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07-0003 (BLCK)T4hf 4 P:O. BOX 1504 r VOICE (760) 777-7012• 78-495 CALLE TAMPICO .FAX (760)'777-7011: LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT p INSPECTIONS (760).777-7153 • - ' ` 'BUILDING PERMIT i � Date: 1/02/07 Application Number: 7-00000003 Owner: = _ ' 'Property Address: 48751 -SAN DIMAS ST' -, «" JEAN'STEPHENSON , a.� �APN: 646-130-002- -_- . - t. '48751 SAN DIMAS STREET ' Application description: WALL/FENCE_ -- -LA QUINTA, CA 92253 _ Property Zoning: LOW DENSITY RESIDENTIAL D e c Application valuation: 2875. . • i r , Contractor: JAN C 2 �OOI �•` _ Applicant: Architect orrEngineer: KIRK CONSTRUCTION INC, MIKE S 72677B EAVERTAC�OF� D - PALM DESERT, cAL ET - 92260 FINANCff (760)346.1820• _ •�*` Lic. No. 521890 S LICENSED CONTRACTOR'S DECLARATION `4? - ' - ' WORKER'S COMPENSATION DECLARATION _ • I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professionals C'giK, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided License Class: B - L' ns o.: 5 890 rr for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - issued. �. ate: '�•�mractor: t 0� 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' O NER-BUILDER DECLARATION insurance carrier and policy number are: .' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the - Carrier STATE FUND Policy Number 1090480-2006 following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires 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, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject t/thewo kers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should me subject to thco ensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or .- 3700 of the Labor Co h rth compprovisions. 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).: te:EA e7 pplic 1 - (_ 1 1, 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 WARNING: FAILURE TO SECURE WORKERS' COMPEp ATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the -work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN X improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT 1 _ ) I, as owner of the property, am exclusively contracting with licensed contractors.to construct the 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 contractors) 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. Date: Owner: 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 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 an .state laws relating to buil di ruction, and hereby a fSo ' representatives _ - of this "unty to enter upo a above-mentioned pro y fcti poses. Lender's Name: r�ff ��ff gnature (Applicant Lender's Address: or ent) 1 LQPERMIT Application Number . . . . . 07-00000003 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2875 Expiration Date 7/01/07 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 115 L.F. VARYING HGT. WALLS, MAX. 6 - CITY STANDARD 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 LQPERMIT Bill # City of LaQ uinta Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet - Permit # Project Address: g 7T/. f'(��v V riWS Owner's Name: A. P. Number: Address: Legal Description: Contractor: K/40 C'G j City, ST, Zip: Telephone: Address: f0 -'% �4 j4(/TA 4/— 57 Project Description: City, ST, Zip: /,C / Telephone: State Lic. # : ^ �/ City Lic. #: G+ f4 -147y— /' 7—{ J Arch., Engr., Designer: C S Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New. Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for; I rections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2" Review, ready for correctionsfissue 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