07-1390 (BLCK)P.O. BOX 1504.
78.495 CALLE TAMPICO "
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
07-00001390 `
1
'Property Address: '
78743 AVENIDA TUJUNGA -
APN:
770-093-004-27 -000000-'r" '
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
1750
VOICE (760) 777-7012
FAX,( 760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/08/0?
Owner:
HERNANDEZ RAMIRO
78743 AVENIDA TUJUNGA
LA QUINTA, CA 92253
---------------------------------
• Contractor:
Applicant:• Architect or. Engineer: Owner
- •i - •` .<< - � ti - . : , - . O ,001 ��: . _
---------------------
aur
of
'LICENSED CONTRACTOR'S DECLARATION - - ` - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with . I hereby affirm under penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. - _ I have and will maintain a certificate,of consent to self -insure for workers' compensation, as provided
License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
• - issued. A -
` Date:.- Contractor. - - - k • _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier , Policy Number -
following reason (Sec. 7031.5, Business and Professions' Code: Any city or county that requires a permit to' certify that, in the performance of the work for which this permit is issued, I shall not employ any .
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if 1 should become subject to the wo r 'compensation provisions of Section ,
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or _ 3700 of the Labor Code, IZshhwith comply witl+ ose provisions. '
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by-
any/�pplicant for a -permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Date` �— 6 '� Applicant: -
G / ) I, as owner of the. property, or my employees with wages as their sole compensation, will do the work, and " - -
V—' the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner.of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and Who does the work himself or herself through his or her own employees, provided that the DOLLARS (000,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within, SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT '
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct.the project ISec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ 1 I am exempt under Sec. , B.&P.C:.for this reason - - the owner, and the. applicant, each agrees•to, andshalldefend, indemnify and hold harmless the City
- - of La Quinta, its officers, agents and employees for any act or omission related to the workbeing
- performed under or following issuance of this permit. ..
Date `p 1. Owner:? 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
CONSTRUCTION LENDING AGENCY permit to cancellation. _ =
I hereby affirm under penaltyr of perjury, that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to o ly with all '
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and er by authorize r pr entatives
of this county to enter upon the above-mentioned property fo ins tion purpo est
Lender's Name: - _ _ - o� /� -- ,. _•. . - - - - - I -- -
Date: J.�27` �gnature (Applicant or Agent): y
t
Lender's Address:
c
11
LQPERA11T - -
- f
Application Number . . . . . 07-00001390
Permit WALL/FENCE PERMIT
Additional desc .
" L Permit" "Fee 41.00 Plan Check
Fee
00
Issue Date;.. Valuation
. . .
. 1750
• Expiration Date 11/04/07
Qty Unit Charge Per
Extension
BASE -FEE .,
15.00 '.
13`.00 2.0000 HND BLDG 501-2,000
26.00
Special Notes and Comments
70-L.F.'61-GARDEN WALL AT REAR P/L.,
CITY.STANDARD
` -Fee summary Charged. Paid Credited
Due
Permit' Fee .Total 41.00 .00
.00
Plan Check Total .00 ..00
00
.00
'Grand Total -41.00. .00
.00
41.00
LQPERA11T
,.
• -
Bin #
City. of La' -Quint+ °
Building & Safety Division
P.O. Box 1504, 78-495,Calle Tampico ,
-La Quinta, CA 92253 - (760) 777-7012 -
,Building Permit Application 4 d Tracking Slieet
Permit #
Ao.''
,�, `_
Project Address:' -
Owner's Name:. plfi; t p9R) o
A. P. Number:
Address: -
Legal Description:
Contractor:
City,ST; Zip: 2 ��
Telephone: b — 7'7 ,y
Address:
Project Description:
City, ST; Zip:
}
Telephone:
;
F
State Lic.
City Lic:
Arch., Engn, Designer:
Address:
City, ST, Zip:
` i• �'
Telephone:
'-
Construction Type:; Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair yDemo
Name of Contact Person: .
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd'.,
TRACKING "
PERMIT FEES
Plan Sets
Plan Cheek submittedItem
Amount
Structural Calcs.
Reviewed, ready for corrections
+Plan. Check Deposit
Truss Calcs. "
Called Contact Person
Plan Check Balance
+ 1
Energy Calcs. °
Plans picked up
Construction
Flood plain plan,
't
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:-
Review, ready for corrections/iss`uc
Developer Impact Fee
Planning Approval
` �''
Called Contact Person
'A.I.P.P.
Pub. Wks. Appr
Date of permit issue'
School Fees
Total Permit Fees
t•.
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OWNERBUILDER 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
t
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: y
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 Jor 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
conditionsc
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 permitmill 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
OWNER'S SIGNATU /DATE
PROPERTY ADDRESS
0 -7
PERMIT NUMBER(S) P