08-0493 (BLCK)ti
P.O. BOX 1504
78-495 CALLE TAMPICO
' LA QUINTA, CALIFORNIA 92253.
Application Number. X08-00000493 �f'
Property Address: 61567 TORO CANYON WY
APN: 764=280-999-119 -3002,3.7-
Application description: WALL/FENCE .
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 375
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
= BUILDING PERMIT
VOICE (760) 777-7012
FAX (160) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/24/08
Owner:
DAVIDOWITZ•
61567 TORO CANYON WAYffT'
LA QUINTA,.CA 92253(009)000-0000
Contractor:
ARTISTIC LANDSCAPE INC.TA
78206 VARNER RD,•#D PMD2_--
PALM DESERT, CA 92211
(760)360-1395
Lic. No.: 379421
ENSED CONTRACTOR'S CLARA
I hereby affirm under penalty of perjury I am licensed un er prov i s of C er 9 ommencing with
Section 7000) of Division 3 of the Bu' sand Profe ion s Code a my se is i full force and effect.
Licens ass: t27 Licens 3 9 21
Da DQ -C actor: .
OWNER -BUILDER DECLARATION
hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the
following reason ISec. 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 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 hoes 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- - - -
1 herebyaffirm 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: PIC
LQPERIMIT
T ,
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and wilf 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 SectipR_ 3700 of the Labor
Code, for the performance of the work for which this permit is issue . M workers' compensation
insurance carrier and policy n mber are:
Carrier DELOS INS CO Policy Number 01KD 1 0 5 4
_ I certify that, in the perform of the work for whic�®r�r
is i u , I shall not employ any
person in any manners a to become subje to thco pe sation laws of California,
and agree that, if I sh ul ecome subiect t the wp sa on provisions of Section
/ 3/00 of the Labor pd „I shall fortWi,)h omplyrr visj ns.
WARNING: FAILLME TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (5100,000). INADDITION 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.
2. Any permit issued as a result of this application becomes null and void if work is not comme ed
within 180 days from dWandate
such permit, or cessation of work foi 18 ays ill subject
permit to Cancellation.- -
I certify that I have read this applicationthe abov info anon is c r ct. I a ee o co ply with all
city and county ordinances and state uilding ens coon, an reby a or' a repr sentatives
of this unt o enter upon the aboverty f r in ecti pu ses.�� /i i
Application Number . . 08-00000493
Permit . . . . . . WALL/FENCE PERMIT
.
Additional -desc__•
Permit -Fee• . . . . 15.00
Plan Check
Fee
.00
Issue Date
Valuation
375
Expiration Date 9/20/08
Qty Unit.Charge Per
Extension -
BASE FEE
15.00
Special Notes and Comments
------------------------
15 L.F. 61 GARDEN WALL, CITY STANDARD
Fee summary-_- Charged Paid
Credited
Due
Permit Fee Total 15:00
.00
.00
15.00
Plan Check Total .00'
.00
.00
.00
Grand Total',_'15.Q0
00
0.0
15.00
• LQPEP-MIT
Bin #
City of La Quinta,
Building 8t Safety Division
Permit ,# P.O. Box 1504, 78-495 Calle Tampico..
j, k a Quinta, CA 92253.- (760) 777-7012
V1 Building.Permit Application and Tracking Sheet
Project Address:' l DYU Owner's Name:
A. P. Number: Address: i
Legal Description: City, ST, Zip: L#�
Contractor: /
' ! L Telephone:. .
Address:
Zl/ Project Description:
City, ST, Zip:
Telephoner Z/ 6
State Lie. # :C % 11 - City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: Construction Type: Occu an
P cY:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft :
9 #Stories:. #Units:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
_
N Submittal Req'd Reed TRACKING PERMIT FEES
Plan Sets Plan Check submitted Item
Amount
Structural Calcs. Reviewed, ready for corrections Plan Check Deposit
Truss Calcs. Called Contact Person Plan Check Balance
Energy Cales. Plans picked up
Construction
Flood plain plan. Plans resubmitted
Mechanical
Grading,plan 2"" Review, ready for corrections/issue . Electrical
Subcontactor List Called Contact Person Plumbing
Grant Deed Plans picked up
S.M.I.
H.O.A. Approval Plans resubmitted
Grading
IN HOUSE:- 'n° Review, ready for corrections/issue Developer Impact Fee
Planning Approval' Called Contact Person A.I.P.P.
Pub. Wks. Appr Date of permit issue
School Fees
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CITY OF LA QUINTAY
BUILDING&SAFETY DEPT.--�� 2, �o f�v4., �.�4 �> +►may,► �� -x -!`1
'APPROVED
FOR CONSTRUCTION SCALE I / , f+ APPROVED BY
/�
DRAWN BY !
DA G BY DATE ).. 6:' ! ,. REVISED J7
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DRAWING NUMBER
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