06-1980 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
06-00001980O80705 LA DC,E
NA TR
772-280-005- -
WALL/FENCE
VERY LOW DENSITY RES
2295
Applicant: Architect or Engineer:
z
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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 Professi nals de, and my License is in full force and effect.
License Cla B ense No.: 610056
Date;J ! !/ 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).:
(_) 1, 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
a 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
r
improve for the purpose of sale.).
(_) I, 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.). ' r
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY '
I 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
Owner:
GELLER BERNIE & PAM
80705 LA DOCENA TRAIL
LA QUINTA, CA 92253
(760)404-7176
Contractor:
REESKE, MIKE
80199 BARCELONA AVENUE
INDIO, CA 92201
(760)466-7529
Lic. No.: 610056
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/17/
fai I~t
IJI
i�111f 1 � �006___j
61 Y Qfi LA QUINI A
FINANCE DEP?:
06
----------------------------------------------—
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.
_ 1 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 EXEMPT Policy Number EXEMPT
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 rkers' compensation laws of California,
and agree that, if I should beco je he rs' compensation provisions of Section
,�J•�//�i3777000 of the Labor Code, rth om with those provisions.
:Date ,P - " , — A=pplicant: I .
—WARNING: FAILURE TO SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -
DOLLARS (S100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
. r
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.
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 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 c ct. I agree to comply with all
city and county ordinances and state laws relating to building cons n, reb orize representatives
of this couy t�Rf /nter upon the above-mentioned property io os
Dat ` fJlJ Signature (Applicant or Agent • -
Application Number . . . . . 06-00001980
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2295
Expiration Date.. 11/13/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
----------------- ------------------------------------------------------------
Special Notes and Comments
106 LF.5' BLOCK/WROUGHT IRON WALL PER
CITY STANDARD & CDD APPROVED PLANS
ALONG FRONT P/L.
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
t
.00
.00
54.00
t
LQPERMIT `
ILL @ LOT 6
JV WALL TO
; ATION
APPROVED BY COMMUNITY DEVELOPMENT DEPARTMENT`
BY DATE �So
EXHIBIT
CASE NO. -------
r
CITY OF LA QUINT
BUILDING & SAFETY
APPROVED
FOR CONSTRUCTION
DATE BY
PLANS PREPARED BY:
DRAWN
J.JOHNSON
CHECKED
S.L.
DATE
05-11-06
SCALE
Y1611 = 11-011
VJOB NO.
2005-074
SHEET
S-1
a
w
H
DRAWN
J.JOHNSON
CHECKED
S.L.
DATE
05-11-06
SCALE
Y1611 = 11-011
VJOB NO.
2005-074
SHEET
S-1
CITY OF LA QUINTA SUB-CONT� S
SUB -CONTRACTOR LIST
_ ✓�
JOB ADDRESS PERMIT NUMBER OWNE • ✓n BUILDER .4 " - 11A&J"L5
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing _on this list or their employees are uthorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a 'stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade /Classification
Contractor
`>'<State;:Contractor's Licenst3
Workers Compensation:Insurance.'.
Company Name
Classification
(e.g.' A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12)
CONCRETE (C-8)
FRAMING (C-5)
STRUCT. STEEL (C-51)
MASONRY (6-29)
l%�
G2�
��3 gl���
�Jo�C �Ce Gte .
/2Z�3,5-4
�s
PLUMBING (C-36)
LATH; PLASTER (C-35)
DRYWALL (C-9)
HVAC IC -20)
ELECTRICAL. (C-10)
ROOFING (C-39)':
SHEET METAL (G43)
FLOORING (C`=15)
GLAZING (C-17)
INSULATION.(C-2)
SEWAGE DISP. (C-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
-
FENCING (C-13)
LANDSCAPING (C-27)
POOL (C-53)
Sin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
D�
L2,
Project Address:' Q
Owner's Name:
A. P. Number: 7 z _ G ..QQ
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone: r
Address: ®:z f cl�ye la
Project Description:
City, ST, Zip:
Telephone: GQ Sid 7
�.
State Lic. # City Lic. #:
Arch., Engr., Designer: C�
Address:
City, ST, Zip: J C4- c ��.
Telephone:.] 4
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Perso �s C
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contac)person:'QG — %
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACHING .
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
2°" Review, ready for correctionsrssue
Electrical
Subcontactor. 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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees