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06-0722 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00000721 "A*. Property Address: 7.9567 CORTEZ IN APN: 649-051-011-11 -2667 - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2875 Tit!t44Q" Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. License: Class: License No.: Date•, Contractor: OWNER -BUILDER DECLARATION I herebyaffirm under penalty of perjury that I am exempt from the Contractor's State License Caw 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 statementthat 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 arpeoplicant for a permit subjects the applicant•to a civil penalty of not more than five hundred dollars. 16500).: (_) 1, as owner of the property, or my employees with wages as their sole compensation, will do.the work,.and thestructure is not intended or offered for sals,(Sec; 7044, Business and Professions Code: The Contractors' State L(oense Lawdoes not apply'to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her ownemployees; 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:orshe did not.build or improve'forthe purpose of sale:): (_) 1, as owner of the property, am exclusively contracting with licensed contractors to eonstruct.the project ISec. 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. , 6.&P.C. for this reason Date: Owner: COWTRUOXWN 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 ISec. 3097,.Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: EPIC ENTERPRISES PO BOX 1573 LA QUINTA, CA 92247 Contractor:. Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/17/06 WORKER'S COMPENSATION DECLARATION I hereby affirm under panAky 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 Cade, 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 Policy Number certify that, in the performance of the work for which this permit is issued,'l shall not employ any person in any manner sous to bewme:subject to the workers' compensation laws ofCalifornia, and',agree that, if l should become subject to the workers' compensation provisions of;Section D.21 11 of the Labor Cod I shall forthwith ompjY,with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORK 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 fora 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 Quints, 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 ISO days from date of issuance of such permit, or cessation of work for ISO 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. my t enter upon the above-mentioned property 'ns action purposes. Date:ignawre (ApplicarmorrAgent): Application Number . . . . . 06-00000722 Permit. . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date Valuation . . . . 2875 Expiration Date 8/16/06 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ------------------------------------------------------------------ Special Notes and Comments ---- 115 LF 6' BLOCK WALL PER CITY STANDARD REAR P/L. Fee summary Charged Paid Credited Due Permit Fee Total 54.00 -00 .00 54.00 Plan Check Total .00 .00 .00 .00 Grand Total 54.00 .00 .00 54.00 II I LQPERMff Bin # City of La Qurnta Budding a Safety Dh�ision 1,� P.O. Box 1504, 78-495 Calk Tampico La Qulnta, CA 92253 - (760) 777-7012 Building Permit ApplicationandTracking Sheet Permit # Project. Address: 0. j Owner's Name:mi l A. P. Number: Address: 0 �Ox 115) 3 Legal Description: City, ST, Zip:TFTW 6pr Contractor: Q -� Address: ^ Telephone: i l S - Project Description: City: ST, Zip: Telephone: j&! WPrtt, State Lic. # : City Lia Arch.,,Engr., Designer. Address: City, ST, Zip: Telephone: �r State Lic. #: Construction Type: Occupancy: Project type (circle one): ew Add'.n Alter Repair Demo Name of Contact Person: Sq. Ft: # Stories: #Units:. Telephone # of Contact Person: V a. Estimated Value of Project: 0 95702—" APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calces Reviewed, ready for corrections Plan Check Deposit Tram Cales. Called Contact. Person Plan Check Balance • Title 24 Cales. Plans,picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading.plan 20° Review, ready for eorrect onafissue. Electrical Subcoatactor List Called Contact Person Plumbing Grant Deed Plans picked up &M.L H.O.A. Approval Pians resubmitted Grading INHOUSE: ''d Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date,of permit issue SchoofFees 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 "Owner/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 other than yourself, you may protect yourself from possible liability if that person applies for 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 by law 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 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 obligations under Federal Law, contact the Internal Revenue Service (and, if you'wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structures 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 or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that 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 obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner-builderveriHcation form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 FAX777-7 FAX:: (7WM-7M 1 n UV ADDRESS -O(e- 00000-7a-07 PERMIT NUMBER(S)