05-4875 (BLCK) (3)P.O. BOX 1504.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00004875
Property Address: 79305 STONEGATE
APN: 772 -040 -016 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: . 1700 ,
`* Applicant:
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
4,:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
GATTI RICHARD D
79305 STONEGATE
D/1 LA QUINTA, CA 92253
NOV 02 1005 Contractor:
WRIGHT GEN CONTRACTOR, PETE
ClTI'OFLAQUlP�TA P.O. ,BOX 580901
�ANCEOEPT N PALM SPRINGS, CA 92258
(760)329,75490
Lic. No.: 735919
I hereby affirm under penaltyof per jur that I am licensed under p visions of Chapter 9 (commencing with
Section 7000) of Division 3 of the B sin s and Profession Is Co ,and my License is in full force and effect.
License Class: B cens 735919
Date:" Contractor:
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 ofproving•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.). _
( ) 1 am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/02/05
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 insuran , as required by Section 3700 of the Labor
Code, for the performance of the work for which thi ermit is issued. My workers' compensation
'insurance carrier and policy number are:
Carrier STATE FUND Policy Number 12375-2005
I certify that, in the performance of the work for which is permit is issued, I shall not employ any
person in any ma a so as to ecome subject to the orkers' compensation laws of California,
and agree that, i I sh uld c e subject o the wor ers' compensation provisions of Section
��'� (r.��37700 of the La r C , I ha f ith ompl wit those provisions.
-6ate:1 tt [ 10 � Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO11ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN FS 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. - r
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 voidLagree
ommenced
within 180 days from date of issuance of such permit, or cessation odays will subject
permit to cancellation.
I certify that I have read this application and state th the bove information is corcomply with all
city and county ordinances and state laws relating.t buildi g c ns ruction, a d herpresentatives
of this county to enter upon the above-mentioned pr pert r s c pur oses.
Date: Signature (Applicant or Agent):
Application Number . . . . . 05-00004875
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 39.00 Plan Check
Fee
.00•
Issue Date .. Valuation
. . .
. 1700
Expiration Date 5/01/06
Qty Unit -Charge Per
Extension
BASE FEE
15.00
12.00 2.0000 HND BLDG 501-2,000
24.00
---------------------"-------------------------------------------------------
Special Notes and Comments
68LF 8' BLOCK WALL WITHIN BUILDABLE
AREA OF SFD WITH ARCHES/LIGHTS/ELECT
OUTLETS(GFI PROTECTED)PER CDD APPROVED
PLAN& ORCO STANDARD.
•
i
Fee summary Charged Paid'' Credited
----------
Due
-------------------------------------
Permit Fee Total 39.00 .00
----------
.00
39.00
Plan Check Total 00 .00
.00
..00
Grand Total 39.00 .00
.00
39.00
r`
LQPERMIT -