09-0930 (BLCK)'Aa . j
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
-T-i&t 4 4-Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011• "
INSPECTIONS (760) 777-7153
Date: 9/02/09
Application Number: - 09-00000930 Owner:
Property Address: 81182 BARREL CACTUS RD I FUSS RICHARD
APN: 764-270-999-33 -300233- 81182 BARREL CACTUS RD
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 625
Contractor:
Applicant: Architect or Engineer: FRENCH CONSTRUCTION INC O2
705 SUNNYSIDE AVENUE
C� REDLANDSNDS, CA 92373
(760) 775-3618
�t
Lic. No.: 667383 ``-
-----------------
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 Li ense is in full force and effect.
License Class: B License No 83 -
Date. "ZContractor:
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 (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 Contractor's State
License Law (Chapter 9 (commencing with Section 70001 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).:
(_) I, 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 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.).
(_ 1 1, 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.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
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:
LQPER111IT
WORKER'S 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 STATE FUND Policy Number 0028844-200.7
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 nsation laws of California,
and agree that, if I should become subject to the rkers' compensate provisions of Section
q �7 3700 of the Labor Code, I shall forthwith comply wi ose provisions.
-Date:f L .Applicant:
WARNING: FAILURE TO SECURE WORKERS' CO NSATION 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.
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 au a representatives
of this coin ter upon the above-mentioned property for inspection purposes.
Date Signature (Applicant/hr Age
A7 ?
Application Number . . . . . 09-00000930
Permit . . . WALL/FENCE
PERMIT
Additional desc . .
Permit Fee . . . . 19.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 625
Expiration Date 3/01/10
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 2.0000 HND BLDG
501-2,000
4.00
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Special Notes and Comments
25 LN FT X 6 FT HT GARDEN BLOCK
WALL PER
ORCO STANDARDS & APPROVED PLANS.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG
STDS ADMIN (SB1473)
1.00
Fee summary Charged
Paid Credited
Due
-------------------------------------
Permit Fee Total 19.00
----------
.00
----------
.00
19.00
Plan Check Total .00
.00
.00
.00
Other Fee Total 1.00
.00
.00
1.00
Grand Total 20.00
.00
.00
20.00
LQPERMIT
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. City of La Cluinta
Building a Safety Division
Permit #
P.O. Box 1504, 78-495 Calle Tampico
/,�
La Quinta, CA 92253 - (760) 777-7012
/
" `J
Building Permit Application and Tracking Sheet
Project Address: 1
C J Owner's Name:
A. P. Number:
Address: 1 t �7- ".1, .CA&MA-l")
Legal Description:
City, ST, Zip)--& NV110-
Contractor: /�/'
•�i'1P-ItiQ� �' �� Telephone:
Address: 7,45 Project Description:
City, ST, Zip:
-Z -3, -. /4--(5-6
Telephone: qo?—/ s-
'.'<"3%Y
j?7
State Lie. #
City Lie. #:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
)nstruction Type: Occupancy:
State Lie. #:
'
�'I:s:;,,res�z.rh• .^5�i? Project type (circle one): New Add'n Alter Repan Demo
Name of Contact Person:
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE. BELOW THIS LINE
# Submittal Req'd
Recd TRACIONG 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.
Tide 24 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
21" Review, ready for correctionsfissue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up. S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
Review,.ready for correctionstissue Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees