04-4883 (BLCK)BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA,- CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . 04-00004883 'Date 6,/11/04
Property Address . . . . . . 55825 TURNBERRY WY
APN: 767-560-002- - -
Application description WALL/FENCE
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation 2079
Owner Contractor
DAO INVESTMENTS LAWRENCE, BUSTER L.
.P.O. BOX 1286 9639 FOLARIS WAY
SEAL BEACH CA 90740 MORONGO VALLEY CA 92256
(760) 272-5472
WCC: STATE FUND
WC: 17445692003 08/11/04
CSLB: 328825 06/30/06
CCC: B
------------- --------------------------------------------------- 7 ------------
_Permit . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee 54.00 Plan Check Fee .00
Issue Date . . . Valuation .2079
Qty Unit Charge Per Extension
BASE FEE 45.00
-1.00 9.0000 THOU BLDG_ 2,-001-25, 000 9.00
--------------------------------
Special Notes and Comments
71 L.F. 6' GARDEN WALL, 19 L.F. 4' ,
GARDEN WALL, CITY STANDARD
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
0 .
1100
_ P.O. BOX 1504
78-495 CALLE TAMPICD N` `
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
Application Number: LJ g g 3
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
VOICE (760) 777_7,01:
FAX (760) 777-701 :
INSPECTIONS (760) 777-71S.-.
Date: 69 -11-0
Architect or Engineer's Address:
Lic. No.
BUILDING PERMIT DECLARATIONS
I hereby affirm under penaltyof LICENSED CONTRACTOR'S DECLARATION
perjury that I am licensed undeyprovisions of Chapter g (Commencing with Section 7000) of Division 3 of the Business and Professronals
Cyde, and my License n full force and effect.
rcense Class_ r License No.
�. Date Contractor
i
I hereby affirm under penaltyof OWNER -BUILDER DECLARATION
perjury that I am exempt from the Contractors' 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 signet
statement that he or she is licensed pursuant to the provisions of the Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date - Owner
I hereby affirm under penaltyof WORKERS' COMPENSATION DECLARATION
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' compensatio insurance• as required by Section 3700 of the Labor Code. for the performance of the work for which this permit is
-Issued. My workers' compensatio rance carrier and poli num r areD
mer% Policy Number G�
_ I certify that m the performance of the work for which this permit is issued. I shall not employ an
compensation laws of California. and agree that, if I should become subject to the workers' unperson in any manner so as to become subject to the workers
forthwith comply with those provisions. Pensabon provisions of Section 3700 of the Labor Code, I shall
,__-Dat c' Cant
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.
CONSTRUCTION
S
I hereby affirm under penally of perjury that there is a construction lending
LENDING AGENCY
gency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT
Application is hereby made to the Director of Building and Safe for a
1. Each g Safety permit subject to the conditions and restrictions set forth on this application,
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, indemnity and hold harmless the City of La ouints, 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' correct. I agree to comply with all city and county ordinances and state Is" relating to building
construction, and hereby authorize representatives of this county to e n the above�rrmenbon property for inspection purposes.
Date v i/S gnature (Applicant or Agent: