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05-0133 (BLCK)BUILDING & SAFETY DEPARTMENT P.O. Box 150.4 (760),777-7012 78-495 CA.LLE TAMPICO _ FAX (760) 777-7011 LA QUINTA, CALIFORNIA°92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number 0.5-000.00 Date 1/13/05 Property Address 78595 SAGUARO DR APN: 646-313-009- - - Application description. a' .` WALL/F.ENCE, Property Zoning MEDIUM DENSITY RES Application valuation . . . . _ 939. Owner Contractor CORONEL ENTERPRISES INC mCORONEL; CONSTRUCTION P O BOX 389 P.O. BOX 389 LA QUINTA, CA 92253_ LA;.QUINTA, CA 92247 (`760.) 56474604' WCC: STATE FUND WC: 1744'45305 01/01/06 CSLB: 634981 0.1/31/06 CCC: B-C13 -----------------=---------------------------------------------------------- JAN 13 2005 CITY OF W QUINTA FINANCE DEPT. P.O. BOX 1504 • ��IIG� Ir'f VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (76 0) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: Date: I -l3' Applicant: I 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 penury that I am licensed under provisionk of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals e, and my Lice in in full force and ect. 3�� icense Class F 5 C� � e No. 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 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 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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. , BA P.C. for this reason Date Owner WORKERS' 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 mer ��issued. My woompensation ' rance cameurs are: : \ L y Number �r O _ I certify that, in the performance of the work for which this emit is '! sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t at, if Is ould becgfne subject to the workers' compensation provisions of Section 3700 of the tabor Code, I shall forthwith comply with tgft provisions. .Date �-05 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. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of pedury 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 nced within 160 days from date of issuance of such permit, or cessation of work for 180 days will subject permit cancellation. I certify that I have read this application and state that the ab v inform 'on is co . I agre to corn ly with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this co my o ente upon above -me toned • roperty for inspection purposes. ate k— Signature (Applicant or Agent). - - - - - - - - - - - - - - - - - - - - - - - - - f- - ------------------------------------- x�:`' ,pplication. Number :' '�ti" '05w0000-,0:13.3 Permit WALL/FENCE PERMIT Additional . desc. , . Permit Fee 25.0.0 Plan Check Fee .00 Issue Date Valuation . . . . 939 Qty Unit Charge Per,, Extension BASE FEE 15.00 5.00 .2..0000 HND BLDG 50'1-21000 10.00 ----------------------------------------------------- ------------------------- Special Notes and Comments '. 36 L.F. 5' GARDEN WALL, 10'`L.F. 4' GARDEN WALL, BOTH CITY STANDARD .Fee summary Charged Paid Credited ------------------ Due ----------------------------- Permit Fee•Total 25.00. .00 ---------- .00 25.00 Plan Check Total .00 .00 .00 .00 Grand Total -25.00 .0.0 .00 25.00