06-3299 (BLCK)P.O. BOX 1504 "
78-495 CALLE TAMPICO
LA QUINTA;. CALIFORNIA 92253
Application Number:
Applicant:
06-00003299
Property Address:
77935 'CALLE TAMPICO
APN:
773-076-006- - ' -
Application description:
WALL/FENCE
Property Zoning:
VILLAGE COMMERCIAL
Application valuation:
1823-
823-
Tdy/
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S LARATION
I hereby affirm under penalty of perj y at I a licensed under pro cions f Chapter 9 (commencing with
Section 7000) of Division 3 of the in and rofessi als Code and License is in full force and effect.
License Class: B -C13' License o.: 634981
OWNER -BUILDER DECLARATION_
I hereby affirm under penalty of perjury that I am exempt 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—)
5500).:(_) 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 [,.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'(Sec. 3097, Civ. C.). '
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
''FAX (760) 77.7-7011
INSPECTIONS (760) 777-7153
Date: 9/11/06
Owner:
CORONEL ENTERPES—�
P O BOX 389
LA QUINTA, CA I9 : 1.111
SEP 112006
Contractor: I CITY OF LA QUINTA
CORONEL CONSTR1f CTION FINANCE DPr
.P.O. BOX 389
LA QUINTA, CA 92247
(760)564-4604
Lic. No.: 634981
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
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 STATE FUND Policy Number 174445 006
_ I certify that, in the rmance of the work for wit is ' sued, I shall not employ any
person in any ma ane as to b come su(4p
rs' co pensation laws of California,
and agree that, if I hou beco subjectcomp nsation provisions of Section3700 of the Labor ode I shall orthwithse ovisions.
�h_ ll . U �- Ap t:
WARNING: FAI E TO SECURE WORKERS' COMPENSATIOG 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 Ouinta, 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 ofthisapplication becomes null and void if work isnot c nced .
within 180 days from date of issuance of such permit, or cessation of work for 18 days will subject
permit to cancellation.
I certify that 1 have read this application and stat th the abov informatC
rect. I ag a to c ntply with all
Dat�city and c unty ordinances and state laws relatin to ilding c nstructioneby aut rile r >resentatives
of th' ounty to !/enter upon the abov mentioned p p y for nspection
k L -u > Sign a (Applicant or Agen '--
. Application Number. . . . . . 06-00003299
Permit . . . WALL/FENCE PERMIT
Additional desc .. .
Permit Fee 43:00
Plan Check
Fee
..00
Issue Date
Valuation
1823
Expiration Date 3/10/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
14.00 2:0000 HND BLDG 501-2,0.00
28.00
----------------------------------------------------------
Special Notes and Comments
COURTESY INSPECTION OF 170 LF 21611
RETAINING WALL/40 LF 3' RETAINING
WALL/20 LF 5' RETAINING WALL/30 LF -6'
GARDEN WALL. ORCO STANDARD.
Fee summary Charged Paid
Credited
Due
- - - -
Permit Fee Total 43.00 "
- -- - - --- --
.00
.00
43.00 -
Plan Check Total .00
.00
.00
.00
Grand Total 43.00
.00
.00
.43.00 .
LQPERMIT
SEP-11-2000MON, 08:4.4 AM` Coro'neI Construction FAX No'',760,564' 4202 tf P. 001/00'1
City of La Qu►inta
Building ez Safety Division
P.O. Box 1504
#.# f a'' �` 78-495 Calle Tampico
ermft °''''
La Quinta, CA 92253
=i'°' Building Permit Application. and Tracking Sheet •
Project Address:? _c� �\ caw a Owner's Name:
A. P. N umber: -7-7 3 •07 (o ^-Ob 6 o U Address: O
Leval Description: �,. �.. � a 3 '
Ci ST; Zi
tY, P' �, � •�,,,, �. S '' -
Contractor: a
Telephone: fby
Address: -�
Project Description;
d.
Cit,_ST. zip: �_ �,� �a a- S 3
Telephone: 5L� � �p`1 ' Y:':. 5>ae 9»intai 3%x.
Q, i� O iC' ^ 3
r
State Lic. r : (j��`t `'
City Lic:
Arch.. Engr- Designer:
v
Address:
6,1 1,
Cir ,'ST.Zip:
�.
one: ti: i'i•s :�ke:Y )., (. (3:
Telepb �,�.?e<�<�.`.'l� ';�3•#grJ"�ut° s? �x;;yc •.
� Construct Type: Occupancy:
ion
:> si ~�
• ;�_ mss.
State Lic.
Alter Repair
Project type (circle one): New . Add'n p Demo
Name of Contact Person: �1
Sq. Ft.:
# Stories:
I.J4 Units:
s
Telephone = of Contact Person: S (\k -14
Estimated Value of Project: "
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