07-1835 (BLCK)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
Application Number: 07-00001835
Property Address: 53800 AVENIDA RAMIREZ
APN: 774-162-025-22 -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
't•, Application valuation: 2109'
PERMITBUILDING & SAFETY DEPARTMENT
BUILDING
Applicant:. ArcfiitecY or. Engineer:
tll
----------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
Thereby affirm under penalty of;perjury.that I am licensed•under •provisions of Chapter 9 (commencing with
Section 7000)�of.Division 3.ofthe Business:and ProfessionalsCode,-and my License is in full force and effect.
License Class: License. No.:
Date:.- Contractor:.
OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury than am exempt'fromthe Contractor's- State iicense Law for the
following reason (Sec. 7031-.5, Business and f rofessions Code: Any city orcounty:that requires a permit to
construct,.alter, improve, demolish;'or repairanystructure, 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 wnh:Section 7000) 'of.Division 3 of the Business and -Professions Code) or
- that -he or she is exempt therefromi and thebasis:for the alleged exemption. -Any violation of. Section 7031.5 by
anypplicant for a. permit subjects the applicant to a civil;penaltµof not more than five hundred dollars (5500).:
I _ 1
1, as owner of the property,-or.my employees with wages as their sole compensation, will do the work, and
the structure,is notintended oroffered.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,
sand 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 611havethe burden of proving That he or she did not build or
improve for the purpose of sale.):
(_ L.1,'asi;owner of,tne:property,.am.exclusively, con r ctiug witli�licensed contractors to construct the project (Sec.
7044, Business andProfessions Code: Th .. ontractors' State License Law does not apply town owner of
property whgqbuilds or improves %Lhwn
n, n who contracts for the projects with a contractor(s) licensed
— Dutsuannt to jhe�Contractors' St a se L :,I am 9 em t o r Sec. B.. f r t s r son
I hereby affirm under penalty of perjurklWt there is a For
work for which this permit.is issued (Se .)3097, Civ. C.I.
Lender's Name:
Lender's Address:
LQPERMIT
for the perftkAaw6 of
Owner:
LYNN CUMMING
53-800 AVENIDA RAMIREZ
LAQUINTA,CA3
9225
------------------ - -
11�
Contractor: .
Owner
-----------------
VOICE (760) 777-7.012,
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/22/07
WORKER'S.COMPENSATIONDECLARATION -
I hereby affirm under penalty of.perjuryone of the following declarations:.
I have and, will maintain a certificate of consent to self -insure for workers' compensation; as provided -
forby Section 3700.of tKii Labor Code,. foe the,performance of the work_for which this, permit is.
issued:.' c .
I have and will maintain workers. compensation insurance, asrequired.by Section 3700 of the Labor
.Code, for the. performance of;the- rk for which this permit is issued. My workers' compensation.
insurance carrier, and policy numb are:
Carrier - icy Number
Yc_ertify that,. in the perform ceof work•for.which this permit is issued, I shall -not employ any
per on in any manner' a to b me subject to the workers' compen • i s of. California,
a gree that if^I st ` sup,!er to the workrs' compensatio pr vision f Section
La a I sh rt ith comply with. -those ovisions.
r
Date: "" - —Ap lic '
f � r
•WARNING: FAILURE TO SEC E KE R IS U F ALL
SUBJECT AN•EMPLOYER TO C NAL PE ALTIES AND CIVIL FINES UP TO'ONE HUNDRED THOUSAND
DOLLARS -($100,000). IN ADDI N TOT.T E'COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INT - EST; AND ATTORNEY'S, FEE S..
�. APQLICANT,_ACKNOWLEDGEMENT '
IMPORTANT Application is hereby made to theDirector,of Building and Safety a permit subject to the
conditions and restrictionsset•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 pec me null and oid if work is not commenced
within 180 days from date of issuance of such p it, or c sati of work for 180 days will subject
permit to cancellation.
I certify t tl ha a read this application and state that the ove informs on is orrect.I agree to comply with. all
city and unty' rdinancets and state laws relating to bu' i g constructio , and ereby authorize represen
of thio c my tt e_{er upon the above-mentionLV pr art or inspection urpo 4 t -
LQPERAIIT .
