06-1306 (TT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
06-000Q1.3.0
53376 VIA BELLAGIO'
772-500-065 -
TEMPORARY TRAILER
LOW DENSITY RESIDENTIAL
Application valuation: 1300
Property Zoning:
_=
Applicant:
Architect or Engineer
4bt 4 XP "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
MAR 302006 IJ
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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: B License No.: 744091
Date Contractor:
OWNER -BUILDER D LARATION
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 (5500).:
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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
).hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
e
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777=7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: . 3/30/06
Owner:
ROBERT CAPETZ
PO BOX 1144
LA QUINTA, CA 92253
Contractor:
SUN VISTA DEVELOPMENT CORPORAT
P.O. BOX 1144
LA QUINTA, CA 92247
(760)771-4722.
Lic. No.: 744091
-----------------------------------------------
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.
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 STATE FUND Policy Number 1705482
_ 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
77 3700 of the Labor Code, I shall forthwith complywiththose provisions.
Oate: —2
� Applicant: '!
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAIS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP O 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.
Application Number
06-00001306
Permit
TEMP TRAILER
/ MOBILE HOME.
Additional desc
Permit Fee . . .
. 200.00
Plan Check
Fee
.00
Issue Date-
Valuation
1300
Expiration Date
9/26/06.
Qty Unit Charge
Per
Extension
BASE FEE
200,00
Special Notes and
--------------------------------------------------
Comments
_TEMP CONSTRUCTION'TRAILER
PER MUP
#
2006-775.
Fee summary
Charged
Paid Credited
Due
Permit Fee Total:,
200.00
------ ----------
.00
----------
.00.
200.00
Plan Check Total
.00
.00
.00
.00
Grand Tntal
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LQPERMIT
03/30/2006. 15:23 7607714922 SUNVISTADEVELOPMENT PAGE 01
Fax Cover Sheep ,
un Vista
Development Corporation
Name: ED
Organization: CITY OF LA QUINT,A
Fax: 777-7011 ,
From: JONI FERNIE"
Date: 03/30/06
Subject: BUILDING PERMIT FOR TEMP TRAILER &,TEMP POWER
Pa es: 5
Urgent Reply ASAP Please Comment For Your Records
Hi Ed
As requested please find attached paper relevant to the above. I have put Bob Sturney as the contact
name, as he is the superintendent, but if you need to speak to me, "please feel free to call.
Thank you in advance.
Joni
From the desk of...
Joni Fernie
Sun Vista Development Corporation
Post Office Box 1144, La Quinta, CA 92247
(760) 771.4722, FAX (760) 771-4922
03/30/2006 15:23 7607714922 SUNVISTADEVELOPMENT PAGE 02
'09/90/2006 TErLI 15:12 FAX
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