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04-3642 (BLCK)�F�a�rw 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 �_ ppllcation Number . . . . ..`'04-00003642_ x_ Date 4/27/04 Property Address. . . . . . . 52720 AVENIDA VALLEJO APN: 773-293'-011-13 -000000- Application description . . . WALL/FENCE Property Zoning COVE RESIDENTIAL ..Application valuation.. 7500 :7 Owner Contractor POWER FINANCE OWNER P.O. BOX 134 LA QUINTA CA -92253 Permit . . . . . WALL/FENCE PERMIT Additional..desc Permit Fee 99.00 Plan Check Fee.. 00 Issue Date . . . Valuation 750D Qty Unit. Charge Per; Extension BASE , FEE 4 5 . 0 D 6.00 9.0000 THOU BLDG 2,001-25,000 54.0D Special Notes and Comments 150 L.F. COMBO WALL, 3' RETAINING, 6' GARDEN & 150 L.F. 6' GARDEN WALL, CITY STANDARD Fee summary Charged Paid Credited ------------ --- - =--------- Due ---------- ---------` --------- Permit Fee Total. 99.00 .00 .00 99.00 Plan.Check Total .00 .00 .00 .00 Grand .Total 99.00 .00 00 99.40 P.O. BOX 1504 tl��� VOICE (760) 777-7012 7E-495 CALLS TAhAlICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: 01- 36 q 7 Date: ' f Z 7- D'� Applicant: Architecta Engineebr Applicant's Mailing Afters Architect or ineer's Address: Lic. No.. BUILDING PERMIT DECLARATIONS effect. LICENSED CONTRACTOR'S DECLARATION 1 ode. and my Lise k b tui loroe and hereby affirm under penalty a perjury that ofect 1 am licensed under Provisions Of ChWW9(oamish en=V wSection 7000) a Division 3 a the Business and Prolessionals Licensor license No. -71193e Dat. z� Contractor B �-� G -K- ' 1 hereby aflim underpemlty a perjury that 1 am OWNER�ER DECLARATION wrtpt from Ie Contractors' Stab License Law for the k0owig reason (Sec. 7031.6. Business and Professions Code: Any city, «county, that requmn a permit b coed uet, aper, improvo. demoisl «repair any strudwe, plexi b lts ksrran%XL also requires the appiant IN tte gem* b fie a signed stalanto that he «she k ioense , pursuant b the provisiors 01#19 Contracbrs' Slab License Law (Chapter 9 (commencing with section 7000) a Division 3 a the Businass and Pfokssbm Code) «tat he «she k ex ono Iherefiom and the basis for the -raged exempom Any violation of Section 7031.5 by" applicant for a Permit subjects l e applicant loa dvi penalty of not more than lima hundred dotbrs ($Sd y U 1, as owner of the property. or my employees with wages as their sob compensation, wa do to work and the structuire is not Mended Or olbred for sale (Sec 7044. Business and Praessiors Code: The Conttracbrs' Stab License Law does not apply b an owner of property who builds «improves thereon, and who does the work himselfsold el fa h or ag« h his her own employees, Provided f % t the WW� M ft are not arded «alerted f« sale. U. howeyer. the buMN or inpromTont is n � a te r' the owner -bolder ova have the burden a proving that he or she did not irtth build or prove for e purpose a sale.). U LOS owner slob 6y, License the l0Law does not conbacbg with k e sed contractors b uct constree pvjed (Sec 7044. Business and Piolessions Code: The Coelrvcwe appy b an owner a property who builds «improves 9eieoo, and who contracts for the projects wish a caMracbr(s) Licensed pursuant lo the Contractors' State License Law.). U I am exempt under Sec . BA P.C. for this reason Dote owner firm under WAS' COMPENSATION DECLARATION 1 hereby affirm Penalty a perjury one a the following declarations: _ I terve and wa maintain a certificate a consent 10 satlinsue f« s• workercompensation, as provided for by section 3700 a the Labor ler a the patomanoe the work f« which this per.. is issued _ I(h�iasyse and will maintain workers' compensation insurance, Si required by section 3700 of the Labor Cade. for the pedorrrance of the work ler which a" permit is Carrier %fol'-fi r• tl ensatan artier and policy number aro: /7 j th OeNumber 3 I f My e rn D afire work ler which this permit is issued. I shall not employ any person Tn any reamerso as lobecome to the workers' �y that. KI should become aubjeet a to workers' compensation provisions a section 3700 a to Labor Code. I alai qlDate Z? WCNtLARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, Mfg SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND FINES LIP TO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. . I hereby affirm under CONSTRUCTION LENDING AGENCY penalty 0 /o that these k a construction lends g agency, ler the Pedormanoe a the work f« which this Pernit is issued (Sec. 3097. Cis. C.). Lenders Name _ Lender's Address IMPORTANT Application is APPLICANT ACKNOWLEDGEMENT hereby mile 10 the Director a Buidng and safety for a Penn' t subject Io the conditions and restrictions set forth on this appicaim 1. Each Penson upon whose behalf this application is made. each Person at whose request and for whose benefit work is pet ton, under or any permit Issued as a resale a this application. the owner, and Ie appicarN, each Pursuant Le t b officers, gents and employees for any act « omission related lo the work s b. and shall. defend. ollowing Issuance of pity and Mold harmless the City a La OuiNa, its 2. Any permit Issued as a result a this application becomes nuc and void I work's no Performed under � v�tin I go days chat of issuance a such Pentyl « cessation a work for 180 days wo subject permit lo ancelafion. 1 certify that I have read Isis application and state that the above inlor abon is correct 1 construction. authorize representatives a firs county lo enter �� lo comply with ap city and county ordinances and stale lows rotating b buildingiriaitioned IoFinspection Purposes. . Date O Signature (APPGcanl or Agent):