04-7365 (BLCK)y i
6Lj; i .. r
l_
P.O. SOX rs"
78.495 CALLE TAMPICO
.LA QUINTA, CALIFORNIA, 9?225`3
BUILDING PERMIT
Application Number . . .
Property Address
APN : .
Application description .
Property Zoning . . . . .
Application valuation .
BUILDING & SAFETY DEPARTMENT
(7601).1717-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04-00007`365 Date 11/19/04
'-5:3-3`6'0 DEL _GATO DR
77`0-350-017 -
WALL/FENCE
LOW DENSITY RESIDENTIAL
4750
Owner
Contractor
AVERILL DAN L
DRURY CONSTRUCTION,
MARGARET
P 0 BOX.275
73807 MASSON'STREET
BIGF.ORK MN 5:9911.
PALM DESERT
CA 922760
(760) 346-72'27
WCC: PREFERRED
INS
WC: WKN1.157592
06/01/05
CSLB: 46.3.4:07
09/30/06
CCC': B -C2.9
Permit . . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 72.00
Plan Check Fee
.00
Issue Date
Valuation . .
. 4750
Qty Unit Charge Per
Extension
BASE
FEE,
45.00
3._00 9.000.0 THOU BLDG,2,001-25,000
27.00
Special Notes and Comments
130 LF 2' RET/61' GARDEN WALL. & 60
LF 6'
GARDEN WALL -ALL PER ORCO SPECS
Fee summary Charged
Paid Credited
Due
Permit Fee Total 72.00
.00 ..00
72.00
Plan Check Total .00
..00. .00
.0.0
Grand Total 72.00
.00 .00
72.00
P.O. Box 1.504 VOICE (760') 777-7011
78=495 C'A.LLE T'AMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760.) 777-7153
BUILDING A SAFETY DEPARTMENT
Application Number: O'� -' �% 3 465-- Date: 1- % % V'¢
Applicant:. Architect or Engineer:
GaNTiI� ca
Applicant's Mailing Address:. Architect or Engineer's Address:
Lic. No,.,:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby a&m under.,penaltyof perjury that I am licensed, under provisions of Chapter,,9 (commencing with.Section7000) of Division 3 of the Business and Professionals:
Code; and my6icen is in ull force;and effect.
is e;rriassl -� S� se o k03 402
(/ OWNER43UILDER DECLARATION
I herebyaffirm under penaltyof pery'ury that) a .• exempt from',the Contractors' State License Law for fhe:fotlowing reason (Sea 7031:5, Business end ProfessionwCode. Any
city or county thatregUirewa,pennit to' construct, alter, improve, demolish, or repair any .structure. ;prior to its issuance, also requires the, applicentfor the permit to file a signed
statement that he or she is licensed pursuant'to•the provisions of the Contractors' State License Law pter 9'(commencing with Section 7000) of Division 3 of the Business
and Professions Code) orthat he orshe is exempt therefrom and'.the.basis for the alleged exam ition. Any violation of Section 7031.5 by anyapplicant totajpermN subjects
.the applicant tomcivil penalty of•notmore than five hundred dollars($500).):
U 1, as owner of the property; or my employses'w th wages as•their sole.compensatlon; will do the work. and the structure is not intended or offered for sale (Sec:.70".
Business and Professions Code: Tho Contractors' State License'Law does not apply,to an owner, of property who builds or Improvesthereon, and who.does the work
himself or herself;or through his or her own employees, prowded'the't the improverrrents: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 orshe d ',n llbuild or improve for the;purpose of sale.).,
U 1, as owner of the property, am exclusively contracting with licensed contractors`fo oonsbvct the:project(Sec. 7044, Busineswand'Professions Code: The Contractors'
;State License Law does not:appiyto,amownerof, property.who builds or improves: thereon, and who contracts for the projects with a contractor(s),licensed pursuant to
the Contractors"State License,Law.).,
U I am exempt under Sec.._, B.& P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of;peri'ury one ofthe,.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' isissued.
I have and will maintain workers"compensation insurance, as required by Section 3700 of the,Labor Code, for the performance of the work•forwhich this permit Is
—�i}rssu rkers' compensation insurance carrierand*
employanyperson in any manner so as to becoms'Wbject:to the workets'
should become subject to the workers' compensation provisions of, Section 3700 of the Labor Code, I shell
WARNING:, FAILURE TO SECURE WORKEIW COMPENSATO-bloC•`OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN.EMPLOYER TO`.CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE'HUNDRED THO AND DOLLARS ($100,000), IN ADDITION TO THE COST OF'.COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 OF THEI ABOR CODE, INTEREST, AND ATTORNEY'S' FEES.
CONSTRUCTION LENDING AGENCY
I,hereby affirm under penalty of perjury that there isa, construction lending;agency for -the performance of the work.for which this permit is issued (Sec. 3097; Civ -C.).
Lendees Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application' is: hereby made to the Director of Building, and Safety for a Permit subject to the conditions and restrictions set fortIvon this application.
1. Each'persom upon whose behalf this application ismade, each person at whose request and for whose benefit work isperfomted under or pursuant to any:permN
issued as a;result of this application,'the owner; and .theapplicant; each agrees to„and^shall, defend, indemntfyand holdharrnless;the;City of La Qllinta, its
officers„agents and employees. for any actor omission related to the work being performed under or followingfissuance of this permit.
2. Anypermit issued as a result of this;application becomes+null and void N work knot commenced within 160_ days from date of issuance ofsuch permit,=or
cessation of work for 180Aays will,subject permit:to cancellation.
I certify that I have read th a application and.state that the above informs" correct:' I eeree'to cornlywith all city and county ordinances and state laws relating to building
construction,, and hereby authorize representatives of this cou",e r upop to above-mentioned property for inspection.purposes.