Loading...
04-7479 (BLCK)9 I BUILDING & SAFETY DEPARTMENT P.O. BOX 1504 (760).777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 Application Number . . Property Address . . . APN. Application description Property Zoning . . . . Application valuation . BUILDING PERMIT . . . 04-00007479 Date 11/29/04 . . . 44185 CARMEN PL 604-151-001-12 -23269 - . . . WALL/FENCE . . . LOW DENSITY RESIDENTIAL . . . 2273 Owner ------------------------ CULLEN JOHN C 44185 CARMEN PLACE LA QUINTA CA 92253 Contractor ------------------------ OWNER ---------------------------------------------------------------------------- Permit WALL/FENCE PERMIT Additional desc Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2273 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ---------------------------------------------------------------------------- Special Notes and Comments 105 LF 5' BLOCK WALL @ EXTERIOR SIDEYARD & REAR P/L PER ORCO DETAIL Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 .00 .00 54.00 �4 P.O. Box 1504�� VOICE (760) 777-7012 Td4f 78-495 CALLS TAMPICo FAX (760) 777-7011 ' LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Oq- Date: Z �7 _ Applicant: D LJ /v Architect or Engineer: Applicant's Mailing Address: Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 License No. Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 strucl:ure, 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 Contractors' 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 th$ applicant to a civil penalty of not more than five hundred dollars ($500).): 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 or 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.). U 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.). U I am exempt under Sec. , B: P.C. for this reason Date!�7 Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perju ne 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 Policy Number Ae 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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi 'ons. Date 2 Applicant WARNING: FAILURE TO SECURE WOR S' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH SAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, I TEREST, AND ATTORNEY'S FEES. 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.). Lenders Name Lenders Address 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 above inf ation is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county t nter u n the above-mentioned property for inspection purposes. Date / Signature (Applicant or Agent): a o`` F CITY OF LA QUINTA BUILDING & SAFETY DEPARTMENT FM OF rte° 777-7012 INSPECTION REQUEST LINE 777-7153G- " OwnerCULLENI JOHN C ContractorOWNER BUILDER Permit Number 04-7479 POST ON JOB INCONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 44185 CARMEN PLACE 105 LF 5' BLOCK WALL @ EXTERIOR SIDEYARD & REAR P/L PER ORCO DETAIL TYPE OF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING /WASTE U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CONCRETE UNTIL ABOVE SIGNED FRAMING COMBINATION ROUGH ELECTRIC oni it -u Di i inncinin COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR f i FOOTINGS / i2, BOND BEAM FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED G3/ a _GRAY PRECISION BLOCK MUST BE PAINTED OR _ COLOR -COATED PRIOR TO FINAL INSPECTION. m A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND JOB CARD ARE NOT ON THE SITE FOR A SCHEDULED INSPECTION. NO EXCEPTIONS! s ,rrorzo mow °fid SCF COP CITY OFLA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION I DATE. ►=BY d A RE -INSPECTION FEE OF $30 WILL BE CHARGED IF THE APPROVED PLANS AND JOB CARD ARE NOT ON THE SITE FOR A SCHEDULED INSPECTION. NO EXCEPTIONS! I 0 OWNER / BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County. They are also required by law' to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of variuus trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations including State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Starc Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760W7-7012 _ 'S SIGNATURE/DATE PROPERTY ADDRESS 61 q _7 7�:Z! PERMIT M TMBER(s)