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05-4770 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: C05-00.004770 —�' Property Address: 81590 TIBURON DR APN: 767-531-002- - Application description: WALL/FENCE. -Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 87 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT D)r e D tti;T Z 5 2005 ERRITT 1-590 TIBURON DRIVE A QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 CITY OFLAQUINTA contractor: FINANCE DEFY. Applicant: Architect or Engineer: NDIAN CREEK CONSTRUCTION _ WCC: EXEMPT WC: EXEMPT 01/31/06 CSLB: 805577 03/31/06 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: //��,^,(wTLicense No.: Date:/ ontractor: �QI41.1 l..Sti� WNSiiII�JGTcO r✓ 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 (5500).:. (_ 1 1, 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.). - (_ 1 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 Date: 10/25/05 Z WORKER'S COMPENSATION DECLARATION 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 insurance carrier and policy number are: Carrier A Policy Number - - - - - - - - - - - - - -- X 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 Labor Code, I shall forthwith comply with Wpse ro 'sions. l LDale�-��'27'--S Applicant: t�Zi WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA 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 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. 1 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 prop for spection purposes. O tQ.ZS�o Signature (Applicant or Agenty f� . LQPERMIT U Application Number . . . . . 05-00004770 Permit . . . WALL/FENCE PERMIT• Additional desc . Permit Fee 15.00 Plan Check Fee- .00 Issue Date . . . Valuation 87 Expiration Date 4/23/06 Qty Unit Charge Per Extension. BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 4 L.F. 5- EQUIPMENT BLOCK 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 15.00 .00 .00 15.00 . LQPERMIT CITY OF LA QUINT SUB-CONTRACTOR LIST §,a JOB ADDRESS �'�90 boa PERMIT NUMBER �-�� %70 ' OWNER WA�r(2 twe—e-tTT. BUILDER" This form shall beoosted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons. appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage -of, work and/o:r the voidance of building permit. For each applicable trade, all information requested. below. must be completed by applicant. "On File" is not an acceptable response.. . ........ ....... i Trade / CI assificat on .................... ...........;:.... . Contra t r c o S .a r�ctor.s.L�cense.......... t to Cont ................ ... Wbtkecs..Com :ensa.t�on.Iris..a:.......................... .. ......................... — ;:;: s "'`>L'icen5 Y us nes .. Company Name Classification LicenseNumber M 'E Date �xx/ Carrier Name Policy Number Exp. DateCom Licenseense Number r ( E x . Date xx xx xx / / 1 - e�.A B 8 9 XX XXXX 1 xk xx . / to Fund CaICo m e . State ) 9 P Format Varies) XX XX XX I xx x x E?kFETF:WQ(3K:.........1........... a w � t� i� L`J �f �%�7�% 1 I ,. 3. 1.t l �s C' a N o 6� 0 0 O6 a �© 2 R 3 Al ' s A- i i r '.r i r �.. - :><'<>.'•> STRUCT SI EEL (C 511:..:::. H�n1i2�j'g �'iLsl. �i gO ��o 0� 31 Cb T'6 I'v�� p�/lo-©0153�(o Oy%nt 0, O (D� 1''7 Ot A .� tr � .I C oot. - 5 3 S 4 o 1 I t d'b ° �aT v �I `7 o .o 6 2 t I 3 10011 ,� .. .02 f1C — - - - 'TAr E I 2 1 o. 0 o , o y // 0 o� ,3 6of HVAC tC .......... e.7 icA ::� :.:�; ►:::>:::<:;::::.::: lt��r�}'I�R- PM SPA T54C,. AD' f. N.:..lC:.;:.......... . SHEET:::MET,:.:::: :............ ANSPA.....:: N.: (G: 'IN>> - L C.ERAMI:C..TIL;>:: :;:....: >> 'A'BINETS'.:::,>< FENCING:.lC..131....:»..:..::.:::.; - O.L..lC..531... .:.:.. ..:.::' CAntvCr4 %I, E'4 Po E� %%9f! �o� 0 3, eAUPo"1A X_45. CO, yb00576 -0101 G DiG6 245 31 a gin # . City of La Quinta Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 05- 1110 Project Address: g l �( ��� Owner's Name: W'A�g A. P. Number: Address: �--- &J Red Legal Description: City, ST, Zip: LA Wi mCA Contractor:'�""" Address: 7,I 2001 :' Telephone: �. s ;< � orf w Project Description: City, ST, Zip: w1,, l:,t CA 1 /!Z z% �t�l i i (� (� unit W'q L' Telephone:eir &0.37-1-Y `i p' r _ '' ` 461F i 4,411 State Lic. # City Lic. #: Arch., Engr., Designer,t�OL O A-bb�S Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: �� Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo . Sq. Ft.: # Stories: # Units: , Telephone # of Contact Person: ((0- 27'�'-q l i Estimated Value of Project: 0 too � o 6 APPLICANT: DO NOT WRITE BELOW THIS LINE'. # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan god Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.iVi.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3'd 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 Total Permit Fees