06-0655 (BLCK)0
Ff.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
06-00000655_______
79180 CORPORATE CENTRE
649-820-014- -
WALL/FENCE
COMMERCIAL PARK
900
Tity/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
DR PAUL JAMES R
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/14/06
Ic
FEB 14 20086
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
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 propepW for inspection purposes.
Signature (Applicant
Contractor: ( CITY OF LA QUIN- A �°
Applicant: Architect or Engineer:
ORR BUILDERS FINANCE DEPT
39301 BADGER, SUITE #300
PALM DESERT, CA 92211
(760)360-6632
LiC. No.: 693077
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B License No.: 693077
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-
issued.
Date: G Contractor:
_ 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
OWNER -BUILDER CLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 1242824-2005
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to_
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, shall forthwith comply with those provisions.
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).:
!
li Applicant:
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
WARNING: FAILURE TO ECURE WORK S' COMPENSATION VERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIV( FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT
as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. ', B.&P.C. for this reason
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
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
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 propepW for inspection purposes.
Signature (Applicant
Application Number . . . . . 06-00000655
Permit . . . WALL"/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 23.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
900
Expiration Date 8/13/06
Qty Unit Charge Per
Extension
BASE
FEE
15.00
` 4.00 2.0000 HND BLDG
501-2,000
8.00
----------------------------------------------------------------------------
Special Notes and Comments
36 LF 6' BLOCK WALL TRASH ENCLOSURE PER
ORCO STANDARD & APPROVED PLANS.
Fee summary Charged
Paid Credited
Due
Permit Fee Total 23.00_
00
.00
23.00
Plan Check Total .00
.00
.00
.00 _
Grand Total 23.00
.00
.00
23.00
V
LQPERMIT
02/14/2006 09:29 7603605591 ORR BUILDERS �� PAGE 04
B« #
City ®f La Quin
Building a Safety Mision
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Buildlncr Permit Application and Tracking Sheet
Permit
Proj cot Address: —A &;
Owner's - Name:
A. P. Number: ��� —if
Addross:.
Contractor:• z &J14 Dom-
Telephone:
Address:—gy-201 yz�,g�2 Sr svr7z--
Project Description:
City, ST, Zip:,OW��.s2T
Telephone: 7AO 2,,�Z2 7� 2
— O 0; cl- T 36 1,14
Stare 'Lie_ # : �p �. r . City Lie. A. I'
Arch., Engr., Designer: Al
-zza PCir � 6 4 f
zad
Address:
0 ^e— l e9GG7 LLQ
City, ST, Zip:
Telephorte:Construction
State Lie. #:
Name of Contact Person: ��a �vR
Typc: Occupancy:
Project typo (circle o : N A,dd'n Alter Repair Demo
Sq. Ft : # Stories: #Units:
Telephone # of Contact Pcrson. 2 Cfj!CJ Z/
Estimated Value ofFrojoa: ovd
APPUCANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rey'd
$ec'd
TRACE3NG
PERMITkx
Plan Seta
Pian Cheep submitted
ltcm
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Culled Contact Pcrson
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flovd plain plan
Plans resubmitted
mechanical
Grading•plan
Zoo Review, ready for corrections4ssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plana picked up
Ii.O.A. Approval
Plans resubmitted
Gmding
IN HOUSE:-
a ° Review, ready for corrcctio usur
Deveioper Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub.'Wkg. A.ppr
Date of permit imuc
School Fees
Total Permit Tees '