06-1550 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 9.2253
Application Number: 1106'0000-155.00
Property Address: 78855 SANITA DR
APN: 604-162-010-82 -23269 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2750
Applicant: Architect or Engineer:
a(A
LICENSED CONTRACTOR'S DECLARATION
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full•force and effect.
License Class: License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I-am'exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county tttat requires a permit to
construct, alter, improve, demolish, or repair ariy 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 Contractor's 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
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 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.). -
( 1 I, as owner of.the.property,amexclusively.contracting withlicensedcontractors 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
puisuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
JUAREZ MARIO
78855 SANITA DRIVE
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS .(760) 777-7153
Date: 4/17/06
------------------
WORKER'S 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 issued. 'My workers' compensation
insurance carrier and policy number are:
Carrier Policy Number
I certify that, in the performance of the work for which this permit is issued, I shall notemploy any
person in any manner so as to become. subject to the workers' compensation laws of California,
and agree that, ould become subject t e rkers' compensation provisions of Section
37 0 of the Labo.shall hwith omply ith those provisions.
I icant:
WA NIN . FAILURE TO SECURE WOfjY ERS' COMPENS ION COVERAGE IS WFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A 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.
APPLICANT -ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building andSafety 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 commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state hat the above information is correct. I agree to comply with all
city and county ordinances and stat laws relating to it 'ng construction, nd he by authorize representatives
of/th/is�ounty o en r upon t ove-mentioned pro y r ins coon rposes
at�D e: 'nature (Applicant or Agent): /
Application Number . . . . . 06-00001550
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 54.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. .
. . 2750
Expiration Date .
. 10/14/06
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
110 L.F. 6' GARDEN
WALL, CITY STANDARD
�/
PIL.
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
Bin #
City .of La Quanta
Building,u Safety Division
P.O. Box 1504, 787495 Calle Tampico
La Quinta, CA 92253 - (,7.60) 777-70.12
,Building Permit Application and Tracking Sheet
Permit #
®
Project Address:
%Owner's Name: ZCA7
A. P. Number:
ddress: "
Legal Description:
`kity,.ST, Zip:
Contractor:
%
Address:
4roject Description: -
City, ST, Zip:
/
Telephone:
State Lie. # :
'City Lit. #. -
Arch., Engr., Designer: i
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
-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 Calcs.
Reviewed, ready for corrections
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"d Review, ready for corrections/issue
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
e�
OWNER/B•UILDERJNFORMATION ;
J 3
Dear Property Owner:
An application fora building permit'has bee'n`sub_ mitted inyour name list ng.yourself as the builder of the property
improvements specified:'
For your protection'you should be aware that as "Owner/Builder" you are„the re'sponsitile party of record on such a
permit. Building permits are not required to be signed by property owners unless ihey4re personally performing their
own work. If your work is beipg,perfocmed by someoneother ahan yourself, you may 'protect yourself from possible
liability if that person applies for the proper permit in his or her name.
r
Contractors are required by law to ,be licensed and, bonded bythe State "of California grid to have a business license
from the City or County. They are'also requireddby law to,put•ytheir%l ense 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:
n
If you employ or otherwise engage any persons other than your immediate 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, then you maybe an employer.
If you are an employer, you must register with.the°State and Federal Government as an.employer and you are subject
to several obligations include State and Federal income ;tax withholding; 'federal social security taxes, worker's
compensation insurance, disability. insurance -costs and unemployment compensation, contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
resp6ct to worker's compensation insurance. „
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, .if
you wish, the U.S. Small Business Administration). ",For more specific information about your obligations under State
Law, contact the Department of Benefit Payments: and ;the Division,of Industrial Accidents. 1
If the structure is intendedfor sale, property owners who are not licensed contracts=aretlallowed to perform their
•�,
work personally or through their own employees, without a licensed contractor -or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons- professing to be contractors is ,to secure an �Owner/Builder” building -
permit, erroneously implying thatathe,;propertyowner, is„providing `h'is, or her,own, labor.and material personally.
Building permits are not required''to be sighed sbyRproperty owners unless they are performing their own work
personally.
Information about licensed contractors may be obtaine6:by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814:. �' s
Please complete;and return the enclosed owner-builder've-rification. form so that we 6 confirm that you are aware of
these matters. The building'permit will not be issued until the verification is r'et6rtied': ;
Very truly yours;
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
PROPERTY ADDRESS
o& - J S16 -v
PERMIT NUMBER(S) E