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05-4834 (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: 05-00004834 77121 CASA DEL SOL 773-360-012- - WALL/FENCE MEDIUM DENSITY RES 6932 Architect. or Eng Tiht- 4 4 Q" & SAFETY DEPARTMENT ILDING PERMIT -------------- LICENSED CONTRACTOR'S DECLARATION Thereby affirm under penalty of perjury that am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division3 of the Business and Professionals Code, :and my License is in full force and effect. Lieense.Class: License No.:. Date: Contractor: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law. for the following reason (Sac. 7031.5, Business and Professions'Code: Anyeity 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 (Chapter9 (commencing with Section 7000) of Division 3 of the.Business and Professions Code) or that he or shelis exempt therafrom.and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a,permitsubjects the,applicantto a civil penalty of not more than five hundred dollars (0500).: (_ 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. 70441 Business and.Professions Code: The Contractors' State License. Law does not apply wan 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 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 am exempt under Sec. BCBP.C, for this reason Date: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there:is a construction lending agency for the work for which this permit is issued (See. 3097, Civ. C:). Lender's Name: Lender's: Address: LQPFJ MU Owner: M.CORRALES/B.,HERNANDEZ 81226 FRANCIS AVE INDIO, CA 92201 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/31/05 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of'the following declarations: 1 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. _ 1 have and will maintain workers' compensation insurance; as required by Section 3.700 of the Labor Code,for the performance ofLthe work forwhieh this permit. is issued. My workers' compensation insurance carrievand policy number are: Carrier Policy Number I certify that, in the performance of the work for which this'permitis issued; I shall not employ any person in any manner so as to become subject to the' workers' compensation Iaws:of California, AFAIWRE ree that, if.I should become,subjectto the workers' compensation. provisions of: Section of the -Labor Code, L all forthwith comply with those prov ns. Date:. Applicant: � WARTO SECURE WORKERS" COMPENSATION COVERAGE IS UNLAWFUL, AND SH SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU D DOLLARS' 0100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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 permitsybje_ ct 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 underor.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 Quints, its officers, agents and,employess for any actor 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,isnot commenced within 180 days from date of Issuance of such permit, or cessation of work for 1 SO days will subject permit to cancellation. I certify that I have read this application and state that the, above information is correct: 1 agree to comply with all city and.cou y ordinances and state laws relating to building construction, and hereby authorize representatives of this cou to fl er upon the above-mentioned property for inspe ion purposes. L Date:,l� Signature (Applicant or Agent) 1 tfw LQPERMff Application Number . . . . . 05-00004834 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 90.00 Plan Check Fee .00 Issue.Date . . . Valuation . . . . 6932 Expiration Date . . 4/29/06 Qty Unit Charge Per Extension -BASE FEE 45.00 5.00 9.0000 THOU' BLDG 2,001-25,000 45.00 --------------------- - --------------------------------------- Special Notes and Comments 281 LF 5' BLOCK WALL PER ORCO DETAIL/TOTAL OF 53 LF POOLEQUIP ENCLOSURE/A/C ENCLOSURE &FRONT A/C ENCLOSURE -ALL PER CITY STANDARD. Fee summary Charged Paid Credited Due Permit Fee Total 90.00 .0'0 .00 -90.00 Plan Check Total .00 .00 .00 :00 Grand Total 90.00 .00 .00 -90.00 Bin # City of La Quinta Building at .Safety Division P.O. Box 1504, 78-495 Calle Tampico- La Quinta, CA 92253 - (760) 777-701.2. Building Permit Application and Tracking Sheet Permit # M Project -Address: Z' c�4 [ sOL a Owner's Name:AFA A. -P. Number: Q Address: gLaa AW 6a AVQ N € Legal Description: City, ST, Zip: ZWJ;t7 . .Contract* •W Auto CU Nva Address: 8 (d, a u/ ... iT ehone FY�TN'c eP Project Description; L City, ST, Zip: 2 c) 02� C� �� ✓ �/ @ ,� % p/ L Telephon State Lic. # : City Lie. #: �, / 7 P� �T/ �,.,c/'a v/t-P. Arch., Engr:, Designer Address:_Z Lf 4f ->T— A16 'G City, ST, Zip: Telephone: State Lic..#: Name of Contact Person: Construction Type: C Occupancy: Project type (circle one): ew Add'n Alter Repair Demo T_ v l �' Sq. Ft.: # # Units: {Stories: Telephone # of Contact Perso : �i a Estimated Value of Project s APPLICANT; DO. NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACKING. PERMIT FEES Plan Sets Plan Checksubmitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called CoutoctTerson Plan CheckBalance Energy Cates. Plans picked up 'Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for correctionsllssue Electrical Subcontactor List Called'ContactTerson Plumbing Grant Deed Plans picked up S.M.I. H.Q A. Approval Plans resubmitted Grading IN ROUSE:- Review,.ready for correctionsPissue Developer Impact Fee Planning.Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees