04-3593 (BLCK)Q BUILDING & SAFETY DEPARTMENT
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OFT1 78-49A'L``L�E'TAMPICO . FAX (760) 777-7011
:,yQuINTA, CALIF61MIA 92253,. INSPECTION REQUESTS (760)777.7153
Application Number BuILDIN94P�gM 3593 Date 4/20/04
Property Address 54126 AVENIDA VELASCO-
APN: 774 -215 -007 -7 -000000 -
Application description.. WALL/FENCE
Property Zoning COVE RESIDENTIAL
Application valuation '1147
Owner Contractor
POWER FINANCE CORONEL CONSTRUCTION
P.O. BOX 134 P.O. BOX 389
LA.QUINTA CA 92253 LA.QUINTA CA -92253
.. (760) . 564-4604
WCC STATE.. FUND'
.WC: .1744453 01/01/05
'CSLB: 634981'''..,01/31/06
CCC B -C13.
Permit WALL/FENCE.`PERMIT.
Additional desc..
Permit Fee 29.00 Plan Check Fee ..00
Issue Date . . . . Valuation.: .1147
Qty Unit Charge. Per .. Extension .
BASE FEE 15.00
7.00 2.00.00 HND. .BLDG 501-2,000 14.00
Special Note
s.and ,Comments
5.3- L . F ' . 5' GARDEN WALL, ' . C I TY " STANDARD'
Fee''summary Charged. Paid Credited Due
---------------------------------------------------------
Permit Fee Total 29:00'.00. 00 29.0&
Plan Check Total .-00 00 :.00' 00':
Grand Total 2,9.00 .00 .00. 29•.00
P.O. 86X 1504 /; ,
{I�/ VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUANTA, CALIFORNIA 92253 44
INSPECTIONS (760) 777.7153
Application Number:
Applicant:
Mailing
BUILDING & SAFETY DEPARTMENT
Date:
Architect or Engineer
Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
I hereby arm.. under LICENSED CONTRACToa'S DECI ARAIM
_Coodepenally d perjury that 1 am licensed under ' ext d Chapter a (MVIMOncLq wdh Section 7000) of Division 3 d am Business and Professionals
and my uoaxete is in full fomoe and attest
License Gass _ License No.3`I 4_� t
I hereby sain. Ynder pensky d pajwy riot 1 am OMVNW4UIIAER DECLARATION
�y or �y that requires a. permit b construct from aro CW*Od rs' Stab Li wuc law for the folowkg mason (Sec. 7031.5. Business and Probssiornt Cods: Any
stalemha►t that he or she is licensed MW°Ms. demor�sh. or repairany structs°. pier b ks its m" also requires the appiicant forria pemit b lis s signed
Dust brie provisions Of" Contractors' State Limme Law (Chapter 9 (comnendng with section 7000) of Division 3 at the Business
Sind Professions Code) or that he or she Is exempt therefrom and to Iasis for to alleged exemption. Any violation of Section 7031.5 by any applicant for a, permit subject:
the npp:cami b a dva penalty nt not riere than five hundred etolars 9500).r
U 1. u+s owner of the PrePOty. or my employees with mages ass ttwir $ob 00mpesa8m will do ore work 04 to structure is not Intended or olkmed for sob (Sec. 7044,
Business and Professions Code: The contractors! Stab Lbense Law does not appy to an owner Of propety who bolds or improves thereon, and who does the work
hirnse f or herself or trough his or her own employees, Provided that the inprovemerks aro not Intended or offered for sale. If, however. the 14 AJi 0 or Nmpovement is
add whin one year of aonple6orh, to owner -Murder will have the burden of provk that he' or she dd not build or:rprove for the purposed sale.):
U Las owner of .tae property, am aeadusivasy oahtractlq with icensed contractors to construct the Project (Sec. 7044. Business and Prolessbns Code: The Contractors!
State License Law does not apply b an owner of property wfq builds or improves rieieon. and who r a h e nus for the projutcts with a contractor(s) icense0 pursuant to
the Contractors' State License law.).
U I am exempt under Sec. _ . Bala P.C. for tis reason
Date Owner
1 hereby affirm under penalty of pejury one of to following declarations: WORKERS• COMPENSATION DECLARATION
_ I have and wig maintain s oert'Ricate Of consent to self4nsure for workers•
of the work for which this permit Is issued 00fA0^• as provided for by section 3700 d the labor Code. foram peAexamnoe
1 have and wB maintain workes' compensation kwxan0e, as required by section 3700 of the Labor Code. for the pehAamharmee of the work for which this pemmif k.
My R' eartmpansa6onZ wrier and policy number are:
_ I certify that in the pe(0mane�e of ore work for which this Permit is issued. l shale not
compensation lam of CaGtomia,'and spree amt t I shhaxAd employ any person in any marxer w is b become subject b are workers'
.. b(th ft.�y Wiwi � 06 oma subject b ria wOdw.e compensation provisions of section 3700 of the labor Coda, l shay
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CML FNES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000). N ADDITION TO THE COST OF COWENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3705 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. .
I hereby affirm under CONSTRUCTION LENDING AGENCY
penalty d perjury that there is a construction bndrV agency forte Pert mwm or the work for which this permit is issued (Sec. 3017. Civ. C.).
Lendees Name
Lender's Address
IMPORTANT Application b hereby mode to the Director of B APPLCMNT ACKNOWLEDGEMENT
wilding and safety for a•prm! subjectb the conditions and restrictions set tort on Iiia application.
1. Each person upon whose behalf this application is made. each person at whose request and for whose benefit work is perlomhed under or pursuant to a
nnit
Issued a result d this OPPk86on, the owner. and she applicant, each agrees b. and shad, defend. Indemnify and hold hamtess the City of Le Okinta, I s�
2 agents and employees for any act or omission related b the work being performed under or following Issuance of this permit. .
My permit issued as a result Of flit application becomes null and void If work is not com amne:ed within 160 days from date of issuance of such pemit or
cessation of work for 150 days will subject pertNt to cancellation.
1 1 have and read this app6w6on and state that the Imtomnation is correct (egree y with ad city and county ordinances and state laws relating b building
hereby authorize representatives d this to eller above ' Property for inspection purposes.
Date 2-2- of(Applicant or Agent).