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05-0106 (BLCK)O� • �Ni�I�'� N s BUILDING & SAFETY DEPARTMENT P.O. Box 1504 D (760) 777-7012 OF O 78-495 CALLS TAMPICO FAX (760) 777.7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 ,IAN 1 0 1005 BUILDING PERMIT CITY OF LA QUINTA FINANCE DEPT. Application Number . . . . .05-00000106 Date 1/10/05 Property Address . . . . -533-40 AVENIDA-VELASCO - APN,:" 774-085-005-5 -000000- Application description WALL/FENCE Property. Zoning . . . . COVE RESIDENTIAL Application valuation . . . . 6250 Owner Contractor POWER FINANCE ADDINGTON, DAVID PO 134 41760 HERMITAGE DRIVE 'LA QUINTA,.CA 92253' INDIO, CA 92201 WCC: STATE FUND WC: 0019787-2005 .01/01/06 CSLB: 682901 12/31/05 CCC: B ------------------=--------------------------------------------------------- P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: OS --0-/ o b Applicant: Applicant's Mailing Address: VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: / - Architect or Erigineer: Architect or Engineer's Address: 1, yl (3 Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division.3 of the Business and Professionals Code..and-my`Lrcense is in full force and effect. License Class _ icense Nc:Go, / Contmctor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' 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 stricture, 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 Contractors' 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 collars ($500).): U 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 or 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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. M)�workers' compensatiominsurance•carier and.policy number are: ertify that, in the performance of -the work-for'which this permit is issued. I shall not emp oy 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. _/0 / 9 plo WARN Q-., AILURE 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 3766 OF THE LABOR CODE, INTEREST, AND AT -ORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construcjon lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name Lender's Address 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 rade, 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, indemnity and hold harmless the City of La Ouinta, its officers, agents and employees for any act or omission related to the work being perforated 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 fepresentatives of this county to enter upon the above-mentioned property for inspection purposes. —Date - G ------------ 7--------------------------------------------------------------- Applr,,,atilon Number . . . . . 05-00000106 ----------------------------------------------------------------------'------ Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 90.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 6250 Qty Unit Charge Per Extension BASE FEE 45.00 5.00 9.0000 THOU BLDG 2,001-25,000 45.00 ---------------------------------------------------------------------------- Special Notes and Comments 150 LF COMBO 3' RETAINING WITH 6' GARDEN WALL AND 100 LF 6' GARDEN WALL. FRONT PROPERTY LINE WALLS LIMITED TO MAX HEIGHT 5' ALONG P/L & 1ST 10 FEET BACK.. CITY STANDARD Fee summary Charged Paid Credited ------------------------------ ---------- Due ----------------- Permit Fee Total 90.00 .00 .00 90.00 Plan Check Total .00 .00 .00 .00 Grand Total 90.00 .00 .00 90.00