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06-1808 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: rp��111 77775 CALLE DURANGO 77.3-231.-001-22 -000000- WALL/FENCE COVE RESIDENTIAL 1400 Iii,ipljFtq r, if Architect or Engineer: ')Ik,^Ir- BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: ZAVALA JUAN J 77775 CALLE DURANGO LA QUINTA, CA 92253 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/05/06 - ----------------------------------------------- LICENSED CONTRACTOR'S DECLARATION -- --- - - - - ------------------------------ - - - - ---- WORKER'S COMPENSATIONDECLARATION I hereby affirm under penalty 'of perjury that I am licensed under provisions of Chapter 9 (commencing with. I hereby affirm under penalty of perjuryone.ofthefollowing declarations: Section 7000) of Division 3 of the Business and Professionals.Code,and my License, is in full force and effect._ I :have and will maimain:a certificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by: Section 3700 of the. Labor Code, for the performance of the,work for which this permit is issued. 'Date: Contractor: _ 1 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 DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Ucense.Law for the. Carrier Policy,Number following reason (Sec. 7031:6, Business and Professions Code: Any city or county that requires a permit to IWany _ 1 certify that, in the performance of the work,for which this permit.is.issued, l shall not _employ any construct, aher,.improve, demolish, or rope structure, prior to Its issuanoa. also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to:the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of: Division 3 of the Business and Professions. Code) or that'he orshe'is exempt therefrom'and'the basis for the all ad exam ion An 'violation of Section 7031 ^ 3700 of the Labor Code, 1 shall forthwith comply with those provisions. eg Pt Y _ . .- .. .. Y any applicant'fora permitsubjects the applicant -to a civil penalty of not more than five.hundred dollars ($500).: 1 _ I 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.). (_ I I, as owner of the r 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 contrector(i).licensed pursuant to the Contractors' State License Law:). (_) I am exempt under Sec. B.&P.C. for this reason CONSTRUCTION LENDING AGENCY thereby affirm under penalty of perjury that,there is a construction.lending,agency for the performance of the - work for which this pe it is issued (Sec. 3097, Civ. C.). Lender's. Name: Lender's Address: II.q6M-,1-1 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 (III 00,000).IN ADDITION TO THE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN. SECTION 3708'OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditionerand restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person st whose request and for whose benefit work is performed under or"pursuanttoany permit issued.as a result of this application,. the owner, and theapplicant, 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 for180 days will subject permit to. cancellation. - I certify that I have;reed:this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building constructioni.and.hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Application Number . . . . . 06-00001808 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . .33.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 14.00 Expiration Date 11/01/06 Qty Unit Charge Per Extension BASE FEE 15.00 9.00 2.0000 HIND BLDG 501-2,000 18.00 ----- ---------------------------------------------------------------------- Special Notes.and Comments .56 LF 6' BLOCK WALL Q INTERIOR_ SIDEYARD J PER CITY STANDARD. - Fee summary Charged. Paid Credited - Due - Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total 00 .00 .00 .00 Grand Total 33.00 .00 .00 33.00 LQPEMT Bin # City of La Quinta Building a Safety Division P.O. BOX 1.504, M-4.95 Calle Tampico La Quinta, CA 92253 - (760) 777=7012 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: Vuy1 ZcwcAlo' A. P. Number: Address: �,,, olPVGIV► O . Legal Description: City, ST, Zip: WMW CA C4 2655 Contractor: I Telephone. ( Address: Project Description: City, ST, Zip: Telephone: State Lie. # : City Lic. #: Arch., Engr., Designer: Address: City,:ST, Zip: Telephone: State,Lic. #:Project Construction Type: Occupancy:, type (circle one): New Add'n Alter Repair Demo Name. of Contact Person: Sq. Ft.: # Stories: , # Units: Telephone #.of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Trues Cates. Called ContactPersou Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading.plan 2" Review, readyfor correctionarmue Electrical Subcontaetor List Called Contact Person Plumbing Graot.Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review„ readyfor corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees pop Qw. OWNER/BUII DER 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 theyare 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 various 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 include 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 Administration). For more specific information aboutyour obligations under State 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 contracts 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 IA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 Calle Tampico La. Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011 ER'S SIGNATURE/DATE PROPERTY ADDRESS PERMIT NUMBER(S)