04-5289 (BLCK)5
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BUILDING & SAFETY DEPARTMENT
P..O._Bo-x-1-5.04 (760).7.77-.7012
OFTl 9 �-,.8-49�5 CaL.LIETAMPICO FAX (760) 777-7011
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LA QUINTA,CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
2004
BUILDING PERMIT
Application Number 04x0:0-0-052.89 `` Date . 6/30'/34
.Property Address .. . . . . . 77740 CALLE SONORA.
APN: 773-225-021- - -
Applcation description WALL/FENCE
Property Zoning, COVE RESIDENTIAL..
Application.valuation. 7500
OWner Contractor
POWtk..FINANCE44 CONTEMPORARY HOMES INCORP
P, 0 .- BOX 134. .. P-.0. .BOX. 1.141
LA'.:QUINTA .. CA 922.53 LA QUI'. CA' 9225.3
:WCC STATE FUND..
. WC: 157.6498 07/011/04
CSLB:.... 236920 03/3"1/05
. ..
CCC:,: B. ..
Permit WALL/FENCE.'PERMIT - --
Additional desc
Permit Fee 99.00 Plan Check Fee ..:�. 00
Issue Date Valuation'7500
Qty Unit Charge Pere Extens=on
BASE FEE.45.00
6.00 9..0000 THOU BLDG 2,001-25.,000 54.00
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'S 1' Comments
300 LF 61 BLOCK WALL PER CITY' STANDARD'.
FRONT P/L WALL LIMITED TO MAX HEIGHT OF
5., y
:Fee.summary Charged Paid Credited Due
-----------------
Permit Fee Total 99.00 ..00 -.00 99.00
Plan Check Total 00 :00 .00 00
Grand Total 99.00 :00 .00. 99.00
P.O. BOX 1504 •
78-495 CALLE TAMPICO. r
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number:
Applicant:
Applicant's Mailing Address:
VOICE(760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: � - 3 o a `�
Architect or Engineel':
Architect or Engineer's Address:
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 ft Business and;Professionals
�
se�Cl my License is.m full force and sited r--)3 6 9 7-0
License No.
Date Contractor
I hereby affirm under OWNER43UILDER DECLARATION
Y 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 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 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 -dollars ($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 kpovement 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.).
GO 1, as owner of the property, am exclusively contracting witt�icensed contractors to construct the project (Sec. 7044, Business and Professions Cade: The Contractors'/� State License Law does apply to an owner of•prppm Arty who builds or improves thereon, and who contracts for the projects with a conk cr(s) licensed pursuant to
the Contractors' State s .law.). �%
U I am exempt under Sec. . B&O C. for this reaeem•-2
I he affirm uncle WORKERS' COMPENSATION DECLARATION
y penalty of perjury one of the following declarations: .
_ I have nd will maintain a certificate of con selfAnsure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the,perfomance
of work for which this permit, ued.
_ I have and will, maintain w compensa ' n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
Issued. My workers' sation i rance carrier and policy number are:
Cartier iry NumMr
he work for which this permit is issued. I shall not employ any person In any.manner so as to become subject to the workers'
and_ a r I should become subject to the workers' compensation provisions of section 3700 of the Labor Code. l shall
WARNING;/FAILURE 10 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO 95NE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN .
SECTION 3706 OFITHE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
1 hereby affirm ukder penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is Issued (Sec. 3097,'Civ. C.).
Lender's Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to rector of uilding and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose f this appli • n is made, each person at whose request and for whose benefit work is performed under or pursuant to any pemhlt
issued as a result o application, the ner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agen d employees for a act or omissiop related to tt)e work being performed under or following issuance of this permit.
2. Any pe ued as a result of . application becomes null and vold if work is not commenced within 180 days from date of issuance of such permit, or
cessati of work for 180 da li subject permit to cancellation.
I certify that 1 ha read this applicatio nd state that thea ' formation Is correct. I agree to.comply with all city and county ordinances and state laws relating to building
construction, an ereby authorize. resentatives s county �entern the above-mentioned property for inspection urpose's.
ate /S a e (Applicant or Agent):