06-3255 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4&t 4 . 4-4"_
Application Number: 06-00003255
Property Address: 50490 ORCHARD LN
APN: 772-050-015- - -
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY' RESIDENTIAL
Application Valuation: 8000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICE SED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 a licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business an rofessionals Code, and my License is in full force and effect.
License Class: C8 C27 C29 icenseNo.: 656128
Date: G Contractor: -
ER•BUILDER DECLARATION
I hereby affirm under penalty of perjury t�Iamex pt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Businessessi ns Code: Any city or county that requires a permit to
construct, alter, improve, demolish; or repair any 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).:
( 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
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, as owner of the property, am exclusively contracting with licensed contractors 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
pursuant to the Contractors' State License Law.).
1 am exempt under Sec. , B.&P.C. for this reason -
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPEIL-si:IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/07/06
Owner:
STANFIELD
50-490 ORCHARD LANE
LA QUINTA, CA 92253
Contractor:
CALIFORNIA PO & SPAS
12
COACHELLLACA 2S [r
v 2
006
(760)398-9222
Li.C.'No. 656 28 CITY Oft I=AAmiNth
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
l Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier SEABRIGHT Policy Number 13BI060510
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as o become subject to the workers' compensation laws of California,
and agree that, if I should b .me
subject to the workers' compensation provisions of Section
7 of the Labor ith comply with those provisions.
Date:o Applicant:
WAR ING: FAILURE TO SECURE WORKE
SUBJECT AN EMPLOYER TO CRIMINAL PENA
DOLLARS ($100,000). IN ADDITION TO THE
SECTION 3706 OF THE LABOR CODE, INTERI
IPENSATION COVERAGE IS UNLAWFUL, AND SHALL
S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -
;T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety 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 Quihta, 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 per it, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above i formation is correct. I agree to comply with all
city and county o finances and state laws relating to building con' ruction, and hereby authorize representatives
of this cou y t ent upon the above-mentioned prope ins' cti urposes.
Date:-Tf V Signature (Applicant or Agent):
Application Number
06-00003255
Permit
BUILDING PERMIT
Additional desc .
Permit Fee
99.00
Plan Check Fee
`. 64.35
Issue Date
Valuation . .
: . 8000
Expiration Date
3/06/07
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
6.00 9.0000
THOU BLDG
2,001-25,000
54.00
Permit
ELEC-MISCELLANEOUS
Additional•d_esc .
Permit Fee . . . .
17.25
Plan Check Fee
4.31
Issue Date
Valuation . .
. . 0
Expiration Date
3/06/07
Qty Unit Charge
Per
Extension _
BASE
FEE
15.00
3.00 :7500
PER ELEC
DEVICE/FIXTURE 1ST 20
2.25
----------------------------------------------------------------------------
Special, Notes and Comments`
.
BBQ & FIREPIT PER APPROVED,PLAN
ONLY
Fee summary Charged
Paid Credited
Due-
ue.------------------
--------------------
Permit Fee Total
116.25
.00 .00
116.25
Plan Check Total
68:66
.00 .00
68.66
Grand Total
184.91
.00 .00
184.91
LQPERMIT
-