05-5051 (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=00005051
46405 CAMEO PALMS DR
643-181-018-16 -2043
WALL/FENCE
LOW DENSITY RESIDENTIAL
1467
c&t!t 4 4 4"
Architect or Engineer:
ars
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ROWLES GEORGIA
Contractor:
DAVIDSON CONSTRUCTION
53875 AVENIDA MADERO
LA QUINTA, CA 92253
(760)910-3627
Lic. No.: 499742
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/16/05
------------------------------------------------------------------------------------
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 Busines d Profes ' ode, y License is in full force and effect.
License Class: H Lice se 499742
/// 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 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 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.).
1 _ 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
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 EXEMPT Policy Number EXEMPT
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 theltwkers' compensation laws of California,
and agree that, if I shou come subject a workers compensation provisions of Section
37000 of the Lab C e, I all fo tom ly with ose provisions.
ate: I' V�J pplicarit:
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 ($100,000). 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 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 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 ab information is torr t. I agree to comply with all
city and county ordinances and state laws relating to bui g structi y authorize representatives
of this c unt%y to enter upon the a -mentioned prop tty fo spe n urpo es.
att v ' ature (Applicant or Agent)
LQPERMIT
Application Number . . . . . 05-00005051
Permit . . . WALL/FENCE
PERMIT
Additional desc
Permit Fee . . . . 35.00
Plan Check
Fee
_
.00
Issue Date . . . .
Valuation
. . .
. 1467
Expiration Date 5/15/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
10.00 2.0000 HND BLDG
501-2,000
20.00
-------------------------------------------=--------------------------------
Special Notes and Comments
50 L.F. 6' GARDEN -WALL, 10 L.F.
5'
GARDEN WALL, BOTH CITY STANDARD
Fee summary Charged
-----------------
Paid Credited
Due
--------------------
Permit Fee Total 35.00
----------
.00
----------
.00
35.00
Plan Check Total .00
.00
.00
.00
Grand Total 35.00
.00
.00"
35.00
LQPERMIT
i
.L
Bin #
City of La Quinta
Building at Safety Division
P.O. Box 15041 78-495 Calle Tampico
La Quinta; CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: LtoS
Owner's Name: Rd s er
A. P. Number:
Address: PALU./S
Legal Description:
Contractor: 5Q 1 C< DA01 OSO/
City, ST, Zip: L,o, Qkj\kj,�k �a 3
Telephone:
Address: j 3 —'c6– 7 S -UL; AJ 10A �(A*0 �
Project Description:
, 1
City, ST, Zip: vl k/l,6, CA
�:k
Telephone: 3(;P,,)-
Coa.State
StateLic. # :
City Lic. #:
i
10
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
'Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: 67Z (C K
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 10 - 3 6;- %
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
2°d Review, ready for corrections/issue
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
Total Permit Fees
F .GK A�ucb�titi i,t�- �3=1G�7Yd.
R
�3-��s���� v�� PROPOSAL
LAI (4,20-1A � G'i 2- S- 3 Page No.
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11.�of -� Pages
PROPOSAL SUBMITTED TO:.
PHONE
AT
NAME `
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JOB NAME
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STREET
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CITY
CITY
STATE
STATE
We herebyv3d;q,
ecifications and estimate for:
%v Ct��$�2cicrl p (� `�QtoCC /,.•L -7A-t(-i42buAro /saG/c y.�-rim
OF F ?l+�Qcs3i�v�rcx�,. i 1W �-A-� e a ICC a� PeAs • 'Mc 6 � - ��r 0+ S o c� �J P A -7c -k.
1tit.G�
TO 104-- L 146 t A -C IC7 Gtr (,✓ 4 (` � ,79!. *To env C-6 C A —0 A el3 Q 6
A. -D O/YcA cn b(27 . IN&L'Ub&-sb E'Y-4A4 ��i 7 j e,lZy Dr- J►A QVJ-4-4A , AIICGO-9045 HA -'V
A&ac-� -te P A7 6'a -c. of ?� Awl i..wR-CA- Cx..'s? . (SCIC t1-D0JJT Nn C0 &J14 k<.-'tS 1-70
IC PG -J Q pA-Iio s L,*eG .A-7 DIA -/JA -R,- ru:0V-1, Oco 2 w 6->o/S--7-"4L
PAc?/� GA -r& Apptmx. Ia'X X4' /NG�u/Jv� L�a,z �- R�s�r �Q (AA ,��ff ;sem,
1�L50 A 5�l"rJ R- l 4,000oo-A-f— 10Aa4IV;4 16/�� A'1 p21vc�Ay &r/-'0.
A+�lv�+•l�
76 /A67/; -(L AAWZt+a-� SZLn<� Cza-Lq /1�0 A3SArG 6z
We hereby propose to furnish labor and materials - complete in acco&ance with the above specifications, for the sum of
0
��UC►�L�F,r.1 �tc�jP.�D Ok6 00'-t)"D 5eve dollars ($ C7 1-70 r ) with payment to be made as follows:
6oQLc6V a&v-o t�io7ArCDcl6 47 �/o (C� .
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practice. Any alteration or deviation
from above specifications involving extra costs, will be executed only upon written orders, and will become an. extra charge over and above the estimate. Al
agreements contingent upon strikes, accident or delays beyond our control. This proposal subject to acceptance within days and is void
thereafter at the option of the undersigned.
Authorized Signature
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as
outlined above.
ACCEPTED: �
Signatdre &&,h Z==
DATE _6 S Signature
(e) F-7 r.nnfmrtnrc Fnrms FORM NO F7 110-1 eaen