05-3622 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-00003622
Property Address:
78570 SAGUARO
APN:
646 -312 -044 -
Application description:
WALL/FENCE
Property Zoning:
MEDIUM DENSITY
Application valuation:
1147
Applicant:
T ilit 4 XP- Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
DR
RES
Architect or Engineer:
.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
1 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 an,P�ofessions Code: Any city or county that requires a permit to
constr''uct,alter,_improve, demolish, or. repair any structure,, prior to its issuance, also requires the applicant for the
permit to file a signed statement that;heor she is licensed pursuant to the provisions ofthe Contractor's State
License Law (Chapter 9 (commencing. with Section 7000) of Division 3 of the Businessland 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).:
I Y 1, as owner of theproperty/or my employees with wages.as their sole compensation, 'will do the work, and
the structure isnot 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 ovoffered 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 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 I am exempt under Sec. , B.&K.C. for this reason
CONSTRUCTIONLENDING 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/07/05
Owner:
CROSS DONALD
78570.SAGUARO DR
LA QUINTA, CA 92253
Contractor:
Owner
kct1'n(y"GF-J_A'QU1MTA iul
2005
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
forby.Section3700 of the Labor Code, for the performance of the work for which this permit is
issued. a '
I have and. will, maintain workers! compensation insurance, as required by Section 3700 of.the Labor
Co,de, forthe'performance of the work. for which this permit is issued. My workers' compensation
insurancecarrier and policy number are:
Carrier -;. Policy Number
II certify that, in the performance ofthe 'work for which this permit is.issued,.l shall not employ any
person in any manner so es to become subject to the workers' compensation laws of California,
and agree that; if I shoull'become subject to the workers' compensation provisions of Section
3700 of the Labor Cod¢ I shall forthwith comoty with those provisions.
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 uponwhose 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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to build
opin construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property f r inspection purposes
G!✓�'�
i
RDate // /,S'OJTsignature-(Applicant or Agentl: r
LQPERMIT
Application Number . . . . . 05-00003622
Permit . . . WALL/FENCE PERMIT INV FEE
Additional desc .
.
Permit .Fee 58.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . . .
1147
Expiration Date 5/06/06
Qty Unit Charge Per
Extension
BASE FEE
30.00
7.00 4.0000 HND BLDG 501-2,000
28.00
• -------------------------------------------------- --------------------------
Special Notes and Comments
53 L.F.,.5' HIGH WOOD=FRAMED,•.PLASTERED
WALL. AT SOUTH ,AND WEST PROPERTY. LINES•,
PER APPROVED ENGINEERED DESIGN.
INVESTIGATION FEE ASSESSED PER 1997
UNIFORM ADMINISTRATIVE -.CODE §304.5 FOR
WORK BEGUN WITHOUT BUILDING PERMIT.
Fee summary Charged Paid Credited.
-----------------
Due
------------------------------
,. Permit Pee Total 58.00 00
----------
.00
58.00
,'.Plan Check Total .00 .00
.00
.00
Grand Total 58.00 .00
.00
58.00
LQPERMIT
'3 01� ` w .;"',
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 yourwork 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 various 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. ormore for the entire project, and such persons are not licensed as contractors or
subcontractors, tlien 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 include.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'Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accident's.
If the structure is intended for sale, property owners who are not licensed• contracts 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 bycontacting�-the=Coritractors''-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 untilthe -verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (769M7-7011
7,7
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OWNER'S SIGNATURE/DATE".
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PROPERTY ADDRESS
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OCT 2 C 2005 I D
October 22, 2005
Greg Butler
Building and Safety Manager
PO Box 1504
La Quinta, CA 92247-1504
RE: Plastered wall — Cross Residence, 78570 Saguaro Drive.
Dear Mr. Butler
In response to our conversation and the request of your letter, of.October..19, 2005, I. trust
this submittal .wilf meet your -requirements.
Your Item 2 requesting linear footage of thewalls.is shown on the submitted plans in
detail.
My site investigation consisted of measuring arid documenting'existing conditions with
the help of photographs of some, of.the construction. Minor, destructive investigation was
performed to verify depth of concrete at various ' locations.. The size of Structural Posts,
and general wall construction were visually estimated and -are easily verifiable by an on
site inspection by your Department.
I am happy to respond with hopes that this will finalize this project.
Cordially,
.V�. Robert S. c
Robert S. Alcumbrac, Architect C-1'0381. ff/ Alcumbrac
No. C-10 8' 1
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Permit #
P.O. Box 1504, 78-495 Calle Tampico p
La Quinta, CA r/c,
92253 - (760) 777-7012
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