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05-1217 (BLCK)1 Ti44-4auha BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012. 8-495 CALLE TAMPICO FAX (760) 777-7011 S L QUINTA, CALIFORNIA 92253 INSPECTION R3Q'UESTS (760) 777=7153 BUILDING PERMIT r M p� cation Number . . . . 05--0-00.0.1217--1 Date 4/01/05, P perty Address 53520.AVENIDA,RAMIREZ PN: 774 -122 -024 -24 -000000 - Application description . . . WALL/FENCE Property Zoning . . . . . . . COVE RESIDENTIAL Application valuation . . 237 Owner Contractor GARCIA JESUS MARTINEZ OWNER 53520 AVENIDA RAMIREZ LA QUINTA CA 92253 Permit . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . 15.00 Plan Check_ Fee .00 Issue Date. Valuation 237 Qty Unit -Charge Per Extension BASE FEE 15:00 Special Notes and Comments 31 LF 5' ORNAMENTAL IRON FENCE WITH MESH ALONG.CALLE COLIMA SIDE OF.HOUSE. Fee summary Charged ------------ Paid Credited Due•. Permit Fee.Total 15.00 .00 .00 .15.00 Plan Check Total .00 .00 .00 .00 Grand Total 15.00 00 00 15.00. r M P.O. Box 1504 • '�Gi. 78-495 CALLE TAMPICO VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 01y_ 124 % I ¢ RS Date: Applicant. O Applicant's Mailing Address: Architect or Engineer: Arcnitect or Engineer's Address: Lic. No.: tsUILUING PERMIT DECLARATIONS 1 ' LICENSED CONTRACTOR'S DECLARATION I hereby affirn 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 No. Date Contractor OWNER -BUILDER DECLARATION . I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).): 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 or 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.). (-_) 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 contractor(s) licensed pursuant to the Contractors' State License Law.). L) I am exempt under Sec. . BA P.C. for this reason Date q Owner WORKERS' 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 . Policy Number 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 shall forthwith comply with those provisions. 1 A t Date V F.pplicant_� �Q 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. 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 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 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 info tion is correct. I agr a to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to en r upon the ab e- ned property for inspection purposes. Q r Date � Signature (Applicant or Agent): " Site dzequirements for: n ;- ,% Corner Lot' (Example A) GARAGE SIDE YARD: S Feet SETBACK: Minimum 20 Feet Min. LOCATE DRIVEWAY AWAY FROM THE INTERSECTION REAR YARD: I' • � 10 Feet Minimum C FRONT YARD: I I 20 Feet MinimumI Ih i AIM t9 PROPERTY LINES -r .r' CURB LINE C)or C SIDE YARD• CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED . FOR CONSTRUCTION DATEBy . 10 Feet Minimum i-9 BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION •'i i. 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 parey 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 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 bonded by the State of California and to hive 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 subco•:itract, 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 wor •(including materials and other costs) is $200.00 or more for the entire project, and such persons are not licenced 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 compensaion 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 contracts