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07-2614 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002614 Property Address: 50905 PALOMA CT APN: 770-104-011-1 -000000- Application description: WALL/FENCE . Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1000 M BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: . CAMPBELL RESIDENCE 50-905 PALOMA CT p LA QUINTA, CA 92253 it (000) 904'-8784 ' 7)'ILU+J VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/27/07 Contractor:. SEP 272007 Applicant: Architect or.Engineer: M J & G MASONRY 10226 VIREO CIRCLEL_F1 CiFyOFjL�q�Sl1�d�A - FOUNTAIN VALLEY, CAIVA�yCeD Pr (760)343—.6193 LiC. No.: 827707 � a . 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 Business and Professionals Code, and my License is in full force and effect. LicenseClass: :C29 License No.: '.827707.. =ate Z Contractor: 1 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 countythat 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'sState . 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 fora permit subjects the applicant to;a civil penalty of not. more than.fivehundred dollars (5500).: 1 ) I, as owner of the property; or my employegs.with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale'(Sec:'7044,. Business and Professions Code: The Contractors' State'License Cawdoes 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 norintended;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 thepurpose'ofsale.):' (_) .l, 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 am exempt under Sec. , 8.&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 WORKER'S COMPENSATION DECLARATION _ hereby affirm under penalty of perjury one of the following declarations: - 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, asirequired by.Section 3700 of the Labor ;Code ,for the performanci.of the work for which this per is issued. My workers' c pensa-" n ins +c�e�yar�ne1 apd poli n ber a e: Carrier EXEMPT f�{{(i)]��7(fjl Number EXEMPT I certify that, in the performance of the.work for which this permit is issued,-I'shall not employ an person inany manner so as to become subject to the workers'. compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith complywith those'provisions. Date: 21 Applicant: WARNING: FAILURE TO SECURE WORKER! COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP. TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject.to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is'made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the.City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application. becomes null and void if work is not commenced -within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit.to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building'construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Signature (Applicant or Application Number 07-00002614 Permit . . . WALL/FENCE PERMIT ; Additional de6c . Permit Fee . . . . 25.00 ` Plan Check Fee .00 Issue Date . . . . Valuation 1000 Expiration Date,. 3/25/08 Qty* Unit Charge Per Extension BASE FEE 15.00 5.00 2.0000.HND BLDG 501-2,000 10.00 ,.. _. .. :>... spec•ial-Notes and—Comments --------- ------ --------- - - - - -- . 40:' L.F. X 6' HIGH'ORCO..DETAIL Fee•:summary Charged Paid Credited Due .Permit Fee Total 25.00 .00: :00 25.00. Plan Check Total 100 00. .00 .00 Grand,;Total. "25,00 00 :010 25.. W --Masonry.. 10226Vir6dUrIbitntainValley, 9270& 760-343-61-9.3. ' 714-964-0663 License # 827707 Me$ M CiLL 50-90S QA � O"A C7 LA QUtNTACG. 160 04 -q 7 94 (pISm6o,?!1 PLgsTE2 FI��SN O2co SpF�, �XCIS(I!vrq W;plt i4Lc- iG. WA%"14(�TON i Bin # Gity odf La: Quinta Building 8i Safety Division P:O. Box 1504, 78 =445 Calle Tampico La Qwnta, CA 92253 - (760)' 777-7012 Rullding'Permit:Appllcation and, Tracking Sheet Permit # `/ �. Project Address: St), Os PA [dMA Owner's Name: _ I'S C_ L L ti A. P. Number: Address: 50 O S - PA; ,I 6'M A e -t Legal Description: Cqy, ST, Zip: Contractor: S C' b/`�SoY�t� Telephone: ct. p Address: l 022_ ite-Cb C'..1(it ". Project Description: 1-YO. -OLo.N ' �O .(a ©12CQ 5 o CiST Zi h', ,P� o� 'T A'. ,, �• J Telephone; 7 (06 3 q3 =41`13 77 State Lic. # 11-1770-7 Cfty Lic • #: . Arch., Engr., Designer: Address: City, ST, Zip: t Telephone: E State Lic. #: b v a Name of Contact Person: Construction Type: . Occupancy: Protect type (circle one)r.New Add'n Alter Repair Demo : Sq' Ft.:. ; #Stories: #.Units: 'Telephone # of Contact Person: ' Estimated Value of Project:. b O APPLICANT: DO:'NO.t�;WRITEBELOW,THIS LINE;,'; # Submittal Req'd Recd TRACKING . ? PERMIT FEES Plan Sets ` Plan Check submitted r Item Amount Structural Calcs. Reviewed,` ready for correcGons Plan Check Deposit Truss.Calcs. 'Called Contact Person Plan Check Balance 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 Tlans•picked up S.M. H.O.A. Approval Plansresubmitted \ Grading IN HOUSE:- ''d Review, ready.for corrections/issue Developer Impact Fee Planning Approval ,Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees