06-2278 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00002278
Property Address: L52943 AVENIDA RAMIREZ
APN: 773-322-999-2 =33415—
Application
—Application description: --WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 1700
Applicant: Architect or Engineer:
4 -
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CORONEL LUCANO S
51324 CALLE TAMAZU
LA QUINTA, CA 9225
Contractor:'
CORONEL CONSTRUCTI
P.O. BOX 389
LA QUINTA, CA 9224
(760)564-4604
Lic. No.: 63'4981
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/06/06
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: '
Lender's Address:
LQPERMIT
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 180days will subject
permit to cancellation.
I certify that I have read this appli tion and state t t - e above informatio is correct. Iprtoomply with all
and my ordinances an tate laws relating to ui ing c nstruction, nd hereby auresentatives
of
'hi
aunty to enter upo a above-mentioned pro rt for i spection p rposes.
ate: (�-y gnature (Applicant or Agentl
-------------------------------------------------------------------------------------------------
RATION
LICENSED CONTRACfNo.-
WORKER'S COMPENSATION DECLARATION
Chapter 9 (commencing with
- I hereby affirm under penalty of pe ' ry th �1 amLssionals
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of t e B sine and icense is in full force and effect.
I have and will maintain a certificate of consent.to self -insure for workers' compensation, as provided
LicenseClass: B -C13 - 4981
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
/
ate: L�_(�_ u tracto :
issued.
1 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
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 STATE FUND Policy Number 1744453-2006
following reason (Sec. 7031..5, Business and Professions Code: Any city or'county that requires a permit to
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
erson in any m r so as to become lett to the ers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
nd agree that ' s ould be ome sub' ct to the wo ers' compensation provisions of Section
' License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
700 oft abo C de, I s II forth ith comply w th t ose provisions.that
L
he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byany
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Date: Applicant:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
"
the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale: If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
_ 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.).
APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whosebehalf this application is made, each person at whose request and for -
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
• (_) I am exempt under Sec. , B.&P.C. for this reason ' -
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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: '
Lender's Address:
LQPERMIT
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 180days will subject
permit to cancellation.
I certify that I have read this appli tion and state t t - e above informatio is correct. Iprtoomply with all
and my ordinances an tate laws relating to ui ing c nstruction, nd hereby auresentatives
of
'hi
aunty to enter upo a above-mentioned pro rt for i spection p rposes.
ate: (�-y gnature (Applicant or Agentl
Application,Number . . . 06-00002278
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 39.00
Plan Check
Fee
00
Issue Date
Valuation
. . .
. 1700
Expiration Date'. 12/03/06
Qty Unit Charge Per
Extension
BASE
FEE.
15.00
12.00 2..0000 HND BLDG
501-2,000
24,00
----------------------------------------------------------
Special Notes and Comments
68 L.F. 6' GARDEN WALL, ORCO SYSTEM
Fee summary Charged
q
Paid Credited
Due
Permit Fee Total 39.00
.00
:00
39.00
Plan Check Total .00
.00
.00
.00
Grand Total 39.00
.00
.00
39.00
JUN -06-2006 TUE 06:06 AM
I
Coronel Construction < FAX -No. 760 564 420? P•001
City of La Quanta V
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Building'K'Safety Dlvlslon
P.O. Box ] 504
Calle Tampico a
1A.78-495
La Quanta, CA 92253
Buildin Permit A IiCation and.Tracking Sheet .r.
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Project Address: S 14 3 �w:�rt
Owner's Name: J ��
A• P, Number:
Address: 3 t�
Legal Description:
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Contractor,\\
Telephone: �`{-
Address: 0 - A
project
City -ST. Zip: 4
Description"
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Construction Type: Occupancy: _
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project type (circle one): New Add'n 'Alter Repair Dehio
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Name of Contact Person:
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Telephone 4 of Contact Person;
Estimated Value of Project;
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