are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractcs, 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 by property owners unless they are performing their own work personally. - Information about licensed contractors may be obtained by contacting the Contractors.' State Lcense 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 :hat 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: (76 77-7011 O ER'S SIGNATURE/1 ATE i Z • PROPERTYAO's e, (7S-lZ r7 PERMIT NUMBER(S) i' -',DELUXE FOR BUSINESS 1400-32$-0304 ReEN G 3W* 2879 -% A-.:S'AP PUATP-11Inc. w 160.12877887 +`760.365-4125 uc xcdz es 3�i -_.Fax 760 3654118 o 1'-80Q 334=7255 P.O Boz 2318 * .Cathe..drai .Ci, CA' 92235 asappLIMPtrg:@aol' com:. ESCRO>V> .:. BILL TO , eA PHONE . .. ADDRESS ., ... _. FAX TECHNICIAN CITY _ _. JOB'NAMEAND LOCATION -. - DESCRIPTION OF WORK iF PAICE AMOWNT - OUAtJT ., .MEscRipmokgF,SERVICES`:.. PurnpingFee per 1000 gal. Rooter s6Nice. : Camera . Labor �151HR .86, tic In"spect'ion. (, Locating /'Opening: Fee : , s75fFtR: Jetting Service ' Out of Area Fee After Hours Fee Comments.Li.. �C�G"�• �� ,2��:cro , ,fir .. 4 CHARGE:O U`U SYSTEM FAILING YES NO A FAILINGSYSTEM MAY FILL BACK UR WITHIN A.FEW DAYS:AND ; '. A Ls ; -CO NTINUETOMAVE PR, OBLEMS.iF:NOT'RECTIFIED .` TOTAL: LABOR:. „ • WAIVEA:, --po Not p 16lo to-ogndd ory ,apo 'eftas wee- .. damage,:ctWpped eohirete,merk;on_sheet oedilveways or trees.: - TAX _ -,-SIGNATURE'"DATE COMPLETED /. / TOTAL 5 Distance from welt: Material,' LOiv 4-tr-'t-- J L- eL.. Number of components ..Total liquid capacity _ to gallond.. Capacity iniefcomponent, q 0 a Inside w - gallons. length, feet L Inside Width, feet UqUid depth, 5 feet. Cesspoot. Dista ' nce from well; ./�( Net Foundation, feet. nearestlot line -at Eltont -:2sider rear feet Inside diameter. - fedt De*pth,. 0 _k0t,UquldPapacfty__gaIIops.- Lining material SECONDASECONDARYTREATMENT consists of []:T1le disposal 'D SeepagepitsOther,�(specify_) .. Tile Q(iposAf Reld: bi h6i toffi well;fleet ndi*h�s* lot line at front f:: []r"r—feet side feet NuMb Totw-jeho'"bf. Ines Number of linis, Qt;jance' between lines, feet. width, T ;or.p onareaat bottom Trencowl _=inches btaleff, OctlVe absorption of french square feet _ Length0f dith. find' .;. feet.. 640thi top of bid to ffnIA inches. Type. of alkmatelot, 0.6av'el 0,'EirbkM stone' Q,Other sp cr.fi.) 6.c y. Depth 6 f. fitter material 6i eneath Me. 1010M .044lt'6fhft6r material 6V 'e r tifia, inches. sewage I --itos. -Number of pits, LOutside :,d'iahieter,4? tlei6t Lining, Material Difs6ribil ftm wel feet; bij , liding''1bundatib nearest lot line at.. MMont 0 side 0 rear_ feet Inspection madb by. State 0. county `QLocal Health 'Authority '. Inspected Oy-.— Date of Inspection: C &I (Nde) REPORT 00 W$PEOTION INEW DUALWATER-SUPPLY SYSTEM Distance t6nearest public water. main, __..;f6dt Size of main, -inches. individual wells. j3' are not, Wsfomary;hl neighborhood. Give most recent record. of faibre of wells in immediate vicinity to furnish adequate supply of Water Properties in.fteighborhodd 0 are E]are 1:not + being developed with 'both individual water supply and sewage disposal systems. 9 Lot size feet wide, _ f6et'deep'. Dwelling set back from proParty line, feet Individual witl��Pypol� from: El Drilled well EJ.Driveni:We'll (3 Dug welf E] *Bored watil; Distaii&*ofiqen,from '... Byi.Pdl`'fb'd-Won" 'feet. nearest lot line at 0':tpnf I j side 0 rear feet Gast.lron sewer, feet, Ile sewer fe6t, seipt!6 tapir feet, disposal field, feet spwag,dpit: feet, cesspool, feet, other sources,of passible pollution, feet Well Co'n , sft Diameter, .-.i-n. c.i;. s;. 'Total depth.,_feet Typeof:casfing, -D epth of casn_g, f eet AgorddifiatedepthAopumping kweloftaterin well; feet Approximate yieldi gallons perminute.ie � depth of feet Exterior space casting sealed with: 1.Cement grout EP��dlad'day 13 Ordinary Well coveF•r E] C�6' ceetd.'. 3Wbod []:'Metal. Openings in well coverwaterti h - [3 yet. . 0 El .. - ..., . " .. . g A. :No. capacity, Pump *`0I6WVel( 0 be' we dipp:�ipez Pump 1 :Deep well. Length gallons per minute. Located "Pumproomoffbasem"en*t-0 PUn phdtiseabcvegrbund_- 3 rtu pitAumpr m,propedy'drained: 1Yes0: No. Pumpmounting watertight: EYes [No.Type-& tioNigO!. b Pressure O:Graft.. y Capacity Has bacteriological examination of water been made? ❑ �eW, Cloqo;111.olhfsanswer .is-"Yes":give date Quality of watir :[] is 0 is not satisfactory for human:consumption. Installation' ❑ does. [I 'does not .comply with 'approved 'exhibits ;;ifany, Inspection made by; -[I State [] County cal-,HeafthAuthor1ty. ''Inspected by Date of inipectiod DMINISTRATION / U S:-DEPARTMENT'0 HOUSING -UR AND • H601 HEAtTti AUTHORITY APPROVAL INDIVIDUAL WATER -:SUPPLY AND. :SEWAGE oi, Le. SYSTEM HUD/ - I'sfotm ehoutd be completed andfiled:as.requited. by extstfng law- 38_'U, S C 1804 and IS- • PARTE T8 BE GnI4GTFn my Utin= A no %/A OR VA OFFICE Forth Approved OMB :No. 290C AORTGAGE NAME AND ADDRESS (Indude Zip Code) 1 MORTGAGE OR SPONSOR PROPERTYAODRESS " 53 S-2 O Aw- :R r1 lee -L S.VSDIVISION I LOT AP. TOTAL NUMB .: Is.T)iFREA:SASE4 MENT?' ISTHISANEW INSTALLATtON7 CAN THE ATTIC,OR71ifERAREABEMAOEINTO ADDITIONAL SEDROOM57 (1 S.''' how mmty9J r LIVING UNITS BEDROOMS gq}}{S ' 3 Z []:YES. EaNO . OYES, El. Q YES ' NO WTER SUPPLY $Y SYSTEM`DESIGNED FOR PUBLIC SYSTEM Q COMMUNITY SYSTEM Q INDIVIDUAL N0. OF 8EDR00W3 GARSAGE DISPOSAL SEWAGE DISPOSAL 8Y: _. `Q PUBLIC SYSTEM U, COMMUNITY SYSTEM, INDIVIDUAL „ ..; , ✓ YES Q NO ;uC-rAK I Mr -MT UR :Ct7MPLIANCE:INSPECTOR tSPECTOR'S,SYETCH(20REPORTAS$UILTDBVJ42IONS..FROM.APPROVMPIAN) j, (-T It is the opinion of the nState Q County. QLocal Depanmetrt.of Health that this individual water-su for'the siib'ecf ro ppty System Q . is Qts not sausfacory. as a dotnestio water supply 1 p •Py` NotInspected It the opinion of the ;[State ❑ Cotmty ❑Local Department of Health that the Inditiduat sewage dtsposal.systeta with proper maintenatxe as be expected to function satisfar!oriiv; and is not ttkely to-create,uamnitary:condtttons,. Q Cangot;be expected to function satisfactorily. Thjs is as inspet itis not a priftan.ty. DATE SIG9ATURE �i Z12_ ITY' i riTLE qSAPUMGP4IN2G-8, 5INC. TECHNICIAN _ !IC# . NOTE: The health authority, should complete the appropriate opttuon.siaternent.above:and afhx datesigtiature title in 6" "spaces provic:4 NOTE: Use of the: reverse of this is at tfvgwntinn nff6p 6Palth �6n.:w PART.III:- FOR (ISE OF FIELD OFFICE I have reviewed the foregoing and the pert'tnerd Compliance inspe..ction Report aad.recotnmend thatthe utdividual water -supply system be considered []:acceptable (3.4 not acceptable and that the. sewage -di spo_aLbe considered Q veer ptable Q not acceptable. )ATE SIGNATURE TRE Q HUD ARCHITECTURAL SECTION CHIEF•OR DEPUTY CHIEI Q, VA CHIEFAPFrZA.ISAL SECTION OR DESIGNEE %A FbRM 26 8395 .APR 1992 SUPERSEDES VA FORM 26.6395, .00T '1478 t - - -