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05-0167 (BLCK)BUILDING & SAFETY DEPARTMENT P.O. Box 1504 (7.60).777-7012 78-495 CALLE TAMPICO �' FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 IN.SP.ECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . 05-0.0.0.00 67 Date 1/19/05 Property Address 49825 JEFFERSON ST APN: 649-520-005- Application 49-520-005 Application description . . . WALL/FENCE Property Zoning . . . . . COMMUNITY COMMERCIAL Application valuation . . . . 37500 Owner Contractor TRANS WEST HOUSING TRANS WEST HOUSING, INC. 47-120 DUNE PALMS ROAD, STE. C 9968 HIBERT STREET, STE #102 LA QUINTA CA 92253 SAN DIEGO CA 92131 (8.58) 653-3003 J WCC: STATE FUND WC: 1648813 10/01/05- CSLB: 701039 01/31/05 ----- CCC: B --------------------------------------------------------- Permit . . . . . WALL/FENCE PERMIT -------------- Additional desc Permit Fee 336.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 37500 Qty . Unit• Charge. Per Extension BASE FEE ,1252.00 13.00 6.5000 THOU BLDG ---------------------------------------------------------------------------- 25,001-50,000 84.50 Special Notes and Comments 1500 L.F. 6' PERIMETER WALL, ORCO SYSTEM Fee summary Charged ----------------- ---------- Permit Fee.Total 336.50 Plan Check Total .00 Grand Total 336.50 • D � Q. 1q1V 0 Paid Credited Due ---------- ---------- ---------- .00 .00 336.50 .00 .00 .00 .00 .00 336.50 P.O. Box 1504 • '�� VOICE (760) 777-7012 78-495 CALLS O FAX (760) 777-7011 LA QUINTA, CALIFORNIAFOR 9225344 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: O Applicant: Applicant's Mailing Address: w0`: 019% Architect or Engineer: Architect or Engineer's Address: A)/A 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 ss Liceycg is in full force and effect. /Xicense/Class ilk icensse/N)o.� `�� /� � Date < Contractor �"Gd4i�'"l�►-C% OWNER -BUILDER DECLARA N I hereby affirm under penalty of pedury 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 the applicant to a civil penalty of not more than five hundred dollars ($500).): U 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.). U 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.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' 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. 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 kers' co ensatio icy Nue caner and poli nymb r mer Policy Number, _ l _ I certify that, in the performance of the work for which this pe it is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date 7 ! b A ant WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 Lenders Address 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 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Z115ate ! O igpplicant or Agent): �� nature (A .0 Jan ,13. 2005 5 : 22PM No , 5246 ' P, 3 — fl' O" HIGH ORCO WALL SYST EM SITE WALL FDR 70 MPH WIND Cal EXPOSURE C 17PTjUW RATCAP ORCO MIA, 6616, OR 6618 ow G WUIEPONLY@ MTSM D6YL7YL7 ER=A. 1, AUOWABLESDA 6FARINS PRE47BLE' =15W PSF 2ALLOWASLELATBMPASSfYEPI mIWpoc 3_ LVA40ZMfaW IISIRBNGJ}J-2WOP @28agM A RIDWUM WS M . az4DE 4p RJR #4S4RSAAlD g R! is GRAQE60 R71T AfSANO LARGW 5• S&MffC-:.VW 4 504 FROM rITEA OR e5OVRCE 41SWPSTISLQSDWYL2'"WEW0/y M IfALFSTRAA'SL6W-NOSREifAL DWWCC M NRBX MIN. Ma,MW DEPTH FOR 5'' OT iRa fT sola E wnLc ® wALt � SLDPE T lop 1 FT. 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