06-2805 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO '
LA QUINTA, CALIFORNIA 92253
Application Number:
06-00002805
Property Address:
53760 VIA BELLAGIO
APN:
772 -510 -059 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
4400
Tiht
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BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer
'1 I
N l
Owner:
GIOIA
53-760 VIA BELLAGIO
LA QUINTA, CA 92253
Contractor:
SAWYER, RONALD PHILIP
AlL78525 AVENUE 41
F! ?ooh+ BERMUDA DUNES, CA 92201--0
(760)200-0893
N L4QV� Lic. No:: 541336
l � nE rq
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury tha am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bus' s'a d Professionals Code, and my License is in full force and effect.
Lice a class: B License No.: 541336
Date: Vb�� o�ntractor:
JOWN)EBUILDER)DECLARATION
I hereby affirm under penalty of perjury that I a 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 (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 _ 1 1, 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.).
(_) 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/26/06
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.
11 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 044231342005
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 t become subject to the workers' compensation laws of California,
ould
and agree that, if I sheco a sublet[ to the workers' compensation provisions of Section
X700 of the Labor Cod hall orthwith comply with those provisions.
scant:
WARNING: FAILURE TO SECURE WORKERS' OMPEN TION OVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL ES CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE CO 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.
11. 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 abo information is correct. I agree to comply with all
cityd unty ordinances and state laws relating to buildi co truction, and hereby authorize representatives
of ancounty to enter upon the ve-mentioned property i e 'on pur oses.
Dale: -7 Z& V ature (Applicant or Agent):
Application Number . . . . 06-00002805
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 72.00
Plan Check
Fee
.00
Issue Date . . .Valuation
. . .
. 4400
Expiration Date 1/22/07
Qty Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
----------------------------------------------------------------------------
Special Notes and Comments
176 LF., 6' HIGH BLOCK WALL CITY
STANDARD
Fee summary Charged
-------------------------------------
Paid Credited
--------------------
Due
Permit Fee Total 72.00
.00
.00
72.00
Plan Check Total .00
.00
.00
.00
Grand Total 72.0.0
.00
.00
72.00
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 #
Project Address: tQ ®
Owner's Name:
.A. P. Number:
Address:
Legal Description:
Contractor: ��
City, ST, Zip:
Telephone:
Address: -V86 LS &bq41
Project Description:
City, ST; Zip: 6 ,
� t11{ F —20 -,
�4 Loz {v-.. V V
Tele hone:
p
t
a*dimax I/
State Lic. # : fo
City Lic. #:
3s. I - ,� f
Arch., Engr., Designer:
4(� L,
Address: -
ut&4� %1• u n1' ��
City, ST, Zip:— 01224-66
Telephone:
State Lic. #: 4
Name of Contact Person: M l/ t
Construction Type: Occupancy:
.Project type (circle one): New Add'n Alter Repair Demo
=SqFt.-.# Stories: # Units:
Telephone # of Contact Person: 'g q
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 Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan -
Plans resubmitted
Mechanical
Grading plan
2'd Review, ready for correctionsrssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I. •
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
"
Total Permit Fees
�j ,