06-3293 (BLCK)Qum&
P.O. BOX 1504 VOICE (760) 777=7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/08/06
Application Number: 06-000032'93 - Owner:
?roperty Address: 78-5-6'3 PEERLESS PL DICK HANNAH
APN:'` 770-250-002- - - 78563 PEERLESS PLA
Application description: WALL/FENCE LA QUINTA, CA 922 Q
Property Zoning: LOW -DENSITY RESIDENTIAL.
Application valuation: 400 „�.
• .�� � ......,, .. /
ContracOST1 9 tor: 1006
Applicant: — Architect or Engineer.'` RAWLINGS CUSTOM CONT R i NIS
5000'E...CALLE S PH, OFt:7A
(760)322'-8788 PALM:SPRINGS, CA 9226 C_ �i A
(760)322'-8788
Lic. No.: 746930
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ENSED' RACTOR S,DE A ION - - - .WORKER'S COMPENSATIOWDECLARATION"
I hereby, affirm under penalty of perjury t , t I amli d under�pr� sof Chapter 9 -(commencing with .1. hereby affirm under penalty of perjury one of the following declarations: '
Section 70001 of.DiSision $ of the Susi ess an, ssionals' ej d my'�License.is in full force and effect. - -- 1 have and will maintain a certificate of consent to,self-insure for workers' compensation, as provided
`
License Clas B o.: 746.930 n ' for by Section 3700 of the Labor Code, forthe.performance'of the;work focwhich'-this permit is
z _ Q`� .� +` -- issued. _ .
t` Date •Contractor. w I have and will maintain workers' compensation insurance,'as required by Section 3700,ofthe Labor,
Code, for the performance of the work for which this permit is issued. My workers' compensation '
~ `
OWNER -BUILDER DECLARATION,
insurance carriei and policy nu er re: -
I'hereby•affirm under penalty of ,perjury that I am exempt from the, Contractor's. State License Law for the Carrier CALIFORNIA INS - Po cy Number 46 046860102 '
-following reason (Sec. 7031 .5, Business and Professions, Code: Any city or county that requires a permit to _ I certify that, in the performan of a work for hich is permit is issued, I shall not. employ any -
construct, alter, improve, demolish; or. repair any. structure,: prior to its issuance,.also requires the applicant for the - -person, in any manner so_ s to ome sub' t to th workers: compensation laws of California,'
permit.i'.o fasigned statement that he or she is licensed pursuant to the provisions of the Contractor's' State and agree that, if I sho d -b e,s to thew rzs' compensation provisions of Section
License Law.IChapteri9'Icommen6ng with Section 7000) of Division 3 of the Business and Professions Code) or 700. of the do IF h " comply ith those provisions:' '
that,he or she is exempt therefrom and the basisfoi the'alleged exemption. Any violation of Section'7031.5 by
. anyapplicant fora,mi
pert subjects the.applicant to A civil penalty of.not more than five hundred'dollars ($500).:
• 1 I I, as ownerof_the-property,or my employees with wages as their sole compensation, will do;the work, and
the structure is not intended or•offered for sale:(Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
andwho does the work himself. or heirself through his or her own•employees,-provtded that the
improvements are hotvintended or offered for sale. If, -however, the buildingor improvement is'sold within .
one ,year of completion, the owner -builder will have the burden of proving tliat,he or.she did.not build or
improve for the purpose ofsale.). •� - '
(_ 1 1, as owner. of -the prop any :am exclusively contracting"- with licensed contractors to construct the project (Sec.
7044, Business an&Professions Code: The Contractors' State,License Law does not appINFto ori owner of
property who builds or'improves thereon, and who contracts for the projects with a contractor(sl licensed
pursuant to the Contractors' State License Law.): • '
(_ 1 I am exempt under Sec. , B'.&P.C. for this reason
Date:. Owner:
CONSTRUCTION LENDING AGENCY '
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: '
Lender's Address:
LQPERMIT
' WARNING:'FA URE T.O.SECUREWORKER51COMPENSA ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN>EMPLOYER TO CRIMINAL PENALTIES.A 4 CIVIL FINES UP TO ONE HUNDRED THOUSAND '
DOLLARS.($ 160,000).- IN ADDITION.TO.THECOST O COMPENSATION, DAMAGES:'AS PROVIDED FOR IN -
SECTION 3706 OF TH&LABOR CODE; INTEREST, AND ATTORNEY'S FEES. ` .r
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 defendnify and hold harmless the City
of La Quinta, its officers, agents and employees for any a orris' on related to the work being
performed under or following issuance of this.permit.
