05-0328 (BLCK)F O�
U
��. BUILDING & SAFETY DEPARTMENT
1.5041 (760),777-7012
P.oB,o�
OF '9-495 CALLI AMPICO FAX (760) 777-7011
D A QUINTA,�C1AIL+IFO.RNIA 92253 INSPECTION REQUESTS (760) 777-7153
FEB 10 225" �v� BUILDING PERMIT
civ
i c a Date 2/08/05
erty Address 54760 AVENIDA DIAZ
APN: 774-291-001-24 -000000-
Application description . . . WALL/FENCE
Property Zoning'. COVE RESIDENTIAL
Application valuation . . . . 2467
Owner
------------------------
ENGLE, MR/MRS JIM
54760 AVENIDA DIAZ
LA QUINTA CA 92253
Contractor.
------------------------
OWNER
----------------------------7-----------------------------------------
Permit . . . . . WALL/FENCE PERMIT
Add.itional.desc
Permit Fee 54.00 Plan Check Fee .00
Issue Date . . Valuation . . . . 2467
Qty Unit Charge Per. Extension
BASE FEE 45.00
1.00 9.0.000 THOU BLDG 2,001-25,000 9.00
----------------------------------------------------7---------7-------------
Special Notes and Comments
EXISTING TWO FOOT GARDEN WALL WITH WOOD'
.FENCE, TO HAVE WOOD FENCE REMOVED, WALL
HEIGHT RAISED TO 6' FOR 90 FEET FROM
REAR P/L AND TO 5' FOR LAST 10' PER
APPROVED ENGINEERING.
1 hr charged for struc plan check @
$75.00 2/8/05 1:46:13 PM jjohnson
----------------------------------------------------------------------------
Other Fees . . . . . HOURLY PLAN CHECK 75.00
Fee summary Charged
Permit Fee Total 54.00
Plan Check Total .00
Other Fee Total 75.00
Grand Total 129.00
Paid Credited Due
---------- ---------- ----------
.00 .00 54.00
.00 .00 .00
:00 .00 75.00
.00 .00 129.00
P.O. BOX 1504 • VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 4 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 077— 0327,57Date: o' q -DS
Applicant: 0(/r✓ 1 Architect or Engineer:
Applicant's Mailing Address:
tvfP007 L/111,
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
lq
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
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 1, 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 exImpt Tder SecyB.& P.C. fo s reason
✓� _ . i
WORKERS' CO PE AXON DECLARATION
I hereby a irtn under penalty of perjury o e of the f Ilowing declarations:
_ I have and will maintain a ce
if
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 pe 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 Calif ree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith com ly with th a provision
IN R
WARNIN& FAILURE TO SECURE WORKltRS'C9lQIPENSATlON COVERAGE IS Ul` AWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSANU 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.).
Lenders 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 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 th ation is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, nd ereb,y, f orize representatives of is county toe r upon the ab e -mentioned propert or inspection purposes.
®� s__Da =Signature.(ApplicantbCAgent .�
X
Bin #
City of La Quinta -?
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
5-- 3zg
Project Address: V4& !tAa
0%%-ncr*s Name:
A. P. Number:
q
Address:
Legal Description!
Cirv. ST. Zip:
Twoniftracrtar: ';)kA% 'OUT tM
FTclephone:
Address: 154,1'(0,0e 2N,
XProject Description:
City? ST, Zip: 6;tl C'4* C a,
2�
)IDW UJA
r
Telephone, 7�>
. . A
nz.r —.
CVIIJ
—
State Lic. #
City Lic. V—z
F- Y 6 e, /I
Arch., Engr.. Designer:
it P X, r 7-..
Address:
City, ST. Zip:
Telephone:
State Lic. #: =
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: 76 L* # Stories: TO —Units:
Telephone * of Contact Person:
Nstimated Value of Prciiect:
APPLICANT: DO NOT WRITE BELOW THIS LINE
0
Submittal
Req'd
Rtc'd
TRACKING.
PERMIT FEES
I
Plan Sets
Plan Check submitted
01-
Item Amount
Structural Cala.
Reviewed. ready for corrections
P120 Check Deposit
Truss C21CL
Called Contact Person
Plan Check Balance
Energy Cales.
Plans picked up
Construction
Flow plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctio-K,—SUe
W,7-—
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
SAM.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Rtview, ready for corrtclionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
O j
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