.
-Application Number . . . . 07-00001835
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee.: 54.00
Plan Check
Fee..
.00
•... . .
,.
Issue..Date
Valuation
2109
Expiration.Date 12/19/07
Qty. Unit Charge Per
Extension
L.
BASE'. FEE.
45-00
.1. 00:" 9-.0000 THOU BLDG;2,001-25.,000
9.00...•
'.. '
Special Notes and.Comments
-----------------------------.--
..
REMOVE EXISTING„ BLOCK WALL, ADD 90:'
L . F . X 5'.,:. 10 '" L . F. X 4 ' . CITY STANDARD .
J
BLOCKWALL.
Fee,'summary- Charged Paid
Credited
Due
t.
Permi_Fee Total :5'4" 00
.00
0'0
5.4.
Plan =Check Total;;,; 0.0:
..00
00
.00 ~�
._
Grand Total 54:00
o0.
..
..00
54.'00
4
LQPERAIIT .
I i
JL
ROD
ck
f � .� 1. \I \\.` � �. � ` , \�.\. •�
DINRA®
ii NBYALDTNA
2:0 l C)
.:-
to�A�)
I
�3 Ave fy v'"ke-
.1.. � • r �t. l�. i i gem
F =
78-495 CALLE TAMPICO'— LA.1GIUINTA, CALIFOR NIA, ,92253
0
TEL' EPHONE (760). 777;;7012 i FAX :(760)'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. g
For your protection you. should be aware -,that as "Owner)builder"'you are.the,responsibie party of record on such a
permit..Building permits #_e.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,youiself,'you may protect yourself from possible
liability if that.person applies for.the:proper'permit',in his -or lier name.
Contractors are required byelaw; to be'licensed and bonded byrthe State of California and to have a business license
from the City or County. They are .0 required' by law [o. put 'their `iicense number on all permits for which they
apply.
If you plan to do your own,;work;; with the• exception of. yarious°:irades'that you plan* tosubcontract, you should be
aware ;of the following infoi7tiation for youi benefit and protection:. t
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,. 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 th&,State and Federal Government as. an. employer and you are subject
to several obligations, include State and -'Federal income tax'withliolding, `federal social security taxes, worker's
compensation insurance, disability insurance costs.and unemployment_compensanon contributions.
There may be financial Yisksfor you if you do not carry.outthese 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.`SmallF,BiAness Admiitistration)::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 rigt,,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
A
permit, erroneously. implying aha't the propertyowner. isfproviding his or her -'own `labor and material personally.
Building permits are '.not ;required to be signed by pro"pertyA,owners unless they are performing their own work
personally. '
Information about license& contractors may be obtained` by contacting the Contractors' State License Board in your
community or.at 1020 tN. Streei,;Sacramento; C_ al {'
Please complete and return the enclosedr,6wner-builder veiiA&tion form: so that.,we can'ci nfirm that you are aware of
these matters. The building permit will'not be'issued until_;the verificatiomis returned._ t
l
Very truly yours,
CITY OF LA QUINTA
DEPT:'.OF BUILDI G AND SAFETY t
78-495 Calle Ta i o..
L(_
rota, CA 9 25
((_ 777-7012..
(760) 77 01
i
a
PROPERTY ADDRESS' )
PERMIT NUMBER(S) -
• 4
k
r
Bin #
Of La
City Quinta
Building & Safety Division
P.O. Box 1504, 78-495. Calle Tampico
La Quinta, CA 92253 - (760)'777-7012
Building Permit Application and Tracking Sheet
Permit.#
Project Address:' Al
Owner's Name:
A. P. Number:
Address: a cv
Legal Description:
Contractor: -- \
Address: ���
City, ST, Zip: V G
'Telephone: —
Project Description:
City, ST, Zip: NA V�
.Telephone.-'QO _&�
mau,-4-
V%
State Lie. # :
Arch., Engr., Designer:
( ��
Address:
City, ST, Zip:
Telephone: L . I
State Lie. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading plan
2nd Review, ready Cor corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3'd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees