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04-3617 (BLCK)�T;'V BUILDING &NAFETY DEPARTMENT c.0..Box 1504 (760) 777-7012. OF78-495 CALLE TAf�frlco FAX(760)777-7011 LA QbINTA, CALIFORN.IA 92253 INSPECTION REQUESTS (760).777 -7153 - BUILDING PERMIT App 1 i c at i on. Number ,-0 -0000-3617 Date 4/21/04 Property Address 53835 AVENIDA DIAZ APN : 774-151.-.03.4-4.' - :0.0.0.0'0 Application description .•.WALL/FENCE `Ml Property Zoning .COVE RESIDENTIAL Application valuation 875 APR 21 2004 Owner Contractor pF UI�TA Cf tAQ --------- ------- ---- ..---------------cl-smMS�F�iEPT: RODRIGUEZ'JESUS PLACIDO OWNER t 53.835 AVENIDA. DIAZ LrA "QUINTA .. ..CA .:92253 ------------------------------------------ Permit ..... ... ; ... WALL./..FENCE.: PERMIT .. . Additional desc . Permit Fee.. 23..00 B1.ari Chec}c F'ee .00 ...... Issue. .Date. Valuation 875 Qty Unit -Charge .Per Extension BASE FEE'15.00 4..QO -2.0000 HND. BLDG 501.-2,.000 8.00 Special Notes and Comments 35LF'6! BLOCK WALL IN .FRONT' YARD. IN LINE . WITH.EXIST-ING:.GARAGE. Fee. summary -C.harged Paid Credited Due Permit Fee Total 23.00 .00 .00 23..00 Plan Check Total .00 :00., .00 .00.. Grand Total 23.00. .00 00; 23.00. t • P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMrICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS -(760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number. Date: 4_2 Applicant: Architect or Engineer. • J �S(� S 20 Gil `1-v �rrl�'� niO.iK.. , Applicant's Mailing Address: - Architect or Engineer's Address: live 2ZS Lic. No. BUILDING PERMIT DECLARATIONS . LICENSED CONTRACTOR'S DECLARATION I hereby affatn under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Plolessionels Code, and my License is in lull fotoe and efidct License Class Llow" N0. Date • Cantrac%or . OWNER -BUILDER DECLARATION I hereby affirm ymder penalty of POM that I am exempt from the Contractors• State License Law for the following reason (Sec. 7031.6, Business and Professions Code: Any city or county that LegAvs; a pemmR to construct, ahw. krmpnove, demolisk or repam any Wuct ue. prior to Its issuance. also requires to applicant for the permit b lie a signed *statement that he of she is licensed pursuant to on povisionc of the CentracloW State License Law (Chapter 9 (conrnencing with Section 7000) of Division 3 of the Business and Professions Code) or that he orshe is exempt twetrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant b a dui penalty of not more than five hundred dollars (t500).y t, as owner.o( the P opo.ty, or my empbyees with wages as tndr sole oampensatiah will do the wok and the stnxxnrne is not intended or offered for sale (Sec 7044, Business and Professions Code. The C.antracloW Slab License Law does not apply to an owner of property who builds or krpre4es thereon: and who does the work hin>self or herself or trough his or her own employees, Provided that the Improvements are not Intended or offered for sale. K however. the building or inprownent is sold will*% one year of completion, the ow(w4xAder 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 poled (Sea 7o44, Business and Protesstors Code: The Contractors• State Lkense Law does not appy to an owner of property who builds or knpmves theieon,' and who contracts for the projects with a contrackods) licensed pursuant 10 the Contractors State License taw.). U 1 aim exempt under Sea _ S.3 P Cris• reason 2 Date` —�/ a� OC/ Owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 1 have and will mratntakn a certificate of consent to self-inme for workers' oenpensation, as provided for by Section 3700 of the Labor Code. for the pertommanoe of the work for which this pemrit is Issued. _ I have and will maintain wakens' compensation ksurance. as required by Section 3700 of the tabor Code. for the performance of the work for which ails PMA is Issued • W workers compensation ksumnoe center and policy number are: Cartier Policy Number 1 certify that, len the palomhame of the work for which this permit is issued. I shall not employ any person in tiny manner so as to become subject 10 the wakens' compensation laws of Cafifomia, and spree triffis AQlx coria subject to the workers' compensation povWoms of Section 3TOO of the L.sbor Code. I stiall i0dhwfth.aw%*y with those provisions. l WARNING: FAILURE YO SECURE WORKERS' COMAS&SATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML 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 ATTORNEYS FEES. . CONSTRUCTION LENDING AGENCY 1 hereby affimn under penally o(PICJMthat trete is a construction lending agency hoc the Wbn naam of the wok 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 pem it wbjed to the eonddions and restrictions set forth on this application. I. Each person upon whose behalf this application is made. each person at.whose request and for whose benefit work is performed under or pumuard to any permit issued as a mssuk of this application, the owner. and the applicant, each agrees to, and shad, defend. indemnify and hold harmless the City of Le Ouknta, Its officers. agents and CnVbyees for any ad or omission related to the work being performed under or following issuance of this per nit. .2. Any permit issued as a result of this application becomes null and void K wok is not tomnenoed within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject pemnit to cancellation. I certify that I have read this application and state that the above Womnati Is mered 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby aWwrize representatives of this county to {mentioched property fa inspection purposes. Date �/ ` Signature (Applicant or Agerd): V 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 required to 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 applies for the proper permit in his 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 variuus 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 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an employer and you are subject to several obligations including 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 Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Starr Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, 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 his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in 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 Quinta, CA 92253 (760) 777 7012 FAX:17 0 7- 02 O R'S SI N RE/DATE PROPERTY ADDRESS PERMIT NUMBER(s) SITE REQUIREMENTS, INTERIOR LOT ��}J[ die ('�J�? '�i\��y�'�d' ,ia t>'�' '�..�/'3 �-5�� {.3CiY�L��{'4117 Cy,�'6�._ a i �� i . FOR CUUAM RUCTION DATE BY SIDEYARD: 5 FEET REARYARD: 10 FEET MDflMUM EACH SIDE MQdII" FRONTYARD: 20 FEET mNpAum 2 c0*1 1407 — -------=------ 1 l , I ON . AREV TO -BE--:- -� -LVIDSCAPED I- PROPERTY LINES 5 m CURBLINE