08-0502 (BLCK)tr<fi t J r d ka -
P.O. BOX 1504 VOICE (760) 777-7012
T/ 78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT. INSPECTIONS (760) 777-7153
` BUILDING PERMIT
r Date: 3/25/08
Application Number:" 8=00000502 Owner:
Property Address: 51380 AVENIDA VALLEJO MARTINEZ ISNOEL POMPA
APN: 773-084-007-18 -000000- 51380 AVENIDA VALLEJO
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL --- - --------------- -------------- -
Application valuation: 2366
Contractor:
Applicant: Ar tea N/ Owner
--------------------------------
--------------------------------------------------------
LICENSED
-------------------------- ----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: I '
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will 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 Labor '
Code, for the performance of the work for -which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION insurance carrier and policy number aie:, ,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State license Law for the CarrierPolicy Number '
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I 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 - and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the L 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 applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.: ate: ^2 65 pplicant: �M.OL( �(=
- I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and - -
the structure isnoi 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the 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.
• 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
pursuantto the Contractors' State License Law.). whose benefit.work is performed under or pursuant to any permit issued as a result of this application, '
(_ 1 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 Quintal its officers, agents and employees for any act or omission related to the work being
'] 6L performed under or following issuance of this permit.
2
Date: s 5-e% Owner: 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 under penalty of perjury that there is a construction lendingagency 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 an state laws relating to building construction, and hereby authorize representatives
-- - - - - -- - _ - - -- - - of this co "ty to enter upo a above-mentioned' property for inspe/ion pur
Lender's Name:
e: —��O gnature (Applicant or Agent): �Vr6'G•
Lender's Address:
LQPER\IIT
Application Number 08-00000502
Permit WALL/FENCE PERMIT
- Additional desc .
Permit-Fee .. 54.00
Plan Check
Fee
00
Issue Date
Valuation
236-6
Expiration 'Date 9,/21/08
Qty Unit Charge; Per
Extension
BASE.
FEE
45.. 00
1:'0:0., 9.0000 THOU BLDG
2,001-25,000
9.00.
Special Notes•and Comments
----
--
7 3 L. F 6i GARDEN WALL, 25 L'. F :. 5 ',
,. & 4'
STEP DOWN TO PROPERTY LINE, 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
Bin #..
„
Citof La Quintsy
Building 4 Safety Division •
Permit
w P.O. Box 1504, 78=495 Calle Tampico
.#
La.Quinta, CA 92253 - (760)'777-7012
'e
•.
'Building Permit Application and Tracking Sheet
Project Address:'k 1
-_
Owner's Name' s ^n^
A. P. Number:-_-
`{i
Address, -e A! t D ` V Ile — •
i4 xj . p
Legal Description: '
City, ST, Zip: 2–
Contractor: r t
Telephone Q
Address: ' 0 ' '
_
Project Description: 0
City', ST, Zip:
,
_ _
Telephone: I c!5�'
---
:City Lie. #:
t(' ;
2 0 , -.e � �
State Lie. # : * ' `
Arch:, Engr., Designer:
-
Address:
s
City, ST, Zip:
Telephone: i
Construction Type: ccupancy:
State Lic. #:
Project type (circle one): ew Add'n Alter Repair Demo'
Name of Contact Person:
Sq. Ft.:,/ O p �
# Stories:
# Units: '
Telephone # of Contact Person: j':' -
Estimated Value of Project:
;'APPLICANT:
DO NOT WRITE BELOW THIS LINE-
N
Submittal
Req'd
Recd
TRACKING .
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..
1�
Plans picked up
Construction
Flood plain plan ,
Plans resubmitted.
Mechanical= _ '
Grading plan
'211 Review, ready for corrections/issue
Electrical
Subcontactor List
i
Called Contact Person`
-
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted -
Grading
INHOUSE:- '
yl
7nd Review, ready for corrections/issue °•
Developer Impact Fee
"
Planning Approval
Called Contact Person '
A.I,P.P..I.
•`_
Pub. Wks. Appr .
'
Date of permit issue
School Fees
,
Total Permit Fees
`
i
TELEPHONE (760)777-7012` FAX (760) 777-7011
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified: -
For your protection you should•be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their '
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible `
liability if that person applies fortheproper permit in his or her name.
Contractors are required bylaw to be licensed and bonded by the'State of California and to have a business license
from the City or County,They are also required by law to put their license number on all permits for which they
apply r
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediatefamily, and the work (including'materials
and other costs) is $200.00 or more for the entire project, and such persons'are not licensed as`contractors or
subcontractors, then you may be an.employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
-.to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disabilit 'insurance costs and unemployment compensation contributions.
There maybe financial risks for you if you do not carry 06 f these obligations, and these iisks are especially serious with
respect to worker's compensation insurance. r
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
f Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. a
` If the structure is intended for sale, property owners who are not licensed contracts are allowed to perform' their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
'permit; erroneously implying that the property owner is providing his or her own labor . and material 'personally.
Building'permits are not required to be signed by property owners unless they are performing their own work
personally. ..
Information about licensed.contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814. ,
Please complete and return the enclosed owner -builder verification form so'that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned. '
Very truly yours, '.
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta,CA 92253
(760) 777-7012
FAX: (760) 777-7011 '
+
sill Iel �
;, • OWNER'S SIGNATURE/DATE
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PROPERTY, ADDRESS
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o8-
PERMIT NUMBER(S)