08-0514 (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:
=0.8-00000514----
,79255 RANCHO LA QUINTA DR'
649-370-030- - -
WALL/FENCE
.LOW DENSITY RESIDENTIAL -
4300
Architect or Engineer:
I
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
TD DESERT DEV LTD PART
79285 RANCHO LA QUINTA
LA QUINTA, CA 92253
-----------------------------
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: C29 License No.: 446180
Date: Contractor:
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 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, 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 notintended 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 tie or she did not build or.
improve for the purpose of sale.).
(_ 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
t2 exempt under Sec. B. P.C. for this reason
_Date: -7` ` ---Owner:-Owner:
C NSTRUC LENDING AGENCY
1 hereby. affirm under penalty of perjury that t uis 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:
LQPERA11T
Contractor:
'BARAJAS MASONRY, JOHN
42901 LIMA HALL ROAD
INDIO, CA 92201
(760)345-3912
Lic. No.: 446180
VOICE (760) 777-7012.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/28/08
------------------
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 ZENITH INS Policy Number Z069532601
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any m)WRS'
to become subject to the workers' compensation laws of California,
and gree that, icome subject to the o ers' compensation provisions of Section
�1J370 ,Votf��the labhall forthwith comply with those p visions.
_-Date: "�' Applicant ,
WARNING: FAILURE TO SECURCOMPENSATION COVERAGE IS UNLAWFUL, -AND SHALL
SUBJECT AN EMPLOYER TO CNALTIES 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 thisapplicationis 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 d state that the above in motion is correct. I agree to comply with all
city and c hty ordi ances nd state law relating to building con ru tion, and he by authorize representatives
of this u ty44to r u D the above -me a property for insp ction
—Date:__. Signature(Applica or gen
i
Application Number . . . . . 08-00000514
-Permit WALL/FENCE PERMIT
:.: Additional desc .
' Permit Fee 72.00
Plan Check
Fee
00
Issue Date:
Valuation
4300 .
Expiration Date 9/24/08
Qty. Unit Charge Per
Extension
BASE' FEE
45.00 "
•3..00 '. •, 9.0000 THOU 13LDG•2,001-25,000
27: 00,
Special Notes and Comments
------------
-----.--
--------------
-'172 LN FT X 6 HT GARDEN BLOCK WALL PER
CITY STANDARDS AND APPROVED PLANS
Fee summary Charged Paid
Credited
Due
Permit Fee Total. 72.00
.00
.00
72.00
Plan"Check Total' .00
.00
.00
.00
Grand Total 72.00
.00
.00
72.00
LQPERMIT -.
.
Permit Fees
Bin #
City of La Quinta
Building g Safety Division
Permit.#
P.O. Box 1504, 78-495 Calle Tampico
U Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:' 125 ?AALVb LA CQ4t4-&)>1t.
Owner's Name:
A. P. Number:
Legal Description:
Contractor: ► I �A A J AS MACOA R
Address. 'j'
r ��1� i
City, ST, Zip: [• Q t�1w�
/Q k_^ P
Telephone:.
Address: C-D/YlA ,v
Project Description:
City, ST, zip:tc� dA (�Q. rizo3
�) LI 4,t o�
�P�i�
t
.Telephone: "� S 3f2
State Lic. # - Cc I p
City Lic. #:
Arch., Engr., Designer:
'
8 � CA QciL+.\A 1A
Address:
City, ST, Zip:
Telephone: Construction Type: -Occupancy:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Ja __E�AR.A Z 4S Sq. Ft.: #Stories: #Units:
Telephone # of Contact Person: $ 9j /2 Estimated Value of Project::
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING .
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
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading, plan
2°" Review, ready for correctionsrissue
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 corrections/issue
Developer impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Permit Fees
.
SD 1•'1-'1 • :
tNy 1N 45.4
1 N\j 00 45. 54
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. performance o'er
¢" • N.Oo435�i"E professio nal 3
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