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06-3353 (BLCK)P.O. BOX 1504 4 4.Q" 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: :0 -2.0.0033.53 Property Address: 44830 CALLE SANTA BARBARA APN: 604-3917006-6 -25953 - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: '1083 Applicant: C io Architect or Engineer: Owner: KRT.T.Y BRENDAN CALLE SANTA BARBARA INTA, CA 92253 :tor: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/18/06 LICENSED CONTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9,(6ommencing with _ I hereby affirm under penalty of perjury one`of.the following declarations: Secti6n,7000) of.Division S of the Busine.ss.and Professionals Code, 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: - License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is ' issued. Date: Contractor:� 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.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 - Policy Numb 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 -t a wo fo hich 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•inany manners ' o be o_ a ub' to the workers' 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 ul beco b at the workers' compensation provisions of Section Li cense.Law'(Chapter9 (commencing with Section 70001-of.Division .3 of the Business and Professions,Code) or . 700 of the Labor Code I h it omply with those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by _ 'y pplicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars�($500).: -I, Date: f - �,6 Ar pplican 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,'Businessand-Professions Code:. The WARNING: FAILURE TO SECURE ERS' COMPENSATIO COVERAGE IS`UNLAWFUL, AND SHALL Contractors' State License Law does.not apply.to an owner of property who -builds or;improyes-thereon,, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI FINES UP TO ONE HUNDRED -THOUSAND and who does thework himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COM ENSATION, DAMAGES AS PROVIDED FOR IN 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 ATT NEY'S FEES. one year 'ofcompletion, the owner-bu(der will have the burden of proving that he or she did not build or ' improve for the -purpose of sale.). - APPLICANT AC OWLEDGEMENT. 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 B Iding and Safety,for a,permit subject to the 7044, Business and Professions Code: The Contractors' State Licens Law does not apply to an owner of ,,conditions and restrictions set forth on this'applicaticn: ' property who builds or,improves thereon, and who contracts fortne p ojects 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 _ 1 1 am exempt under Sec. , B.&P.C. r this reason / the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City - J - of La Quinta, its officers, agents and employees for any act or omission related to the work being Da- performed under or following issuance of this permit. te:r,tOw tENDING 2. Any permit issued as a result of this application becomes null and void f work is not commenced within 180 days from date of issuance of such -permit, or sa n f work for 180 days will subject `!J CONSTRUCTION AGENC permit to cancellation. I hereby affirm. under penalty of perjury that there is a construction lending agency or the performance of the I certify that I have read this application and state that the ve in r at is orrect. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). - city an un ordinances and state laws relating to buil g con u� tion a h eby authorize representatives ' Lender's Name: I of tl c nt to en r upon the above-mentioned prop a do ur �� - . `Date:' —/ �D ignature'(Applicant or Agent): Lender's Address: r LQPERMIT Application Number . . . . . 06-00003353 Permit . . . . . . .WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 27.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1083 Expiration Date . 3/17/07 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 2.0000 HND BLDG 501-2,000 12.00 ---------------------------------------------------------------------------- Special Notes and Comments 50.LF 5' BLOCK WALL TO CREATE FRONT COURTYARD. CITY STANDARD. Fee summary Charged =--------- Paid Credited Due --------------------------- Permit Fee Total 27.00 ---------- .00 ---------- .00 27.00 Plan Check Total .00 .00 .00 .00 Grand Total 27.00 .00 .00 27.00 1 LQPERMTT Bin # :. City of La in6 Building U Safety Division P.O: Box 1'504,''78-495.Calle'Tampico Quints; .CA 92253 - (760);7,77- .2 701 B401ding Permit Appllcatlon; d Tracking Sheet Permit # JLa ProjectAddress: j'�'C) C4LLF.-C(}N.' a n - L Owner's l Name: ��EniUA� I l'(EI c A. P. Number: Address: L(L( D C/1 [% SRN 7* 714�gA-1?1-�— Legal Description: City, ST,Zip:. LA it wq?l — �j''LZ•j�� Contractor: Telephone: �' .rg s 19 Address: Project Description: f j7e t7 -V,)4 L G � .City, ST, Zip: s V SO Fr- x S # Telephone: $ City Lic: #: t State Lic: # : " C Arch., Engr., Designer: Address: City, ST, Zip: Telephone:. A ; Constiuction Type: Occupancy: State Lic. #:Prgj Name of Contact Person: fat*,(circle on New Add'n .Alter .Repair Demo . ' Sq: Ft.: ` "*'Stories:' #Units: Telephone # of Contact,Person: Estimated Value of Project:: ,APPLICANT: DO,NOT'WRITE BELOW THIS'LINE .. x # Submittal Req'd.:• Rec'd TRACKING PERMIT FEES Plan Sets .Plan Checksubmitted Item Amount Structural Calcs. Reviewed;• ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person' plan Check Balance Energy Calcs. Plan's picked up Construction Flood plain plan Plans resubmitted Mechanical. Grading plan Review, ready for corrections/issue Electrical Subcontactor List Call d'Contact Person Plumbing Grant Deed Plans picked.up. S.M.i': H.O.A. Approval. .. Plans resubmitted . r Grading , IN HOUSE: -,Review; ready for corrections/issue Developer,Impact Fee. Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr Pate of permit issue School Fees _. . .... '.Total Permit Fees' .. ... C3 I ,- 1 x i3 n I I � C3 I ,-