012
Building Permit Application. and Tracking Sheet
Project Address:
Owner's Name:
A. P. Number.
Address:
Legal Description:
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City, ST,:Zir
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Contractor:
Telephone:
Lai
Address:
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Project DescripGoti:
City, ST, Zip:
,
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Telephone:
State Lic. I:
_
City. Lic. #•
.
Arch., Engr., Designer:
Address:.
City.: ST, Zip:
•
Telephone:
Constntctton T
: YPe Occupancy:
State Lie.
.Project type (circlepne): New Add'n Alter . Repair Demo
Name of Contact Person:
FL.
1#
Stories:
#Units:
Telephone # .of Contact Personi
Estimated Value
of Project:
APPLICANT
..DO NOT, WRITE BELOW-:Mls UNE
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Submittal
Req,d
Reed
TRACKING.
PERMIT FEES
Plan Sets
Plan Chetk submitted
Item
Amount
Structural Cates.Renew
txl,:read 'tor eorroctious..
y
Plan Check Deposit
Truss Cales
Called Coutaet Peison
Plan Check Balance
Energy Calcs.
Plan; picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Gradiag.ptaa
2`' Review, ready for eorrectiogs/issue
Electrical
Sabcoatactor ListCalled
Contact Person
Plumbing
Grant Deed.Plans
picked Up .
.
... ..
S.M.I.
H.O.A. Approval
Plans resubmitted.
Grading
IN iiOUSE:-
"4 Review, ready tor. corrections/issue
Developer Impact Fee: ;
Planning Approval
Caped Contact Person
A.I.P.P.
.Pub. Wks. Appr
Date of permit issue •
?:
School Fees
.. ;, .,:::
.. ,.: ......:.
..:.......::.:
I Permit Fees
,
..... .:. ...
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�78=495 CALLE TAMPICO = LA, QUINTA, CALIFORNIA, 92253
F o �9�' I
TELEPHONE (.760). 777-7012 FAX (7,60) 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 theyare personally performing their
own work. If your work is being 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 bondedby the. State of California and to have a business license
from the City or County. They are also required by law to puttheir 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:piotection.
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 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 "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 -to -be signed=,byppcoperty'owners"unles"s`they are—perforrriing their own work
personally.
Information about licensed contractors.may be. obtairied by,contaetingr 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,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (760) 777-7011
_XAo.4tviw
WNER'S $IGNATURE/DATE
OSP o�EADDRESS�
PERMIT NUMBER(S)