10-1137 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00001137
Property Address:
57654 BARRISTO CIR
APN:
762-500-023- -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
325
Tu�14,4Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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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: C10 C53 License No.: 634338
Dater wZ f-1Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 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).:
1 _ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and .000
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 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.).
(_ I 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:
LQPERMIT
Owner:
ALLILNGHAM DANNY E
57-654 BARRISTO CIRCLE
LA QUINTA, CA 92253
Contractor:
RODRIGUEZ LANDSCAPE
79461 40TH AVENUE
BERMUDA DUNES, CA 92
(760)345-8302
Lic. No.: 634338
VOICE (760) 777-7012
FAX (760) 777-701.1
INSPECTIONS (760) 777-7153
Date: 10/29/10
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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 MANFCTR ALLIANC Policy Number 2010010117887Z
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.
ate: ---pplicant:
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 ($100,0001. 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 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 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 uportthe above-mentioned propen: fons/pectio-n purposes.
5tel0-Z��l ignature (Applicant or Agent): C/
Application Number
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
. . . . i0-00001137
WALL/FENCE PERMIT
15.00
4/27/11
Plan Check Fee . . .00
Valuation . . . . 325
Qty Unit Charge Per
Extension
BASE FEE
15.00
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Special Notes and Comments
RE -LOCATE POOL EQUIPMENT AND ADD 13
L.F.
6' EQUIPMENT ENCLOSURE WALL, CITY
STANDARD. 2007 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG
STDS ADMIN (SB1473)
. 1.00
Fee summary Charged Paid
---------------------------
Credited
----------
Due
----------
Permit Fee Total 15.00
.00
----------
.00
15.00
Plan Check Total .00
.00
.00
.00
Other Fee Total 1.00
.00
.00
1.00
Grand Total 16.00
.00
.00
16.00
LQPERM IT
'CITY 0F. LA Oyu'"��r�
BUILE3,a(3& SAFETY
E, --PT.
FOR CO'MS� j:i
N
DATE BY
&n # City Of LA Quinta
Building 8f Safety Dfv dW
Permit # P.O. Box 1 SO4, 7849S Cane TamplM
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: 5-7� 5 4 ZeL(f i s -i6 Ci - Owner's Name � � ! l i
A- P. Number. Address: j 41 C "r, l e r
�,e$a, Desairption: u 3 C• may, ST- L r� C,.4
ContrActor. Telephone:
Addrws: -7 2 1 40 �"Ave Description: gm_e
city, ST, zip: (3 e rrvua.G14 Incl ('<1 9 Z zv 3 -
-0 .
Telepdeonv 4 J) 3 4$- j U Z MY L u P14V, iP /ke,1
t,-� Tx
Arch., EW.. Desigax.
Ad4ow:
City, ST. Zip:
TelephMe:
State Lip. #:
Name afconw Person:
Telcahono # of Contest Person:
B Submittal
Ptan Sets
Strueta id Cales.
Truss Cato.
Title ZI Cala.
Flood plata pian
Grading plan
Subeontaetor List
Grant Deed
H.O.A. Approval
IN HOUSE --
Planning Approval
Pub. Wks. Appr
School Fee
Lie, d:
Estimated Value of Project: 41P �Oo
APPLICANT: DO NOT WRITE BELOW THIS LINE
Reed T ACMG PERMIT FEES
Plan Check tabm[tted
Ihm
Reviewed. ready for corrections
Plea Cknek Deposit
Called Contact Person
Plan C keek: Balance.
Plans picked up
Coastmctioa '
Plans resubmitted
Meehankal
r Review, ready for correctlowAssue
Fleetrieai
Called Contact Person
Plumbing
Plans picked up
&M -L
Plans resubmitted
GMOIng
Review, ready for wmctionsAssae
Devdoper impact Fee
Called Contact Person
Date of permit Issue
Total Permit Fees
Anoant