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05-0730 (BLCK)..BUILDING & SAFETY DEPARTMENT O Box - g 1504 (760).777-7012 OF • =495 CALLE TAMP,1C0. Tt`2oo5 L FAX 777-7011 QUINTA; CALIFORNIA 92253 .. INSPECTION: (760) 777-7153 x, �Q•. of vE BUILDING PERMIT fIPIA�CE - _ Applicatiori'Number . . ��"`0;000073-0, A Date 3/02/05 Property Address 043708 PARKWAY ESPLANADE W APN: 6.0-9.-59,0-026- Application description WALL'/ FENCE' Property Zoning LO.W DENSITY RESIDENTIAL Application valuation . 500 Owner Contractor BRANDON FERNANDEZ OWNER 43708 PARKWAY ESPLANADE,�.WEST LA QUINTA 'CA 92253 ---------------------------------------------------------------------------- Permit WALL/FEN'CE-PERMIT Additional desc Permit Fee'. 15 00:. Plan.•Check.Fee .00 Issue Date `'`4 -: Va'lua'tion 500 Qty Unit Charge °'-per '. Extension 'BASE - FEE 15.0.0 -----------------7----------------------------------------------------- Special 'Notes and Comments a 20 L.F. 6•' GARDEN °WALL, ; �ORCO' °SYSTEM .Fee summary Charged -Paid Credited -Due ---------- ---- ------------ - ---- ------ --- ---------- Permit Fee Total 1b.:00 00. .00 15.00 Plan Check Total.. 00 ';00 -. .00 .00. Grand Total 15.~:0,0 00 :00 15•:00 P.O. BOC 1504 • 'GC��� 7$-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT Application Number: O J - 7 _� 3O Applicant: Applicant's Mailing Address: Architect or Engineer: W, VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3-a-05 Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS 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 License No. Date Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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 plicant 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 or 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.). I, as owner of the properly, 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.). L) I am exempt under Sec.B. C. for this re so 3-2-o S WORKERS' COMPEMSkTION 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 Policy Number I 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 Califo a, and agree)n. *11 should pecome subject t workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pfovisions. i) / / 3-2 05 - WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS U FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITI O THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury that there is a construction lending CONSTRUCTION agency orJthe peAGENCYING performance of he work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address IMPORTANT Application is hereby made to the Director of Building and Safety APPLICANT Cor ap ACKNOWLEDGEMENT rmit ubo he conditions and restrictions set forth 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 Ouinta, 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 rep tatives of this count o enter upon po a above- entioned grope for inspection purposes. Date �� 2 ®� ignature (Applicant or Agent): 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 requiredto 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 apphes.for.the proper permit in or her name. Contractors are required by law 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 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 immediate family and the work (including materials and other costs) is $200.00'6r more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be ademployer: 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, disability insurance costs and unemployment -compensation contributions. There may be financial risks for you if you do not carry, out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations. under. Federal Law, contact the Infernal Revenue Service .(and, if you wish, the U.S. Small Business•Administration): For more specific; information about your obligations under State Law, contact the Department of Benefit Pay ments:arid4he .Division.of Industrial Accidents. 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 subcontiactor, 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 hi"s'or her own labor; and. material personally. Building permits are not required -.to be signed" k y:property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by. contacting the. Contractors' State License Board iri 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 Quints, CA 92253 (760) 777-7012 FA (760) 7777011 OWNER'S SIGNATURE/DATIi/ � PROPERTY ADD S 0S 21d 0 PERMIT NUMBER(S)