06-3688 (BLCK)rJr
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: C:06_0.0003688
Property Address:
80345 POMELO
APN:
772-250-020-186 -30357 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
12100
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING &SAFETY DEPARTMENT
BUILDING PERMIT
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 Nip.: 777699
`Dai l Contractor._�'LJ�KY'✓�
OR-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am 6mpt 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 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:
LQPERMIT
Owner:
TOLL CA V
C/O KEVIN D DUERMIT
8901 E MOUNTAIN VIEW 200 rrSCOTTSDALE, AZ 85258
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/17/06
Contractor. �U NOV 0 7 2006
TOLL BROS, INC.
14350 NORTH 87TH ST, STE #310
SCOTTSDALE'
CITY QF<p�
SCOTTSDALE' AZ 85260 ! FIMANCED_EPT
TA
(760)674-9699
Lic. No.: 777699
-----------------------------------------------
- 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.
1 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 ZURICH AMERICAN Policy Number WC38-7821301
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 su ject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall fort i[h comply with those provisions.
' -Date: ��Applicant:
WARNING: FAILURE TO SECURE WORKERS C MPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
.DOLLARS 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 37.06 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 186 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 constructio , and hereby authorize representatives
of this county to center upon the above-mentioned property for inspection urposes.
;Date: ��� Signature (Applicant or Agent):-
Application Number 06700003688
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 144.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 12100
Expiration Date 4/15/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
11.00 9.0000 THOU BLDG'2,001-25,000
99.00
----------------------------------------------
Special Notes and Comments
-----------------------------
484 LF 6' RETAINING WALL PER ORCO
STANDARD AT NEW TENNIS COURT PER
APPROVED PRECISE GRADING PLAN.
f
Fee summary. Charged Paid
Credited
Due
----------------- ---------- ----------
ft Permit Fee Total 144.00
----------
.00
----------
.00
144.00
Plan Check Total .00
.00
.00
.00
Grand Total 144.00
.00
.00
144.00
LQPERMIT
Bin f
City of La Quinta
Building u Safety Division
Permit ##
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760)'777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner's Name:
A. P. Number.
Address:
Legal Description:
City, ST, Zip:
Contractor:
-.
Telephone: NA
Address:
-W-1
Project Description:
City, ST, Zip:
Telephone:
n
State Lie. # :
City Lie. #
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lie. #:
Pro'ect
_ J type (circle one): New . Add'n Alter Repair Demo
Name of Contact Person:-F#
erson:A/ /
�G` Sq; FL: # Stories: #Units:
Telephone # of Contact Persoa '%Q) a'%$ =?0 o'Z— Est�ed Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd .
Rec'd
TRACE NG ..
PERMIT FEES
Plan Sets
Plan Chuck submitted
Item Amount
Structural Cates.
Reviewed,.ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Cheek Balance..
`
Energy .Calcs.
Plans kicked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading.plan•
2" Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing .
Grant Deed
Plans picked up
S M L
H.O.A. Approval
Plans resubmitted .
Grading
Developer Impact Fee: ;
A p P
IN IIOUSE:-
'a'Review; ready for correctionstissue
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
:....
...•: ,,, ....
..
.. .......:.......
, ..
otal Permit. Fees ; .:..:.
.