08-1208 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
0:8-000,01208
Property Address:
50057 JMI;E�OAXACA
APN:
773-340-029-29 -14496
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
700
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
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 Nness and Professionals Code, and my License is in full force and effect.
License Class: 13 ense No.: 795252
ate: � ntractor.
NER-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 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 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, 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.).
I—) I 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:
LQPERMIT
Owner:
GISS VERNON J
50057 CALLE OAXACA
LA QUINTA, CA 92253
Contractor: D
LOCKEN CONSTRUCTION CO
78183 CALICO GLEN DRIVE
BERMUDA DUNES, CA 92203
(760)534-5303
Lic. No.: 795252
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/16/08
16.2009
.ITY OF tJ� (�BINTA
�..teatGEDEPT.— �--
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 EXEMPT Policy Number EXEMPT
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 to become subject to the workers' compensation laws of California,
and agree that, i hould become subj. om Iworkers' compensation provisions of Section
_ 3700 of the La or ode,' I shKll forthw' h ctwijh those provisions.
WARNING: FAILURE TO SECURE WORKERS' BGMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 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 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 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 that the above information is correct. I agree to comply with all
city and ounty ordinances and state laws relating to b ' in construction eby authorize representatives
of thi ou ty t9 enter upon the above-mentioned pro for i pection urpo
ate ature (Applicant or Agentl: --
Application Number . . . . . 08-00001208
Permit . . . . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 19.00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 700
Expiration Date . . 1/12/09
Qty Unit Charge Per Extension
BASE FEE 15.00
2.00 2.0000 HND BLDG 501-2,000 4.00
----------------------------------------------------------------------------
Special Notes and Comments
9 L.F. 6' GARDEN WALL @ WEST P/L & 19
L.F. 6' GARDEN WALL @ EAST P/L, CITY
STANDARD
Fee summary Charged
Permit Fee Total 19.00
Plan Check Total .00
Grand Total 19.00
LQPERMIT
Paid Credited Due
.00 .00 19.00
.00 .00 .00
.00 .00 19.00
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1-3 OZ
JCITY OF LA QUiN A ,
BUILDING & SAFETY DEPT.
APPROVE®
FOR CONSTRUCTION
DA "1&'0 BY 16M
9
SITE REQUIREMENTS ,-
INTERIOR LOT
SIDEYARD: S FEET REARYARD: 10 FEET
MINIMUM EACH SIDEMININIUM
y ' 1
' I
c
R. PROPERTY
1 ( LINES
FIhDNI'YARD: ARU TO BE
20 FEET LANDSCAPED Sn A I ,t',a �kt' ,
MINIMUM
4
r4 c I
CURBLINE
Within all districts, the maximum fence height shall be five feet
front setback ared
rea (measured from the street right-of-way) and six feet thin any rear or side setback arin.the fj st ten feet of the �ea'ad-
joining a public street.
Locken Construction Co.
CA General Contractors License No. 795252
78183 Calico Glen Drive
Bermuda Dunes, CA 92203
Phone (760) 534-5303
Fax: (760) 834-2400
Proposal To: July 10, 2008
Richard Giss
Property Address: 500-57 Oaxaca, La Quinta CA 92253
of work to be
➢ Paint living room - 1 color $1,875.00
➢ Hang 2 ceiling fans $ 150.00 ($75.00 each)
➢ Build 2 sections of garden wall, 6' high x 9' long and
6' high by 19' long $3,500.00
Accepted and Approved by Z e-�
As Agent for Richard Giss
Sin €f
Permit #
Project Address: —
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name: (� es .S
A. P. Number: Q( QC G
Address: CSO —57 CLQ
Legal Description:
Co'ntra'r.cto
- �
#-- acI /ZA � l5G
City, ST, Zip:&LOWkin,
Telephone:
Address: Ca� 4 wI
Proje D�escv�iption: F7
City, ST, Zip: - 0,
Telephone: T60 6'�f 530-L—MMN3
(O
State 1,ic. # :
City Lic. #:
Arch., Engr., Designer:
Address: t
City, ST, Zip:
Telephone:
Stale Lic. #:
Construction Type: Occupancy:
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
Plan Sets
Req'd
Rec'd
TRACK[NG
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
'Plans resubmitted
Mechanical
Grading plan
2sd Review, ready for correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Review, ready for correctionstissue
Dtveloper Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees