07-1108 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 4"
Application Number:
07-00001108 -
Property Address:
80705 LA DOCENA TR
APN:
777-040-005- - -
Application description:
WALL/FENCE
Property Zoning:
VERY LOW DENSITY RES
Application valuation:
11250
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BERNIE GELLER
80705 LA DOCENA TRAIL
LA QUINTA, CA 92253
Contractor:
REESKE, MIKE
80199 BARCELONA AVE E
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/11/07
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 (55001.:
1—). 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 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.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractorsto 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 contractods) licensed
pursuant to the Contractors' State License Law.).
( ) .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
WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD TION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABORICODE, INTEREST, AND ATTORNEY'S FEES. I -
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Ap ' ation is h by made to the Director of Building and Safety for a permit subject to the
conditions and restrictio 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.
1 certify that I have read this application and state that the above info anon is correct. agree to omply with all
city and county or 'nances and state I s vela ' g to building con coon, and here authori representatives
of this co to ter upon the a e -mention property for i ection p pos
D re (Applicant or Age
INDIO, CA 92201. a zoo f
(760)466-7529
Lic. No.: 610056 CV,
J
-----------------------------------------------------------------------------------7-------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed uodefm 0visions of 2apter 9 (commencing with
Section 7000) Division 3
I hereby affirm under penalty of perjury one of the following declarations:
of of to Business an�p essior de, and m r cense 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: B 1cense No.: 10056
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
f�afe: tractor
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 DEC ATION
insurance carrier and policy number are:
I hereby affirm un er penalty of per ry that I am exempt from the Contractor's State License Law for the
Carrier E} MPT Policy Number EXEMPT '
following reason (Sec. 7031 .5, Busi ass and Professions Code: Any city or county that requires a permit to
construct, alter; improlr , demolish, repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed sta ant that a or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (com ting ith Section 7000) of Division 3 of the Business and Professions Code) or
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 beco subject to the orkers' compensation laws of California,
/and agre that, if I should beco _ ubject tq the wo ers' comp sation provisions of Section
37,60 oft Labor Code, I shal orthwith mpl ith those p visions.
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 (55001.:
1—). 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 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.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractorsto 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 contractods) licensed
pursuant to the Contractors' State License Law.).
( ) .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
WARNING: FAILURE TO SEC RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN AD TION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABORICODE, INTEREST, AND ATTORNEY'S FEES. I -
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Ap ' ation is h by made to the Director of Building and Safety for a permit subject to the
conditions and restrictio 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.
1 certify that I have read this application and state that the above info anon is correct. agree to omply with all
city and county or 'nances and state I s vela ' g to building con coon, and here authori representatives
of this co to ter upon the a e -mention property for i ection p pos
D re (Applicant or Age
Application Number . . . . . 07-00001108
Permit . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 135.00
Plan Check
Fee
.00.
Issue Date . . . .
Valuation
. . .
. 11250
Expiration Date.. . 10/08/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
10.00 9.0000 THOU BLDG -2,001-25,000
90.00
---------------------------------------------------
Special Notes and Comments
------------------------
450 L.F. 6' GARDEN WALL @ WEST SIDE OF
PROPERTY, CITY STANDARD
Fee summary Charged Paid
Credited
Due
-------------------------------------
Permit Fee•Total 135.00
----------
.00
----------
.00
135.00
Plan Check Total .00"
.00
.00
.00
Grand Total 135.00
.00
.00
135.00
LQPERAI[T
Bin #
CI of L a Quinta
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (76.0) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 70 J
Owner's Name:. elle
A. P. Number: 7 7 " — QC �` ,���J
Address:
Legal Description:
Contracto . . J 0 ' f e d4 0.50
Address: ,[
City, ST, Zip:
.,Telephone::
roject Description: Sa
City, ST,Zip: G%v2-4�es*1S1
Telephone: U-
State Lie. # : City Lie. #:
Arch.,. Engr., Designer:
Address:. .
City, ST, Zip:
Telephone:
State Lid. #:
Name of Contact Person �,�s
Construction T SSo Cr Occupancy:
Project type,(circle one): New Add'n . Alter Repair Demo.
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact erson: L Q. _
Estimated Value ofProject:
APPLICANT: DO NOT WRITE BELOW THIS LINE . .
N.
Submittal .
Req'd: •
RiWd
, TRACMG
PERMfP FEES
•Plan. Sets
Plan Check submittedItem
Amount
Structural Caics.
Reviewed, ready for corrections
Plan. Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plaits picked op
Construction'
Flood plain plan.'
Plans resubmitted
Mechanical
Grading. plan
2sd.Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up'
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
INHOUSE:-
'"' Review, ready for correctionstissue.
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
I