2. Any permit issued as a result of this application beco s null oid if work is not commenced
within 180 days from date of issuance of such pe it, or c tion of work for 180 da will subject
permit to cancellation. '
certify that•I have read this application and statethat the ove inf ation is correct. I afire o c ply with all
city and unty ordinances and state laws relating to buil and hereb ize re esentatives
of thi n(c/o/�Qtty/fo enter upon the bove-menti
Sign re (Applicant or Agent):
Application Number . . . . . 06-00003293
Permit . . . WALL/FENCE PERMIT
Additional desc
Permit. Fee . . . . 15.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . 400
Expiration Date 3/07/07
Qty Unit Charge Per Extension
BASE • FEE 15.00
Special Notes and Comments,..
16 "L: F.' 6`'' GARDEN WALL•. TO MATCH
EXISTING:yWALL; CITY STANDARD
Fee summaryCharged Paid Credited Due
Permit Fee Total• .15". 00 .00 ..QO 15.00
Plan;Check Total .00 .00 .0.0 .00
Grande Total 15.00 .00 .00 15.:'00.
LQPERMIT - '
Sep 08 06 01:07p Patrick Rawlings 760-322-8755 p.1
a.
Bin #
City •Of • Ld Quinta. .
Rw mg. 8t Safety Divl'don
P.O. B.oic 1504, 78-495 Calle T'ampIco
La QWnra, (A 92253 = (760),777-7012
Building Perfm'ApMib' o' n and hacking Sheet
permlc #
2%� 3
3
Project Address: -7 - ,P -le ��
0%iier'sNmnc:
A. P. Number: -7- 70. �`� ti-�. Di,2_
Address: ZLJ F, rL t✓-
Legal.Description:
Contractor: S
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Sc hone: V,<:->.±. • u;�':��
Address: s"Oi�ri �'LLf - S�I✓ /�1, =
'Project Description:. r� i,l,
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City, ST, Zip: •�o fi ! S iii CL1, %Z gra
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WALL�D t�,/,�/,- < —7
1,16
'Tele hone f7 7
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ass.•' z.:SYr>Y.•i% . ��4`?✓c.�.:";
City Lid #:ll'�D"7';"'
Stale Lic. # ta. �.:� C?
Arch., Engr., Designer. ?44 /• 0,
Address
City., ST, Zip: Aw <
a
.�.•Mr ,.xz...
Telephone: E :
State Lie. # a*�S
Name of Contact Person: f/ :
r Y .C/L�i S'
Construction -Type- Occupan -
Projecitype (circle one): New. Add'n Alter Repair Demo
S Ft:
4
#, Stories:
# Units:
Telephone # of Contact Person: t` b" �� Z�- % `���
FAtiinated Val ue,of Project:
APPLICANT: DO NOT WF TE 6130W THIS UNIE
#
Submittal
Req'd'
Recd
TRAdm.G
PERMIT FEES
Plan Sets
Plan &cck submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrtetioas
Plan Check Deposit
Truss Cales.
Called CoatactPersoa
PiaviChcek Balance
Me 24 Calm
•
Plans picked up
Construction
Floodplain an
P [�
Plans resubmitted
•
'Mechanical
Grading plan
2"Review, ready for corrections/fssue
Electrical
Subcootactor List
Called Contact Person.
Plumbing .
Grant Deed
Plans picked up
S.M.I.
ILO.A. Approval
Plans resubmitted _
; Grading
TT
HOUSE: -3.4
Review, ready'for eorreetions/issue
Developer Impact free
Planning Approval,
Called"Contact Person
A.I.P.P.
Pub. Wks Appr
Date of permit issue
School Fees
Total Permit Fees