07-1448 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
07-00001448
Property Address:
77271 CALLE DURANGO
APN:
773-211-030-22 -000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
3592
T -,&t 4 4 Q"
Applicant: Architect or, Engineer'
LICENSED CONTRACTOWS DECLARATION
BUILDING. & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that l am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 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 Contractor's. State License, Lawforthe
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 703] .5 by
any applicant for -a psrmit;subjects the:applicaM;to a civil penalty of not more than five hundred, dollars (9500).:
(_) I, as owner of th&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 Lieense.Law does not applyto an owner of propertywho 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.orimprovement is.sold within
one year of completion, the owner-builderwill,have the burden of proving that he or she did not build or
improve for the:purpose of sale:)..
(_) 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, a who contracts for rojects.with a contractor(s) licensed
pursuant to the State Ci_ Law.
(_) I am exempt under Sec: B. .C. for thi reaso
Date: -S / 13 /-'b
CONSTRUCTION LENDING AGENCY
1 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:
LQPEBMff
Owner:
QDAY ALAN E
---------------------------
VOICE (760) 777-7012
FAX (760) .777-7011
INSPECTIONS (760) 777-7153
Date: 5/15/07
Contractor:
JUOwner MAY 151007
CI1Y OF LA QUINTA
. WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of;perjuryone 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
I h isissued.
s end 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, (.shell notemploy any
person in any manner to becomesub`ect to orkers' compensation lawvof California,
and agree that, if ould' oma subj to orl rs' compensation -provisions of:Section
3700 of the Labor ode, P ell forth th,co p y wit those provisions.
Dater J�r, a7 Applicant:
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made%to,the Director of Building and Safety fora 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 Quints, 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 notcommenced
within 180 days from date of issuance of- such per easationof rk,f days will subject
permit to cancellation.
I certify that I have read this application and state that the ove inform ion is rrec 1 agree o'comply with all
city'and courtyordlnances and.state laws relating to buil ng constructi n,.and arab authoriz representatives
of this coun)q to a er upon the above-mentioned prope for ins cti purp
Data: �gnature (Applicant or Agent):._-
Application Number . . . . . 07-00001448
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 63.00
Plan Check
Fee
.00
Issue Date
Valuation
. .
35.92
Expiration Date . 11/11/07
Qty Unit Charge Per
Extension
BASE FEE'
45.00
2.00 9.0000 THOU BLDG 2,001-25,000
18.00
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Special Notes and Comments
90 IN. FT. 6 FT. BLOCK WALL AND 62
LN.FT,5 FT. BLOCK WALLS PER CITY SPECS.
May 15, 2007 1:18:56 PM jjohnson
Fee _summary Charged Paid.
----------
Credited
Due
_
Permit Fee Total 63.00
----------
.00
--_--------
.00
63.00
Plan Check Total .00
.00
.00
.00
Grand. Total 63,.00
.00
.00
63.00