05-4184 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:,
Property. Zoning:
Application valuation:
Applicant:
0:0AA'4- 4"
54440 AVENIDA RAMIREZ
774-244-.010=15 -000000-
WALL/FENCE
COVE"RESIDENTIAL
2467
Tihf 4 4 -Q" -
Architect or.Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/19/05
Owner:
DELARA ALFREDO
54440 AVENIDA RAMIREZ
LA:QUINTA, CA 92253
---------------------------------
ln1 u Contractor:
Owner
SEP 19 2005
CITI( OF LA ®UIPITA
iE LICENSED CONTRACTOR'SDECLARATION .v
I hereby affirm 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 penbltyof perjurythat,l°am exemptfrom the Contractor's State License Law for the
following reason .ISec. 703.1:5, Business and ProfessionsCode: Any city or county that"requires a permit to
construct,. alter, improve, demolish, or repair any structure; prior to its issuance, alsorequiresthe applicant for the
•
. permit to file a signed statement that he or she is licensed. pursuant to:the.proyisions of the Contractor's State
"License Law•(Chapter 6 (commencing with,$ection 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 4 1 I, as owner -of the property] or my employees with wages as their sole compensation, will do the work, and
the structure is 66t intended or offered for sale (Sec. 7044, Business and Professions Code:.. The
Contractors' State License Law aoes'not apply to an owner'ofproperty who builds or improves thereon,
andwhodoes thework 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:yearoficompletion, the owner -builder will have the burden'of'pro-ving 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 _) I am exempt under
Spec. B.&P.C. for this reason
CONS"UCTION 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
------------------
WORK ER'S' COMPENSATION DECLARATION
hereby.affirm under penalty of perjury one of the following declarations:
_ I hove and will maintain arcertificate. 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 whichthis"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 andpolicynumber are:
Carrier Policy Number
I� I certify that, in the performance of the work for which'.this permit is issued, I shall riot employ any
person in Zany 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
6 3700 of,the Labor Code, Ishall forthwith comp) with those provisions. .
+Oats: •—...Z ��ApplicaAt-: "
WARNING: FAILURE TOSECUREWORKER ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND"
DOLLARS ($100,10.00).:IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN .
SECTION 3706 OTHE 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 j/jligection pprposej n. A
LQPERMIT
Application Number. ...05-00004184
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit'Fee 54.00 Plan Check Fee'.
.00
sue,*DateValuation
2467
.,is '
Eirtion Date 3%18/06
Qty Unit Charge Per'
Extension
BASE FEE
45..00.
1.00. 9.0000 THOU .BLDG 2,001-25,000
9.00
-- -- - - -- -.- -- - - -- ----------------------------
Specal Note's -and • Comments.
--
90 ,L ' 6..' BLOCK`. WALL•. P:LONG`; SIDE P/L'`& 10
LF 5''::BLOCK' WALL 'LAST10' 'OF SIDE _P/L: '`
CITY 'STANDARD . 11
�22, Ll a �d--�o . ,7 `l /Qf/.. • 6 (�/�''"^'
V/(,�`�
Fee summary Charged Paid Credited'
Due
--------- ---- ----- -.---------
Permit Fee Total 54:.00 .00 .-;00
54.00
Plan Check Total .00 .00 .00
.,00
Grand. Total 54:00 .`00 .00.
54.'00
°aaT
.. .. .,. ... _. _ ..._ ......_...__... _.. .. ._... :. _.
A RE-INSPECTION FEE OF :$30 -
,�i I BE CHARGED IF THE APPROVED
_....__..._...___..__.... ......:....
THE SITE FORA SCHEDULE
INSPECTION.
N.0 EXCEPTIONS!.
SITE REQIllRT'E, NT
11XT'ERIOR 'LOT
OWNER/BUILDER INFORMATION
Dear Property :Owner:
An application for a building.permit has been submitted in your name listing yourself as the budder of the property
improvements -specified:
For your protection'should be aware that4s,"Owner/B`uOder,2'
you. are the responsible party of record on such a
permit.,Building permits are norrequired to be signed by, ners-uhles'stlfey� e personally performing their
,y.-propertrow
own work. If'you'r.-;W6rk-is-�6'e"''n'g performed:,by so'm'eone other , 'than. yourself; you may
. 1 .1 . . .. 11 'I ' .' ' . protect yourself from possible
liability if that person. applies for"the proper',
perrnit,in hisor her name. - -
Contractors are required by.Ja�v to be: licensed and', -bonded by the State :of California -and to have a business license
from the City, or C6v'nty,. They !are also require'd.15y, l4'w,.,Jt6 put their license - number o'n all permits for which they
apply.
If you plan . to do your.own-work, with the .on of v ' ario6s'trades that you plan." - to subcontract, you should be
"ex exception
aware of the following information for your b2i&it.arid� protection:
If you employ or otherwise. engage. any persons other than your immedWeiamily, and the work (including materials
and other costs) is $200;00
or more' the entire' project, and: .ad'.re not licensed 'as contractors or
pro ln ,.suc persons a,
subcontractors, -,the ni, you maybe an employer.
If you are.an employer, yop'must register with the State and Federid-,"Goverriment as arf.employer and you are subject
to several obligations include State and :Federal int=61ax',Y�A"o � I d ip`g; federal social` security taxes, worker's
compensation irisura'nce,.disa&ilky insurance ;costs ';ar'u n
d,e r mp I lo n . fent co mpe�nsafion.contributions.
There may be financial- risksfor you if you do not -o carry uvthese,obligdtions, and these risks are especially serious with
respect to worker's ciompefisation insurance.
For more, specific. inform akicin,abouvyour obligations uhd&Federal La'w,*qontact the.Internal Revenue Service (and, if
you wish, the.u..S...Small B-u'siness.,Administratioti)F6r,nio-ke - sp6cifi&'infbrma6on =about *your. obligations under State
Law, contact theDepartme'rit of-Benfefit.'Paiyments an4 t h.6`bivigi6n� of Industrial Accidents.-
If
ccidents.If the structureAs intende- d, for sale, -property o . wners. who are not licensed contracts, are. allowed to perform their
work personally or through
rough. their dwnmploy'ees';. -w'iih6iii--a'lice6sed.contractor . or
subcontractor, only under -limited
conditions.
A frequent practice of unlicensed . persons profes'sing t6:6e' "contractors is to. secure 4n "Owner/Builder" building
permit, erroneously g---thai the property.' is r viding his or; her. own labor ;And material personally.
pe implying: yin Pro
Building permits ar e. not ot . required
qu- i re d to, be signed b�, prdjpe'ity ownersI . -unless,they are performing their own work
personally.
Information about licensed contractorsmaybe. 'obtained, by'contacting the Contractors' State License Board in your
community or at 1020 N. Street,* Sacramento, California 95814.
Please complete and return* the enclosed 6wheribuilderverification 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
JF: (760)'777-7011
OWNEA' SIGNATURE/DATE
PROPERTY ADDRESS
PERMIT NUMBER(5)-.