10-1351 (BLCK)rf s
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
10-00001351
Property Address:
7888-0"SANITA DR
APN:
604-1'63-013-113 -23269 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2500
Applicant:
Architect or Engineer:
°f:FQ�w
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BOUDREAU:::NORMAN C
78880 SANITA DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) .777-7011
INSPECTIONS (760) 777-7153
Date:, 12/10/10
lJ,�`
Contractor: I
DESERT CONCEPTS CONSTR, IN,
77770 COUNTRY CLUB DR, STEI� 1 0 20fU
PALM -DESERT, CA 92211
(760)200-9007 G;T+�rfs
Lia'. No.: 849837 C•,��. s4it1 TA
LICENSED CONTRACTOR'S DECLARATION
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 ofthe following declarations:
Section of Division 3 of the Business 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
_7000)
License Class: C27, C8 C29 License No.: 849837.
for by Section 3700 of the Labor. Code, for theperformance -of .the work for which this permit is ,
Date ` tractor:
issued.
- I have and will maintain workers''compensation insurance: as required; by Section.3700 of the Labor
_ _
C"
Code, for the performance of. the work for whichthis'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 CALIFORNIA CONT. .. Policy Number 4563--"133
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;peimit is issued,.l 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 to the workers' compensation lawsof California,
permit to file assigned statement that he;or sheis license pursuant to the provisions of the Contractor's State
and agree that, if I•should.become subject.to;the workers' compensation provisions. of Section
License Law (Chapter. .9 (commencing with Section 7000) of Division 3 of the Business"a nd,Professions.Code) or
- 3700 of t e Labor Code, -I sh forthwith• .mply with those prodisions.-
-Date.
?that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of: Section 7631.5 by
any applicant for'apermit subjects the applicant to acivil penalty of not more than five hundred dollars ($500).:
'
d Applicant:
1 _ 1 I, asowner of the property; or my employees with wages as their sole compensation, will do the work, and
_
:,' • :•
'
the structure'is not intended or' offeredtor'sale',(S66: 7044, Business and Professions Code: The
WARNING: -FAILURE T SECURE WORKS S"COMPENSATION COVERAGE IS UNL_AWFUL,.AND SHALL•.
Contractor`s'. State License.Law does'notapply 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 herselfthrough_hs or her own employees, "provided that the -
DOLLARS ($100,0001;',. IN, ADDITION TO THE COST OFLOMPENSATION,DANIAGES AS'PROVIDED FOR IN
-i
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' FE ES.
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.l.- -
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 town 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 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 tnis'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 andhold 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 aresult 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.I.
city and county ordinances and state laws relating to building constructio , and hereby authorize representatives
county to enter up he above-mentioned proper r inspec ' t purposes.
Lender's Name:
/,
'
)/te..s
, ,,
l /1 04 gnature (Applicant or Agent).
-
Lender's Address:
/ ,
LQPERMIT
LQPERMIT
Application Number. . . . . . 10700001351
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00
Plan Check Fee
.00 .
Issue Date
Valuation
2500.
Expiration Date 6/08/11
Qty Unit Charge Per
Extension
BASE. FEE
45.00
1.00 9.0000 THOU BLDG 2,001=25,000
9.00
.
Speciale Notes' and., Comments
100 L.F-. 61 'GARDEN WALL, CITY -
ITY'STANDARD:-2
STANDARD ..-.200 7 '. CODE S
..
t.
----.----.---------_---------------------- -----------------.----- -
Other Fees . . . BLDG SIDS'ADMIN (.SB1473)
1.00
Feeysummary. Charged Paid
Credited
Due.
Permit Fee Total 54.00
00 .00
.54.00
Plan Check Total '06,.00
00
.0;0
Other Fee Total 1.00
.00, .00
1.00•
'Grand Total 55.00
.00 .00
55..00
,T
-
x
LQPERMIT
Bin #
City of La Quina
8i 11ding k SafetyDivision.
P O Box 1504, 78-495 Calle, Tampico
L4 QuM4 , CA 92253 -• (760) 777-7012
Buildmg�Permiit;Applicadon and .Tracking Sheet
permit # r I
J
I d
Project Address: pp
v y ` '
Y'
.,Owner's Name:
�. .I
A. P. Number:
Address:
Legal Description:
;City; ;ST, Zip:
q 225 3
Contractor.:,Telephone:
uc btU
_
Address: _ C_ U% Q
,Project Description:
City, ST, Zip: .. f C.�- 22l_
(J(J %/ 7"T. 8T ll'j'1P Y W .
Telephone's (� ate_ Q (� 01
State Lic. #: City Lic. #;
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone: j
State Lic. #:
Name of Contact Person: _
,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. 3 000.60
APPLICANT: Da 140T WRITE'sELOW THIS LINE „ f
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item,
Amount
Structural Calls.
.Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted .
Mechanical:
Grading plan
2`d Review, ready for correctionsItnue
�.
ElecMcal
Subcontactor List
Called ContactTirson
Plumbing
Grant Deed
Plens,picked up
S.M.L ,
H.O.A. Approval
Plans resubmitted
Gra.11 ding
IN HOUSE:-
7n° Review, ready for correcdons/issue
Developer Impact Fee
Planning Approval
Called Contact Person'
" A.LP.P.
Pub. Wks. APPr
Date. of permit issue
-
School Fees
-
. Total Permit Fees
.. 4
ON
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