06-0641 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number
X06 0,0,.000643 T
Property Address:
�.� .', se *',
54685 AVENIDA RAMIREZ
APN:
7747275-021-9 _000000 -
ilk
Application description:
WALL/FENCE .
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1750
T4ht
4--Q"-
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
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: B License No.: 831504
Date: Contractor:
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 ISec.-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 theprovisions of the Contractor's State
License Law (Chapter glcomr iencing with Section 7000) of Division of the BusinessandProfessions Code) or
that he or she is exempt therefrom and the basis for the alleged 'exemption.' Any violation of.Section 1031.5 by
any applicant for a, permit subjects.the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 1 1, 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,owtter,of property who builds or improves thereon,
and who does 66 work himself or herself through his or her own employees, provided that the
improvements are not iAterided or offered for sale. If,'however, the building.or improvement is sold within
one year of completion, the owner -builder will.have the ._bu_rden 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.l.
1 _ 1 I am exempt under Sec. , E),&t7(fo1 this reas
CONSTRL`VION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a coWstruction 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
Owner:
FOSTER VIRGINIA (GINNY)
54685 AVENIDA RAMIREZ
LA QUINTA, CA 92253.
(760)564-2502
Contractor:
DSA* CONSTRUCTION•• INC
49111 HWY 111 STE A
COACHELLA, CA 92236
(760)398-9995
Lic. No.: 831504
---------------------------
WORKER'S COMPENSA'
I hereby affirm under penalty of perjury one of the following'dec
1 -have and will maintain a certificate of consent to s
for by Section 3700 of the Labor Code, for the 1
.issued. -
_ I have and will maintain workers' compensation'ir surance, 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 GRANITE . STATE - Policy Number 1519630. .
1 certify.that, in the performance of the work for which this; permit is issued, I shall not employ any
person in any manner 'bec subject to the.woikers' compensation Jaws of. California,
and agree that,'if 1 oul o `i theworkeis' compensation provisions'of Section
3700 of the Lab Co all for with:c mply with those provisions.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/10/06
WARNING: FAILURE TO:SEC ORKE OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER 70 - IMINAGP ALTIES'AND CIVIL FINES UP TO.ONE HUNDRED THOUSAND
DOLLARS 0100,0001. -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 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 suc ermit, or cessation of work for 180,days will subject
permit to cancellation.
I certify that I have read this applicatio 3dtate that th information is correct. I agree to comply with all
city and county ordinances and sta a o uildi constr tion, and hereby authorize representatives
of this coupty to Pnter upon the , ove- ned propert or inspe ion purposes.
Application Number . . . . . 06-00000641
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit.Fee . . . . 41.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 1750
Expiration Date 8/09/06
Qty Unit.Charge Per
Extension
BASE FEE
15.00
13.00 2.0000 HND BLDG 5.01-2,000
26.00
--------- --------------------------
Special- Notes: and Comments'.
70 LF 6',BLOCK WALL 'ALONG„SOUTH P/.L PER
ORCO STANDARD,..GENERA-L;CONTRACTOR ALSO
DOING SIDING.REPAIR & ELECT OUTLET.
..Fee summary Charged _ Paid Credited
Due
.Permit Fee Total 41.00 .00
.00
41.00
Plan Check Total .00; .00
.00
.00
Grand Total 41..00 00
.00
41.00
LQPERMIT
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Bin #;City
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of la. Quinta
Bullding 8t Safety Division
P.O' Boxr1504 7&.495 Calle Tampico
Permit #
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"'Quints CA 92253.- (760) 777-7012.
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.vBullding�Permt,Appllcation.and Tracking Sheet
Project Address:'
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Owner's Name:
G�''�
A. P. Number:
Address`T
Legal Description:
~ City, ST; Zip:
Contractor:
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Telephone 7/V
Address:
'ProjectDescription:
-Description.
City, ST, Zip:
1ICO
�tLot,�se/sI'n t/4
Telephoner-
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State Lic. # :
City
Arch., Engr., Designer:
Address:
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City, ST, Zip:
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'Telephone:
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F Constrgction Type S. Occupancy:
State Lic..#:.
111 o ect;type (circle one): ew,. :Add'n Alter Repair Demo
Name of Contact Person:
4 Sq Ft :.
#Stories:
#Units:
Telephone # of Contact Person:
�_
� Estimated\!alue of Project yg
kAPPLICANT DO NOT,.:,WRITE BELOW.THISyLINE
N
Submittal
Rd ,.:
eq'
Re- ;
` e TRACKING _
E. -PERMIT FEES ,
Plan Sets
Plan Checksubmitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
PIawCheck Deposit
Truss Calcs.
Called Contact Person 7Plan
Check Balance
Energy Calcs.
Plans'pickedup
Construction
'Flood plain plan
:
Plans resubmia-.tted
Mechanical
Grading plan
=
2 "Review, ready+for corrections/issue
Electrical'
Subcontactor List
Called Contact Person
Plumbing
Grant DeedPlans
picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading.
IN HOUSE:-.
'`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called ContactTerson
A I.P:P.
Pub. Wks. Appr
Date of permitissde
School Fees
Total Permit.Fees