06-2614 (BLCK)P.O. BOX 1504 .
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
06-00002614
45275 SUNBROOK LN
604-302-005-16 -23995 -
WALL/FENCE
LOW DENSITY RESIDENTIAL
- 1500
414 Qiolla;'- VOICE (760) 777-7012
FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT _ INSPECTIONS (760).777-7153
BUILDING PERMIT
Date: 7/10/06
Owner:
JOSE MERCADO
45275 SUNBROOK LANE
LA QUINTA, CA 92253
---------------------------------
Contractor: J
Applicant: Architect or Engineer: Owner
a1 -------------
D S -11
JUL 112006
CITY OF LA QUINTA
FINANCE DEPT.
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 andwill 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.
Date: Contractor: `'
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Libor
•
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 r
and agree that, if I should become subject to the workers' compensation provisions of Section
. License Law (Chapter 9.Icommencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the La r Code, I shall forthwith comply with those 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).:
ate: /pplicant:
( 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
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 ($100,000). 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, as owner of the property, am exclusively contracting with licensed contractors toconstructthe project (Sec.
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. '
I�f
' 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, -
(_ ) I am exempt under Sec. , B.&P.C. for this reason
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
CONSTRUCTION LENDING AGENCY -
permit to cancellation.
I hereby affirm underpenalty 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 comply 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 hereby authorize representatives
Lender's Name:
of this my to enter upon the above-mentioned prop] y for inspection pu oses.
rtpl ///IP� '
ate: Si ure (Applicant or Agentl:.._J—tom,/ /"'
Lender's Address:
-
LQPHRMIT -
Application Number . . 06-00002614
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee35'.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
1500
Expiration Date 1/06/07
Qty Unit Charge Per
Extension
BASE
FEE
15.00
10.00 2.0000 HND BLDG
501-2,000
20.00
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Special Notes and Comments
-------------------------------------
60 L.F. 6' GARDEN WALL, CITY STANDARD
Fee.summary Charged
Paid Credited
Due
Permit Fze Total 35.00
.00
.00
35.00
Plan Check Total .00
.00
.00
.00
-' Grand Total 35.00
.00
.00
35.00
Bin # r
�'
City of La Quinta
Building & Safety Division
Permit.#
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
.
Building Permit Application and. Tracking Sheet.
Project Address:
Owner's Name: ,� ���
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
_
Telephone: J
Address:
Project Description:
City, ST, Zip:
Telephone:
o
t
State Lie. # :
City Lie. #:
"
Arch.; Engr., Designer:
i
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one):. New Add'n Alter Repair
Demo
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
Recd
TRACMG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs:
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading. plan
2a4 Review, ready for correctionsrssue
Electrical
Subcontaetor.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 correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
5 _..
Total Permit Fees
i
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' _ x DUX,. TITLE SCALE DATE
SITE PLN �. , m,�. 03/28/05
DU1G. NO.
PROJECT TITLE
GARAGE ENCLOSURE
yr MERCADO RESIDENCE
A2
r - f n �+ x'•YC w1 r! t E, ,�'s^r: DE5IGNER RODOLFO LIZARDE
:Y• rt . t,, f lv[ °. A. Y.. t4 a .rr 14-854 NELIE WAY T
PALM DESERT, GA,94160
160-119.0334'