06-3156 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-701.1
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 7.77-7153
BUILDING PERMIT
.. ..- -- __ Date: 8/29/06
Application Number: 06-000_03156 t Owner:
Property Address: 50490 ORCHARD LN JPW CONST
APN: 772-050-0157 - - 79395 BRIARWOOD
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL D
Application valuation: 5500 (�
• Contractor.
Applicant: Architect or Engineer: SPARKS CONSTRUCTION, AUG 32��6
P.O" BOX 1716
'LA QUINTA, CA 92247 CITY DFLAQUINTA'
(760)771-1941 FINANCE DEPT
!/ Lic. No.: 674074
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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 of the following declarations:
Section 7000) of Division 3 of the Business a fessionals 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
Livens a . o.
B Lic : 6.74074 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date• ntractor: 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 icense Law for the Carrier STATE FUND Policy Number 0000348-2005 -
_ .following reason (Sec. 7031 .5, Business and Professions Code: Any city or county t at 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 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 I should become s tee o the workers' compensation provisions of Section
License Law. (Chapter 9 (commencing with Section 7000) of Division.3 of the Business and Professions Code) or 00 of thebor Code, I shall rthwith mply 'f a provisions. i
that he or she is exempt therefrom and. the basis for the alleged exemption. Any violation of Section 7031.5 by a7//
any applicant for a permit subjects the applicant to'a civil penalty of not more than five hundred dollars 1$500).: Dat Z pplicant:
(_) 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 WAR ING: FAILURE TO SECURE WORKERS' COMPENSATION 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 1$100,000).) IN ADDITION TO THE COST OF COMPENSATION, 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 ATTORNEY'S FEES.
one year of completion, the owner -builder will have the burden of proving that he or she did not build or r "
improve for the purpose of sale.). APPLICANT `ACKNOWLEDGEMENT
I _) 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 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 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 orfollowing 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 and state laws rela ' ing con tion, and hereby authorize representatives
Z' ' cou to ter upon th bove-m oned propert fo sped on purpo
Lender's Name: - '
Dat 1. ature (App' ant or nd:
Lender's Address: - -
LQPER 11T
` Q1.
- Application Number 06 -00003156-
-Permit . . . WALL/FENCE PERMIT"
Additional desc .
Permit Fee . . 81.00
Plan Check
Fee
.00
" Jssue Date . . . .
Valuation-
5500
Expiration Date 2/25/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
Special Notes and Comments
220 L.F.6' GARDEN WALL, ORCO SYSTEM
Fee summary Charged Paid•
Credited
Due
Permit Fee Total 81.00
.00
.00
81.00
Plan Check Total .00
.00
.00
.00
Grand Total 81.00
.00
.00
81.00