06-1622 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA,QUINTA, CALIFORNIA 92253
Application Number:
06-00001622
Property Address:
78890 SONESTA WY
APN:
604-151-023-34 -23269 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1750
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 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: C29 License No.: 776632
755tceContraeC6r: Zdry L
` 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, orrepair 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 70001 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 _ 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 (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 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 contractors) licensed
pursuant to the Contractors' State License Law.l.
(_ 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:
BERUMEN
78-890 SONESTA WAY
LA QUINTA, CA .92253
! ,f
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153.
Date: 4/24/06
Contractor:
JIMENEZ CONSTRUCTION APR 2 4 1006
26900 DOLLAR ROAD
DESERT HOT SPRINGS, CA 22
(760)342-7881 OF
.r A
Lic. No.: 776632
------------------------'-----------------------
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 ofthe 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 STATE FUND Policy Number 1795093
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 Labo 11 forthwith comply with those provisions.
Dax!;• �L Applica .
WARNING: FAILURE TO SEC ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 restrictionssetforth 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 180days 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 buildi onstruction, and hereby authorize representatives
of this"my to enter upon the above-mentioned pro —o"-' for i ection purposes.
Date: y?y oG' Signature (Applicant or Age ��T, 7 �✓�
-G'
a
Application Number, 06-00001,622,
Permit WALL/FENCE PERMIT
Additional desc .
Permit -Fee-.., 41.00 Plan Check
Fee
.00
Issue Date Valuation•
1750.
Expiration ,Date ,. .10/21/06
-
Qty Unit Charge: Per
..Extension
BASE: FEE
15.00
13.00 2.0000 HND 'BLDG,501-2,000
26.00'
--------------------
Special Notes and Comments
------
---------------
70 LF 61 SLUMP -STONE WALL PER ORCO
DETAIL AT LEFT SIDE OF PROPERTY LINE.
Fee summary. Charged Paid Credited
Due
Permit Fee Total 41.00 .00
00
41.00
Plan Check.Total .00 '00
.00
.00 ".
Grand Total 41.00 .00
.00
41.00
LQPERMIT
Bin #
� -
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking' Sheet
Permit #
(p < (0
Project Address- 7 �j—
Owner's Name: 1 C/ - �.
A. P. Number:
Address: fr
Legal Description:
City, ST, ZiAAN - ' Z
-
Telephone:
r-
Contractor: _ w� o . ,
Address: _, o
Project Description:
City, ST, Zip:It
f,
Telephone: 60j '-
G
State Lic. # : City Lic. #:
Arch., Engn, Designer:
m o
Address:
e r t' I v ---b 4i LL
City, ST, Zip:
O
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one):. New Add'n Alter •Repair . Demo
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount'
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up -
Construction.-
onstruction-Flood
Floodplain plan.
Plans resubmitted
Mechanical
ti
Grading,plan
2°" Review, ready for correctionsfissue
Electrical
Subcontactor. List '
Called Contact Person
Plumbing
Grant Deed '
Plans picked up
S.M.I.
H.O.A. Approval °
Plans resubmitted
Grading f '
IN HOUSE:-,
''" Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
'
Total Permit Fees
BLOCKW WALL LOCATION AGREEMENT
This document attests and affirms that both of the property owners at
78-890 Sonesta Way and 78-900 Sonesta Way in La Quinta, California,
agree and warrant that the proposed block wall to be. built on the common
property line between these properties is built ori the center line of the
Property Line, and that this location is acceptable and undisputed.
Further, both parties agree to hold harmless the City of La Quinta and
City staff for any approvals of this location and issuance of this block wall permits.
o
Property Owner Address
(Print e) La Quinta, California 92253
Property Owner
. (Sign re
Property Owner2�/1�� L ,6,— 1 e,,- Address 7 Ct - 9
(Pent Name) La Quints, California 91253.
•Property Owner ,�-...
.(Signature)