Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
06-2113 (BLCK)
4 P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA; CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/23/06 Application Number:06-00002113 Owner: " Property Address: 51100—CALI;E OBISPO MIHAJLO JOSIMOVIC APN: 770-142-002-92 000000- 51100 CALLE OBISPO Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL n-- -------------------------------------- Application valuation: 1083 D luf p�/ ontractor: Applicant: Architect or Engineer: MAY 2 3 2006. ner C1 TY OF IA QUIPdT FIAIiiMCEDEP4. - ---------------.---------------- :4 - LICENSED CONTRACTOR'S DECLARATION " WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed-undei.provisions of Chapter 9 (commencing with I hereby affirm under penalty of. perjuryone of the following declarations: - - Section 7000) of Division 3.ofthe Business and Professionals Code, and,my License is.in full force and effect. _ I have and will maintain a.certificate ofconsent-to -self-insure for workers' compensation, as provided . License Class: License No.: for by Section 3700 of the Labor Code; for'the performance of the work for which this permit is -� issued. Date: - Contractor: - _ I have and wilbmaintain 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: . hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for. the Carrier Policy Number 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 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 subject to the workers' compensation provisions of Section License Law (Chapter 9 (commericirig -with Section 7000) of Division 3 of the Business and.Professions Code) or - 3700ofthe Labor Code, I shall fort withcomPly with those provisions. " that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byp --1 - any applicant for a permit subjects the applicant to a civil penalty of not more. than five hundred dollars ($500).: l Date's -,0' �Applicant:a.+.r-J�� " (_ ) I, as owner of the property, or niy.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 Coder The . - Contractors' State License Law does not 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 issold within one year of completion,,the owner -builder, will have the burden of proving that he or she did not build or . y 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, Businessland Professions'CoCe:' 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 I am exempt under Sec. , B.&P.C. for this reason Date:.� C 72 9 - ©, Owner: _ ; /7 ..��1r 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS.UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP'TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 dateof issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that 1 have read *this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection Aur es. Daie!%`12- �DiI(/Signature (Applicant or Agent):— _101 IV I LQPERMIT Application Number . ... 06-00002113 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 27.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 1083 Expiration Date 11/19/06 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 2.0000 HND BLDG 501-2,000 12.00 ---------------------------------------------------------------------------- Special Notes and Comments 50 LF 5' BLOCK WALL PER CITY STANDARD TO FORM FRONT COURTYARD. CITY STANDARD Fee summary Charged Paid Credited Due ------------------------------------- Permit Fee Total 27.00 ---------- .00 ---------- .00 27.00 Plan Check Total .00 .00 .00 .00 Grand Total 27.00 .00 .00 27.00 Bin # City of Via" Quanta Building uSifety Division P.O: Box 1504, 71#-495 Calle Tampico La Quirita, CA 92253 - (760) 777-7012 Building Permt.Application and Tracking. Sheet Permit # U� Project Address:/ I D v C11-L�G Owner's Name: /.S//% J"Lo.. �� Ji /7 C, vi A. P. Number: Address: S- /cc, G/./-ee ee Legal Description: It �.�✓ G/9ZC Contractor: S C'Z F- Address: City, ST, Zip: 4f Telephone7,rS Project Description:- escription:City, City,ST, Zip: Telephone: State Lic. # : City Lic. #: Arch., Engr., Designer: 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 Rec'd TRAGHING . PERMIT FEES Plan Sets Plan Check submitted Item . Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calm Called Contact Person Plan Check Balance Energy Calcs. Plans picked up J Construction Flood plain plan. Plans resubmitted Mechanical ' Grading. plan 2°" 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 resubmittedGrading N 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 OWNER/BUILDER' INFORMATION Dear Property Owner: An application for a building permit has been -submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as 'iOwner/Builder" you are the:responsible�party of record on such a permit. Building permits are not required.to be signed by'property owners'unless<they are personally performing their own work. If your work is being performed_ by someone'* bi ier than yourself, you may.protect yourself from possible liability if that person'applies foi the proper permit.in his -or her name._ Contractors are required by law: to be licensed -and -bonded by the State of California and`to have a business license from the City or County. They are also required byelaw to put .their license • 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: 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 may be 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 respect to worker's compensation insurance. For more specific information about -your obligationsun_ der Federal Law,,'.contact.the Internal Revenue Service (and, if you wish, the U.S. Small BuSIneSS.Administration). ;For inose specific information about your obligations under State Law, contact the Department of Benefit Payments arid; the Division of Iridustrial_Accidents.,: If the structure is intended for' sale, property owners `who are not-. licensed .contracts are allowed to perform their work personally or through their own employees; without a licensed. contractor, orsubcontractor, only under limited conditions. A frequent practice of unlicensed` persons professing to be .contractors is to 'secure an "OwnerBuilder" building permit, erroneously implying tliat the property owner. is ,providing -his .or .her own labor.- and material personally. Building permits are not .required to be' signed by property"" owners unless, they are performing their own work personally. Information about licensed contractors may be.;ob-tained':by contacting the Contractors' State License Board in your community or at.1020 N. Street,Sacramento; Ca46rnia.95814. Please complete and returnJiie'enclosed owner -builder verification form so,that we can confirm that you are aware of these matters. The buddingpertnit will not be' issued -until the'verifcation is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quirita, CA 92253 (760) 777-7012 FAX: (760) 777-7011 f i f A( 47r1 OWNER'S SIGNATURE/DATE PROPERTY ADDRESS PERMIT NUMBER(S)