06-3261 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/07/06
Application Number:061-0'0'0'03261 Owner:
Property Address: C78677�SAGUARO DRQ KRIBBS BRUCE
APN: 646-313-0'17-117 -000000- 78-677 SAGUARO DR.
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: MEDIUM"DENSITY 'RES. ---------------------------------
Application •valuation: 541 f<,
Contractor:
Applicant: "Architect or Engineers Owner
---------------------------------
-. — — - o11- — — CONTRACTOR'S D CLARATIO� — — — — — —• — _ — — — — — — — _ — — — _ — — — — — — —
e 4 WORKER'S COMPENSATIOWDECLARATION .
I hereby affirm under penalty•of-perjury that I am licensed underprovision of, apter'9.(commencing with I hereby affirm under penalty of: one of the following d clarations:
Section"70001 of. Division 3 of the Business and Professionals Code,:and y.Li nse.is irrfull f- eand'effecRt• " _ I have and will maintain a certificate of consent to self -insure for workers' compensation, asproGided
License Class: Licensfor by Section 3700 of the Labor Code, for the performance of the',workfor which this permit is
issued.:
Date:Contractor: - a — 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
' - OWNER -BUILDER OECLA I N Q. insurance carrier and policy number are:
.�� I hereby affiim,under penalty,of:perjury that I am' exempt from �the 'Contra ,� State Licen Law fors Carrier ` i Policy Number '
following reason (Sec: 7031.5, Business and Professions Code '^Any city' a regwres a permit to - I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter; improve demolish, orrepaii any structure prior to its issuance, also requires•the applicant for the person in any manner so as to become subject to the workers' compensation laws of:California,
permit.to file a signed.staterient�thathecorshe is.licensed,:pursuant to the.provisions'of'the Contractor's State and agree that, if l should become ubject to the workers'. compensation provisions of Section
License:Law'(Chapter 9 (commencing witti.Section 7000) of Division'3 of the ' usiness and Professions•Code) or 3700 of the•Labor Code, I shall forthwith comply with those provisions. - -
that he•or she Js exempt therefrom and the basis for the alleged'exemption.'Any ion -of Section 7031.5 by _
any applicant:for a per`r6i sublecis.the applicant to a.ciSil penalty of;nof,more than five hundred dollars5500).
1: Date 4 �2'� pylic
(_) I, as owner of the property; or my employees with wages,as their sole' compensation, -.will do the work, and - ', . • ,
the structure is not intend4:6i offered for sale (Sec. 7044, Business:and Professions Code: 'The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION -COVERAGE IS UNLAWFUL, AND SHALL
Contractors', State License".Law does not applyao an owner -of property wRo builds or improves theieon, _ SUBJECT.AN EMPLOYER.TO CRIMINAL PENALTIES AND CIVIL -FINES UP TO, ONE HUNDRED THOUSAND
and who does the woik himself or herseli thiough his or her own employees, provided—that—the DOLLARS ($,100;000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended. or offered'forsale: If, however, the'ouilding or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
one year of completion, the owner -builder will hive the buiden of proving that fie or she did not build or
improve for the purpose of sale.). - - APPLICANT ACKNOWLEDGEMENT
(_ 1
1, as owner of the property, am ezclusively'contracting with licensed contractors to construct•ttie project (Sec. IMPORTANT Application is,hereby made to the Director of Building and Safety for a permit subject to the
7044,'Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set.forth on this application. :
property who builds or improves thereon,, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
1 _ ) I am exempt under Sec. B.&P,C, for this reason 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.
ate: ,,
Owner:2. Any peimit 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 .
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives
• of this c unty to enter upon the above-mentioned property for inspection rposes.
Lender's Name: ��,.,/�
ate: -V ignat/5 use (Applicant or Agent):
Lender's Address:
1
LQPERA1IT
a
LQPEnlIT
Application Number . . . . . 06-00003261
Permit . . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 17.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 541
Expiration Date 3/06/07
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 2.0000 HND BLDG 501-2,000 2.00
-----.--- -------------------------------- ----- ---
------------------------ Special Notes and .Comments
5 BLOCK'COLUMS 6' HIGH WITH 6' i#IGH
' WOOD FENCE -BETWEEN COLUMS PER PLANS
Fee,•sumMary Charged' Paid•. Credited Due
Permit.. Fee Total 17.00 . 00 00 1-7 .`00
PlAn.Check Total .00 .00 .00 ..00
Grand Total 17•.00 00 .00.. 17:00
OWNER/BUILDER: NF0RMAT101'4
Dear Property Owner:
An application for,a building permit has been submitted irryour 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'pfoperty owners unless. they are personally performing their
own work. If your work is being perform6d by someone -!.8th6r thiii: yobis'elf, 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 requited by law.to 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 engagd' ariy persons 'other than y9urJm mediate family, and the work (including materials
and other costs) is $200.00 or*, more for the entire project, and such persons, are not licensed as contractors or
subcontractors, thenybu may be an employer.
If you are an, employer, you must register with the State. and Federal-Goverinment'as an employer and you are subject
to several obligations include State.and Federal incom'ei':tax withholdipg, federal social security taxes, worker's
compensation ihsurance�,disAbility, insurance costs arid., unemployment compensation contributions.
There maybe financial risks for you ify'ou-do not carry out these obligations, and these risks:aie especially serious with
respect to worker's compensation insurance.
For more specific information abput.your obligati6fis-uridei,Fedetal',,Law, contact the"'InternaLRevenue Service (and, if
you wish, the U.S. Sm'al'I'Business Adi I nini . str I aiion):* For' more
specific
information abo6t you i obligations under State
e l
Law, contact the Department 6UBenefit'P��y6' Payments and Industrial Accidents*.
If the structure is -intended for., sale, propero- owners ww
ho"ar5 not licensed �htraccts, are allowed to- perform their
work personally or through thein,own.emp . loyees, without a,licensed�cotitractor'c'su'bcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors i$ to. secure- an "Owner/Builder" building
permit, I erroneously ;implying that theabo"
property owner is. providing - hi is or tier own I r. and material personally.
Building• permits are 'not required to be I signed by projpe;rft�,owners unless they are performing their own work
personally.
Information about licensed contractors maybe obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street§5
," Sacramento, California 5814.
Please complete and return the enclosed owner-buildeir verification fdrm 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
(760) 777-7012
FAX: (760) 777-7011
OWNER'S SIGNATURE/DATE
:1796-7
PROPERTY ADDRESS
06- 3a61
PERMIT NUMBER(S)
J
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,C -Oft Quhita
Buildin'g U Safety Division
P.O. Box 1504,78-495 CalkTanipico
La iQuinta, CA 92253 - (766) 77.7-7012
Building Permit. Application and Tracking
Permit #
Project Address::/ -WG 7 7 5iq&v/-VZ3 /20.
Owner's Name:
A. P. Number:
Address: .7
Legal Description:
City, ST, Zip:..
Contractor:
Telephone..
Address:
Project Descriptio4) 03
City, ST, Zip:
Telephone:
City Lic.
L4 AF-e—
State Lic. #
7u^)
Arch., Engr-, Designer:
7
Address:
43 LF "v.J &I
City, ST, Zip:
Telephone:
ConstructioType: Occupancy:
State Lic. #:'
Yl Project(circle one)' (Ee3i-_ A'dd'n..—.Alter R76 pair.
Sq. Ft.: # Stories: # Units:
Demo
Name of Contact Person:
Telephone # of Contac - t Person: %>I 63-, -v.>
rEgimite d .* Valu I e iif;Prqject:
N.V
APPLICANT: DO NOT -WRIT#,i-'0EL0 W TH I S I i LI N E
#
Submittal
Req'd
Rec.'A
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan ChcckrI3alance
Energy Calcs.
Plans iiicked'u p
1
Construction 4
Flood plain plan
Plans rcsubrhiltted
Mechanical
Grading.plan
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ATI
'
Na I
�:d Ri:viei ec,ibnsrissue
. y;,rq . �,fdr�,corr
Electrical
Subcontactor List
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6.W
6.W
10 160* 3� 'i IV %"' "I
IC�ntaq Mhj,,�Persons
—
Plumbing
Grant Deed
V
—4 ked
a 0 n s. p -14,u
S.M.I.
H.O.A. Approval
o ITO U L
Wei f*^
IP*65"Msor 'es u b . i t te d
Grading
IN HOUSE:-
3rd Review, iready"for correAonsfissuc
Developer Impact Fee
Planning Approval-
Calle&con'
tact-PeIrson—r
A.I.P.P.
Pub. Wks. Appr
Date of permit.iisue
School Fees
•
Total Permit Fees
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nIRV-
ICq•;sa�.a��� ��i'6'��
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." i or-
Bin #
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City of La Quinta
Building g Safety Division
P.O. Box.1-504, 78-495 Calle.Tampico
La Quinta,•CA 92253 - (760) 777-7012
Building Perin it'Ap'plicad ' .and Tracking Sheet
Permitfl
Project Address:' -7,t?4.,'7 S,r}-(, ,�q,,�,� �`
Owner's Name:. -2-36-_ /<�Z,,Sar
A. P. Number:
Address:? d; 6,77 554 C- -A7f- 44—
4 -Legal
LegalDescription:
City, ST, Zip: 41,a
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
Telephone:
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City Lic. #: Z S
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S"
StateLic. #:
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Arch., Engr., Designer:
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Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person: I..• - - �.�� f,
. Construction Type: ; Occupancy:
Project type (circle one): New , Add'n Alter Repair Demo
Sq: Ft.: # Stories: #Units:
Telephone # of Contact Person:
,Estimated:Value of Project: POP
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 Cates.
Called Contact.Person'.
Plan Check Balance
Energy Calcs.
`Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical•..
Grading, plan
2"d Review, ready, forcorrectionsrssue .
l Electrica.
_a
Subcontactor. List
Called Contact P,ersoW,'
Plumbing
Grant Deed
Plans picked up,'
S.M.I.
H.O.A. Approval '
Plans resubmitted:..-',
Grading
IN HOUSE:-
'`" Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue' _y
School Fees
Total Permit Fees
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