06-3824 (BLCK)P.O.+BOX 1504 ^�
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
06-00003824
Property Address:
79400 - STONEGATE
APN:
772-020-022- - -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
750
Applicant: IArchitect or Engineer:
-------------------------------------- - - - - -- - - - - -
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: B Lici nse No.: 691405
Date: O:2- �/fOEontractor. LZ
.
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 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.).
a (_) 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:
' LQPERMI'I' -
Owner:
CUMMINGS C T
10040 E HAPPY VALLEY NO 57
SCOTTSDALE, AZ 85255-
Contractor:
5255
Contractor:
CLASSIC BUILDERS,.
45-475 CLUB DRIVE
INDIAN WELLS, CA 9
(760)772-1991
Lica No.: 691405
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/25/06
D G� 0 ..
IN G� 2006
�,LT 5
2, 1'0
CITY OF LA QUINTA
FINANCE DEPT.
----------------------------------------------—
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 EXEMPT Policy Number EXEMPT
1 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
37000 of the Labor'' Code, I shall forthwith comply with those provisions.
Date: �� �.i;IMPApplicant �-• .
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 setforth 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. 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 pl!:4.ty
.nfurposes.
DateSignature (Applicant or Agen`
Application Number. 06
-00003824-
-Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 21.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
750
Expiration Date .' 4/23/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
3:00 2.0'000 HND '-BLDG
501-2,000
.6.00
---
Special Notes and Comments
30 LF BLOCK WALL PER ORCO DETAIL
Fee summary Charged..Paid
Credited
Due
Permit Fee Total 21.00.
:00 ..00
21.00
Plan'Check'Total .00
.00
00
.00.
Grand Total 21.00
.00
.00
21.00
LQPEPMIT
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: _ `finds
A. P. Number:
Owner's Name:
L' v M nt N
Address: -79 _ q pa 5
City, ST, Zip: ,
Legal Description:
Contractor:
Address: V— Y 7 F C L tJ 8 DR
Telephone: 3
Project Description:
I ( /A I NGL U bfAJ a 2o T$
City, ST, Zip:
Telephone: 3 3
State Lie. # :. 6 City Lie. #:
Construction Type:3t%OGI� . '>Occup'aiicy:
Arch., Engr., Designer:
Address:
City,. ST, Zip:
Telephone:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo'
Name of Contact Person:
Sq: FL:
# Stones:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT:
DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd .
Rec'd
TRACKING ._
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, yeady for corrections
Plan Check Deposit
Truss Cities.
Called Contact Person
Plan Check Balance
Energy .Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2" Review, ready for corrections/issue
Electrical
Sabcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
$.M.I.
Ii.O.A. Approval
Plans resubmitted .
_Grading
INHOUSE:-
7r4Review, 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