05-3438 (BLCK)tv
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kM'
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00003438
Property Address: 78390 CRESTVIEW TER
APN: 643-192-003-35 -2117 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1250
Applicant: Architect or
9W 7
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BUILDING. & SAFETY DEPARTMENT
BUILDING PERMIT
AUG 0'4 2005
r: CITY OF LA QUINTA
LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm under penalty of perjury that 1 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: A C27 Q License No.: 667547
Date: - Contractor: RAO !O A�:��
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).:
(_ 1 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 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 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.).
I _ 1 I, 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.).
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:
SASSORD LARRISSA.
78390 CREST VIEW TERRACE
LA QUINTA, CA 92253
Contractor:
DESERT RESERVE INC
68845'PEREZ ROAD SUITE 9
CATHEDRAL CITY, CA 92234
(760)343-7322
Lic. No.: 667547
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/04/05
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty 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 Code, for the performance of the work for which this permit is
issued.
1 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 EVEREST NATL IN Policy Number
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 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 comply with those provisions.
Date: � Applicant: Rro 6/I/5L # '
r—
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 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.
DaterSignature (Applicant or Agent):
I
a
LQPERMIT
Application Number . . . . . 05-00003438
Permit . . . WALL/FENCE' PERMIT
Additional desc . .
Permit Fee . . . . 31.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 1250
Expiration Date . . 1/31/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
8.00 2.0000 HND BLDG 501-2,000
16.00
-----------------------------------7----------------------------------------
Special Notes and Comments
50 LF 6' BLOCK WALL, STUCCO FINISH IN
FRONT YARD, 27 FEET BACK FROM P/L. "A"
& "C27" CONTRACTOR ALSO DOING
IRRIGATION, LANDSCAPE PER SIGNED
CONTRACT ON FILE..CITY STANDARD FOOTING
DETAIL.
Fee summary Charged Paid Credited
Due
-----------------------------------------------
Permit Fee Total 31.00 .00
----------
.00
31.00,
Plan Check Total .00 .00
.00
.00
Grand Total 31.00 .00
.00
31.00
I
I nu hit
A .RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
PLANS AND JOB CARD ARE NOT ON
c_r THE SITE FOR A SCHEDULED
INSPECTION.
NO EXCEPTIONS!
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
Bin #r CICS o1 La Quinta.. ,
s�
P10 Jr Building 8t Safety. Division
P P.O. Box 1504, 76-49S Caffe Tampico
Permit ff ��M,y La Quinta, CA 92253 - (760) 777-7012
''V Building Permit Application and Tracking Sheet
Project Address: `7 3 C&5X Ug w M Owner's Namc: L T r
A. P. Number: Address:' '"7
Legal Description: Cit}', ST, Zip: LQUTt�I C, A 95.
Contractor: Telephone.
Address: v QC7 '� [1 �C{ Project Description: ?,k 1-T 1_T �NpLA�F
F
T, Zip: Aone: '760
State Lie. # :�
Arch., Engr., Designer:
Address:
City, $T, Zip:
Telcphbnc:
State Lie. #:
Name of Contact Person:
Telephone # of Contact Person:
City Lie. #:
6 27
# Submittal I Req'd Recd
Plan Sets
Structural Calcs.
Tl'uss Calcs.
Title 24 Cala.
Flood ptaiirplan
Grading plan
Subcontactor Lis'
Grant Decd
II.O.A. Approval
IN iIOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
,cm
J
Construction Type:Occupancj':
Project type (circle one):. New Add'n Alter Repair Demo
Sq. Ft.: #Stories: # Units:
Estimated Value of Project:
DO NOT WRITS BELOW THIS LINE
TRACtaNC PERMIT VETS
Plan Check submitted
Item Amount
Reviewed, ready for corrections
Plan Check Deposit
.Called Contact Person
Plan Check IRalance
Plans picked up
Construction `
Plans resubmitted
hicchanical
2" Review, read} for Carr ectionslissue
Electrical
Called Contact Person
Plumbing
Plans picked. up
S.t.i.l.
Plans. resubmitted
Grading
Review eadr for correctionslissue'
Developer Impact Fee
Called Contact Person
A.[.P.P.
Date of permit -issue '
Total Permit Fees
DESERT RESERVE, INS BIDICciNT�Cl'
www.DwenReseme.com
68845 Perez Rd #9,Ca&e" Cty,CA9223* DATE mo&4xfnRAM
.Phone (760) 343-7322 Fox(760)770-1000 MM 40392
General Contraclor Lic. #667547
"Fuudyy Bonded 8 Insured'
NAME IAaDRESS PROJECT
LARTSSA SASSORD
78-390 CRESTVIEW TBRR
LA QUINTA, CA 92253
CELL: (949)254.8873 FAX: (949)458.6648
DESCRIPTION OTY COST TOTAL
BUILT IN PLACE BLOCK WALL. FOR FRONT YARD. STUCCO BOTH SIDES, S7 90.00 5,130.00
APROX- 57 LNF'T X 6 HEIGHT
PROVIDE AND INSTALLATION OF BMGA17ON FOR FRONT YARD, 1.983.00 1.983.00
IRRICATION CLOCK AND UIRM VALVES AS PER PLAN
DEPOSIT OF $1.000 ON 7123MS (CK tt837)
.. - -- �_ -
we {honk you for the oppWulty to bid on your project!!. Pkase visit us at
www.deseraesare.eom. -
TOTAL $7.013.00
An =WW 6 gemrmtmd w be cmWietod in a wmkroard$e a mum wcwdtoe to nowlard pruacm AAY aue a m of deviation fivm sbove qwJae.eton9 mvelving
aura cads will be a mm! oozy upm wrium = m. and w01 become an eft esssye over =a above the estimate. An atecmcoes eomm4 m "m sOr*m
weldeau or delays beyond aur aoatrai, Ora0crla nary tlsq taroado, and o ne0msaty atgitanax Oar a0rkas an My ew W by W&b=S Ceoipaagim
Lasarenoe to Ike creat k mon bsi+.aa psdec here -0 ta:rrcetaias tba prael. i and obtipadaru ander this a000rae W uW dispute betaaea St natim
bei the p" preultleg in curb dlspade wt71 be I0 tt mmtatde-attwWc fees All bdls aad mvniem aye to be paid within ton (10) days flom the date of
bia;n� arehcsul�ootp� 1fe skaObeOvttthicandanams' et 11%pw=m=im(dpaidinftdL
CIlS1 stcNA � _ - � _o n GA��i� .
DATE ESTIMATORS SIGNATURE DATE
1'd 0OO1-0bL-09L..=T,#T0Pd 9 OAJaSaa %J0220 •d4S=Z0 SO 10 2nU