06-0499 (BLCK)(
P.O. BOX 1504
787-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
r-06-000004991
Property Address:
t-529-4-3 AVENIDA RAMIREZ
APN:
773-322-999-2 -33415
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1875
"`&t!t 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
---------------------------------------------------
LICENSED
-------------------------------------------------
LICENSED.CONTRACTOR'S DECLARATION -
hereby affirm under penalty of pe ur that I am licens ender pro% ons f Chapter 9 (commencing with
Section 70001 of Division 3 of the usi ss and Profe ionals Code and y License is in full force and effect.
License Class: B -C13 Licens No.** 634981
ate; ontractor:
r 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 (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. 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
improve for the purpose of sale.).
(_ 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 am exempt under Sec. , B.&P.0-. for this reason .
Date:
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: A
Lender's Address: P %
LQPERMIT
Owner:
CORONEL LUCANO S
51324 CALLE TAMAZULA
LA QUINTA, CA 92253
Contractor:
CORONEL CONSTRUCTION
P.O. BOX 389
LA QUINTA, CA 92247
(760)564-4604
Lic. No.: 634981
VOICE (760) 777-7012.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/01/06
t D ,
i
:F!EB06Y
OF:NTAFINANCE DEPT �
�N
------------------
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 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 STATE FUND Policy Number 174 -2006
_ I certify that, in the rformance of the work for which tl' permi is issued, I shall not employ any
person in any m nn so as to become 'jectto the orker�C compensation laws of California,
and agree that, i I sh uld become sub' ct to the wo ars' compensation provisions of Section
3700 of the Labo Co e, I sh 11 forth ith comply wi th se provisions.
ate: _ l -O', pplicant: `
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 Ouinta, 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 issuancLpermit, r cessation of work for 0 days will subject
permit to cancellation.
I certify that I have read this application and state tmatio is correct. I gra to comply with all
city and county ordinances and state laws relating ttion, and hereby a hor' a representatives
of this county to enter upon the bove-mentioned pion p rposes.a0 te: D -t -& S' ature (Applicant or Agent)
Application Number . . . . . 06-00000499
V Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . 43.00
Plan Check'Fee
.00
Issue Date ..
Valuation .
. 1875
Expiration Date 7/31/06
Qty Unit Charge. Per
Extension
BASE FEE
15.00
14 nn ? n n n n unm RT,nr Rni-?-nnn
?R --nn _
Special, Notes and Comments
.38 L.F.'6' GARDEN WALL & 37 L.F. COMBO
WALL 32" RETAINING; 6'GARDEN BOTH ORCO
SYSTEM
Fee summary Charged Paid
Credited
Due
Permit Fee Total 43.00
.00 .00
43.00
Plan Check Total .00
.00 .00,
.00
Grand Total 43.00
.00 .00
43.00
r�
LQkRMIT
FEB-01-2006'WED 08:23 AM CoconeI Construction FAX No' 760 56.4'42.01 P•002
t A
-City of " La Quinta
'rF°>u= ,; Building 8t Safery Divlslon
P.O. Box 1504
76-495 Calle Tampico
L_ a Quinta, CA 922 53
$wilding°Permit Application and Tracking Sheet
Aroject Address: - t Owner's Name:
A. P. Number: Address: f
CirytST. Zip: C �-s
Legal Description: -L,
Contractor; Telephone: y _ O
�
Address: f Project Description:
Cin'"ST. Zip:
11-t'(10 `f< `ls `::;y:<s:..:s;`< 's' ��b t C, a.
.Telephone:
State l.ic. 4 Y $1 Lic. H.
-City
Arch.. En.r.• Designer:
Address: '
CiR'.-ST, Zip:
Telephone:
R:,t;:<,.: •• >a•iy:yZ.s.. Construction Type: Qccupattcy:
r<F (s2
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Na[ne of Contact Person: Sq. Pt.:
# Stories:
#Units:
- ed Value of Prn'ect:
Telcpbone of Contact Person:
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