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06-0585 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 06-00000585 Property Address: 77600 CALLE_TECATE APN: 774-302-022-14 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 2500 Applicant: Td!t4`4Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT FrS O _1%,8 ?Rog -------------- ----------------------------------- 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 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 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).: 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 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.). ( ) I am exempt under Sec. , B.&P.C. for this reason 6 .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 Owner: GARZA RALPH L 77-600 CALLE TECATE d,A­ QUINTA, CA 92253 r VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 ------------------ WORKER'S COMPENSATION DECLARATION Date: 2/08/06 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 nsurance carrier and policy number are: Carrier Policy Number 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 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 Lab Code, I shall forthwith comply with those provisions. Date: �a-�->D� Applicant: �� . WARNING: FAILURE 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 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 pursuanf'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. 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 representatives of this county to enter upon the above-mentioned preeiWy for inspection purposes. i Application Number . . . . . 06-00000585 Permit . . . . . . WALL/FENCE PERMIT Additional desc . Permit Fee 54.00 Plan Check Fee .. .00 Issue Date Valuation 2500 Expiration Date 8/07/06 Qty Unit Charge Per Extension BASErFEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 -------------------------------------------------------------- Special Notes and Comments 100 LF COMBO 4' RETAINING WITH 6' GARDEN WALL ALONG REAR P/L. PERMIT ISSUED TO.OWNER BUILDER WITH WIC POLICY. Fee summary Charged Paid Credited Due' Permit Fee Total 54.00 .00 .00 54.00 Plan Check Total .00 .00 00 :00 Grand Total 54.00 .00 .00 54.00 LQPERMIT Interinsurance Exchange of the Automobile Club Members' Preferred. Homeowners' Policy Coverages and. Limits Renewal Declarations - Form 3 We are pleased to offer you a renewal for your homeowners insurance policy. To renew your policy, send at least the minimum payment on or before the due date. Insurance is in effect only for the coverages and limits of liability shown on this declaration page and as set forth in the insurance policy and endorsements. These declarations, together with the contract and the endorsements in effect, complete your policy. YOUR NAME AND MAILING ADDRESS GARZA, RALPH PO BOX 1874 LA QUINTA CA L AND SHIRLEY 92253 LOCATION OF RESIDENCE PREMISES 77600 CALLE TECATE LA OUINTA CA 92253 HOMEOWNERS POLICY NUMBER CHO 002086258 POLICY PERIOD (PACIFIC STANDARD TIME) THIS POLICY IS EFFECTIVE FROM: 06-12-2005 12:01 A.M. TO: 06-12-2006 12:01 A.M. PREMIUM SUMMARY Additional Coverages Basic Less Medical Residence CIGA TOTAL Coverages Discounts Liability Payments Employees Endorsements Assessment PREMIUM . $1,030 - $608 + $25 + + + $42 + _ $489 PREMIUM DISCOUNTS APPLIED TO YOUR POLICY Multi Policy Senior . Roof Type Fire Alarm Burglar Alarm Deadbolt Loyalty 20 yrs . Single Story COVERAGES AND LIMITS OF LIABILITY - Coverages are subject to all conditions of this policy. Part I Property Covera-ges Description Deductible* Limits Dwelling Coverage A** Yes $ 175,000 Other Structures Coverage B** Yes $ 17,500 Unscheduled Personal. Property Coverage C Yes $ 131,250 Loss of Use Other Coverages 1. (20% of the amount of Coverage A) No .Building Code Upgrade Other Coverages 5. (10% of the amount of Coverage A) Yes The limit of liability for this structure Coverage A is based on an estimate of the cost to rebuild, your home, including an approximate cost for labor and materials in your area, and specific information that you have provided about your home. *A deductible of $500 will apply as indicated per occurrence. Part 1 limits may have been adjusted.to reflect an updated replacement cost. **Coverage A and Coverage B - Guaranteed Replacement Cost Included. Part H Liability Coverages Description Limits Personal Liability Coverage D(Bodily Injury and Property Damage) - Each Occurrence $ 300,000 (Personal Injury) in the Aggregate Medical Payments to Others Coverage E - Each Person $ 1,000 Part IV Workers' Compensation and Employers' Liability Coverages Description Workers' Compensation Coverage F - Statutory Employers' Liability. Coverage G (per Conditions Part IV Provision 3) Residence Employees - Outservant(s) 00 / Inservant(s) 00 THIS POLICY DOES NOT PROVIDE COVERAGE AGAINST THE PERIL OF EARTHQUAKE CAH0201A PROCESS DATE 04-13-2005 PLEASE KEEP WITH YOUR POLICY (SEE REVERSE) E200501 H Z. -the following. persons: will be -insured under the- policy: a: •an•y member`: " of the deceased's household wh6 is an'�Msured at the time ' :6f'the'deatht, b'bf;only.w' N16 a resident of the residence premises; b with respect to the property of the deceased that is insured under this ,, ^ policy, theh person ._having proper. temporary -custody of the -property until` appointment and qualification of alegal representative..,. . Coverage under this provision will be provided only"Iuntil: the,'end:of the policy-'pedo&-during` which the death occurred. However; if the -death occurred after we offered to renew, this policy, we .will continue coverage until the .end of the policy period for which° we- offered renewal, contin.gent:upon payment of tlie'premium. YOURPREMIUM :; You agree to pay: 1.. -_---the .premium' stated in. the. declarations for ,•.the policy period; and 2. any additional premium resulting during the policy period,. -from: a.. the.correction or .completion of; b. :any changes to;;_ any information on file that "affects the ':".premium for this insurance. If , a. or b. above results in a premium decrease during the policy period, any refund due will be: a. mailed,to you if your, premium is paid in .fuli; Or .. .. b:, applied. to your.outstanding balance. PART IV' -WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY . COVERAGE F-- WORKERS'COMPENSATION COVERAGE G - EMPLOYERS' LIABILITY WHAT LOSSES. ARE COVERED COVERAGE F AND COVERAGE G Withrespect to residenc%e employeesof ; `any insured, we agree'. 1. Under COVERAGE F, to. pay promptly when due all. compensation` id -'-'other'-. benefits re.quired,;of any. insured. by the; ,California Wo.rkers'., Ggmpensation Law- for., residence employees: - 2`...6nder: COVERAGE. G`; Bin # Y City of La' Quints - °' Building U Safety Division P.O. Box 1504, 78-:495 Calle Tampico Permit,# 11 Ob' a, _ • La Quinta, CA 92253 - (760) 7 77-7012 Yi Buildin Permit Application and Tracking Sheet Project Address:`,, 7— 4bd . C ` -� Owner's Name: G' Z� A., P. Number: _ !t " . Address: '7 7 —6,9e' C LLE . EC Legal Description: , City, ST, Zip: Contractor: hone: Tele P K Address " Project Description: (90 .Fj' City, ST, Zip: .. /2 e- 7.4 1A 1414, Telephone: * .. j"z" ���� State Lic. # : City Lic. #: Arch., Engr., Designer: Address:." City, ST, Zip: Telephoner Construction Type: ll/*4 Occupancy: f Project type -(circle one): New ' Add'n Alter _. Repair Demo' State Lic. #: ., Sq: Ft.: # Stories: _ # Units: Name of Cotitact Person:. Y. Tele hone # of Contact Person: P 7 d L %O Estimated Value of Project: (�t CW,,, APPLICANT: DO NOT WRITE BELOW THIS LINE " # Submittal Req'd Recd > TRACEING : A PERMIT FEES Plan Sets " "Plan Check submitted' Item Amount , Structural Calcs. Reviewed, ready for corrections Plan Check Deposit c Truss Calcs. 'Called Contact Person Plan Check Balance Energy Calcs.. Plans picked up Construction Floodplain plan § Plans resubmitted Mechanical Grading. plan 2" Review, ready for corrections/issue Electrical Subcontactor List y Called Contact Person . Plumbing, Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person Pub. Wks. Appr • . Date of permit issue ° School Fees , Total Permit Fees' j Y v - 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/Builder" you are the responsible party of record on such a permit. Building 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 are 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 for 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 the State and Federal Government 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 or subcontractor, only under limited conditions. A frequent practice of unlicensed 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 permits 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, , CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 " (760) 777-7012 FAX: (760) 777-7011 OWN R' IGNRURE ATE ,ee C,a/,Lf cdr� PROPERTY ADDRESS o PERMIT NUMBER(S) - 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/Builder" you are the responsible party of record on such a permit. Building 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 are 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 for 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 the State and Federal Government 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 or subcontractor, only under limited conditions. A frequent practice of unlicensed 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 permits 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, , CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La Quinta, CA 92253 " (760) 777-7012 FAX: (760) 777-7011 OWN R' IGNRURE ATE ,ee C,a/,Lf cdr� PROPERTY ADDRESS o PERMIT NUMBER(S)