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06-3874 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00003874 Property Address: 53220 AVENIDA NAVARRO APN: 774-065-010-14 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Appjicatlofl Valuatii)ri:' b2bO Applicant: Architect or Engineer: 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT . LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licen er p isions of Chapter 9 (commencing with Section 7000) f:Division 3' of the Business and essionals Co License is in full foice and effect. License Clas B e 83 Date: ntractor: OWNER -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).: (_) 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, 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 L 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 _ 1 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: KHAIR JOSEPH D P 0 BOX 529 NORTH HOLLYWOOD, CA 91603. Contractor: BRAUCKMANN INC 50855 WASHINGTON STREET, #227 LA QUINTA, CA 92253 (760)485-9269 Lic. No.: 781834 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11./06/06 N71 %17 2006 CITY OF LA WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury oneof 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. 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 bec . ct to the workers' compensation laws of California, and agree that, if I should a subject to he w�orkeyS' ertfiensation provisions of Section eN 3/�,�0,%f the labor Co , I shall r y with those provisions. Datev ��Applicant: 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 ($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 o t for 180 days will subject permit *to cancellation. I certify that I have read this application and state that the ab informa ' 'eevrTEC . ree to comply with all Ycity and couor inances and state laws relating to build' c ctio -representatives of this /coun, nter upon the above-mentioned prope r ' purpo 'Date: ff� C� Signature (Applicant or Agent): Application Number . . . . 06-00003874 Permit .._ WALL/FENCE PERMIT - Additional.desc . Permit Fee 90.00 •Plan Check Fee .00 - Issue Date Valuation 6250 ,Expiration Date 5/05/07 Qty Unit Charge Per Extension•' BASE FEE, 45.00 .- 5.00 9.0000 THOU BLDG 2,001-25,000 45.00 -- Special Notes and Comments ----------------- ---------------- 150 L.F. COMBO WALL, 3' RETAINING, 6' �- GARDEN, 100 L.F. 6' GARDEN WALL, CITY STANDARD f_ Fee summary i Charged Paid Credited Due Permit Fee Total 90.00 .'00 .00 90.00 Plan Check Total .00 00 .00 .00 Grand Total 90.00 Ab .00 90.00 - LQPERMIT - B'° # City of La Q uinta Building az Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit•Application and Tracking Sheet Permit # 3�� Project Address: 3 2JO AV �-; - Owner's Name: --Yoe-- -Yo A. A. P. Number: 7 7y 0 65-' d Address: Legal Description: Contractor: ou-,j(16 C City, ST, Zip: (.0 Telephone: © (M lIgo Address:t'-->o qDK �Z%� ProjectDescription:31 ,o-4+ City, ST, Zip: AA1✓,11V //0 60-0045e—Ca`.9��t � /SD 3 / 1�P�%�/vlt 6�7AKA5aa Telephone &/g_WY a MEWNWM /d 0,n , a i - �U/ �/ State Lic. # : City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: 3' ' CQ Telephone: State Lic. #: Name of Contact Person: Construction Type: Cccupancy: Project type (circle one): New Add':n Alter Repair Sq. Ft.: # Stories: # Units: Demo Telephone # of Contact Person: Estimated Value cf Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check -'Deposit Truss Calcs. Called Contact Person. Plan ChecILBalance Energy Calcs. Plans picked up 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 resubmitted . Grading IN HOUSE:- "d.. 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 . <�7 Rg"Z?