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05-1815 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: 53360 AVENIDA VELASCO APN: 774-085-006-6 _000000 - Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 1104 Applicant: Architect or T414f 4 4 Q" I BUILDING & SAFETY DEPARTMENT BUILDING PERMIT MEL MAY 12- 2005 CITY OF LA QUINTA - -------------------------------- I - - - - -FMANCF-OM---- LICENSED CONTRACTOR'S DECLARATION I hereby affii�rn under penalty of perjury. that I am licensed under provisions of Chapter 9 lcommencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that -I am exempt from the Contractor's State License Law for the following reaso n (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 perm it 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 bnd 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 pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1, 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, 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 I am exempt under Sec. B.&P for this reason i I I I CONSTRUCTIDIN LENDING AGENCY I hereby affirm under penalty of perjury that there is a construjition 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: TRIPLETT SALLY 53360 AVENIDA VELASCO LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 --------------------------------- Contractor: Owner -7 ---------------- WORKER'S COMPENSATION DECLARATION Date: 5/12/05 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 Policy Number ,or 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 byome subject to the workers' compensation laws.of California, and agree that, if I should beco subject to the workers.' compensation provisions of Section 00 of the Labor Code, I s withQirose provi . sions. LA l�i—bcant:NMPA 70V _Ln vche.� ' — WARNING: FAILURE TO SECURE WOR/EIS"(CO'MPIISUIOL'N�60'�(ERAGE 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 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. * I - 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 infor4tion is correct. I agree to comply with all city anp county ordinances and state laws relating to building construction, and h:;nebauthorize repres2atives QLthiVcount mer upon the above-mentioned property for inspe&�6-purpos 1v to b_ Application'Number . . . . . 05-00001815 Permit . . . . .. . WALL/FENCE PERMIT Additional desc * * Permit Fee 29.00 Plan Check Fee .00 Issue,Date . . . . -valuation . . . . 1104 Expiration Date Qty - Unit Charge Per Extension BASE FEE 15.00 7.00 2.0000 HND BLDG 501-2,000 14.00 ----------------------- ­� ------ 7 ----------------------------------------------- Special Notes and Comments 51 LF 5-- GARDEN WALL ALONG FRONT P/L BACK TOWARDS GARAGE TO CREATE COURTYARD AROUND POOL. CITY STANDARD. 2001 CBC Fee summary Charged ------------ ---------- ---------- Paid Credited ---------- ---------- Due Permit Fee Total .00 .00 .29.00 Plan Check Total .00 .00 .00 .00 Grand Total 29.00 .00 .00, 29.00 OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property. improvements specified. For your protection you should be aware that as "Owner/Budder?' you are the responsible party of record on such a permit. Budding permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for,the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City or County They a�e also required by law to put their license number on all permits for which they apply. if you plan to do your own work, with the exception of various trades that you, plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200.00 or more f6r the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. if you are an employer, you must register with ihe State and Federal Govern m-eni as an employer and you are subject to several obligations include State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation'contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the, Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under,State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform their work personally or through their own employees, without a licensed contractor of subcontractor, only under limited conditions. A frequent practice of unlice ' nsed persons professing to be contractors is to secure an "Owner/Builder" building permit, erroneously implying that the property,owner is providing his or her own labor and material personally. Building �ermits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Very truly yours, h CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 (760) 77/�7012 FAX: (760) 777-7011 Ss PROPERTY ADDRESS PERMIT NUMBER(S) P