07-0684 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 07-00000684
Property Address: .�_54575_-WINGED FOOT
APN: 775 -110 -012 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 320
Applicant:
r
vL
Architect or Engineer:
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: C36 C53 ��/ LicenseNo.: 618116'
Date9^��/ Contractor: IUK 40,1ly pmwa/x
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 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 7031.5 by
+ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 1 1, 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 nr improves thereon,
and who docs 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.).
( -) 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 witha contractor(s) licensed
pursuant to the Contractors' State License Law.).
(' ) I am exempt under Sec.. ,'BAP.C. for this reason
Date: Owner: '
CONSTRUCTION LENDING AGENCY
Owner:
MIKE SOUZA
54575 WINGED FOOT
LA QUINTA, CA 922
Contractor:
LEAK DETECTORS
P.O. BOX 8674
PALM SPRTNrS, f a.
(760)773-9070
Lic. No.: 618116
17
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
MAR 0 5 2001
CITY of LAQUINTA
Date: 3/05/07
-----------------------------------------------
WORKER'S 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 workers' compensation
insurance carrier and policy number are:
Carrier CALIFORNIA INS Policy Number 460089600102
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 California,
and agree that, if I should become subject to the "workers' compensation provisions of Section '
3700 of the Labor Code,
II shall forthwith comply
Lwith
�those
fprovisions.
Date: 3 f�'1 Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IG UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 0100,000). 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 for a permit subject to the,
N. 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 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and here thorize representatives - -
of this county to enter upon the above-mentioned property for inspect n
-
Lender's Name: �7
•l/G Signature -(Applicant -or Agent): - -
Lender's Address:
LQPERMIT
Application Number 07-00000684
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 15.00 Plan Check Fee
.00 ,
Issue Date Valuation
320
Expiration Date 9/01/07
Qty Unit. Charge Per
Extension
BASE FEE
15.00
.
----------------------------------------------------------------------------
Special'Notes and Comments
20 LF 4' BLOCK WALL PER'CITY STANDARD
EQIUPMENT ENCLOSURE
Fee summary Charged Paid Credited
Due
Permit Fee Total 15,00 nn :00
13.00
Plan UheCk Total, .00 .00 .00.
.00
Grand Total 15.00 .00•- .00
15.00
sIT
z
1
,
LQPERMIT
-
:..
Bin. # -
Permit
Project Address:
A. P. Number.
Contractor: Contractor:
Address:
City, ST, Zip:
Telephone:
A
C
Td
tl
d
Y
PState Lie. #':
ArdL,.Fn9r, Designer:
n
Address:
City, ST, Zip:
Telephone:
State Lic.
Name of Contact person:
Telephone # Of Contact Person:
Submittal
Plan Sets
Structural Calcs.
Truss Calc&
EU"V CA10.
Flood plain plan
Grading.plin,
Subcodtac . t6r List
Grant Deed
H.O.A. Approval
IN HOUSE. -
Planning Approval
Pub. Wks. Appr
—School Fees
City Of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 CallE Tampico
La Quinta, cA 253 - (760)
92 '777-7012
..
Building Permit Application and Tracking .Sheet
Owner's Name:
Address:
5- 1-4)
City, ST, Zip: 4.-.
V L5 Telephone:
Project Description:
? &)14
Total Permit Fees
3
Construction Type:
Occupancy:
Project type (circle one):
New Ads! Alter Repair Demo
Sq. Ft.:
- ----- 1
0 Stories:
I Units:
Estimated value 0 Projem
APPUCANT:
DO NOT WRtTE BELOW
THIS UNE
TP'jhtn
TRACIMG
P . ERMU FEES
Check submitted
Item
Amount
Reviewed, ready for Corrections
Plan Chitic Deposit
Called Contact person
.
Plan Check Balance
Plans Picked. up
.
.............
Constructiod
Plain resubmitted
—
Mechanical
—
2'4 Revitwt ]ready for correctionsAssu e
Electrical
...............
Called Contact. person
Plumbing
Plans picked up
S.KL
Plans resubmitted
Grading
Review, rtady.for.corrcctionetssue
Developer impact jFcj
Called Contact Person
[A.I.P.P.-
.Date or permit issue
permitissue
Total Permit Fees
3
o JY o� ti
sri s CITY OF LA QUINTA
-
w� BUILDING & SAFETY DEPARTMENT ,r
�FM
OF777-70112
INSPECTIO Q
7 7
Owner MARK�SO.UZA •-
-LEAK DETECTO -
_ Contractor
Permit Number
07-684
POST ON JOB, IN CONSPZALSRACQS
C
INSPECTOR MUST SIGN ALL Aft
JOB ADDRESS 54575 WINGEDW6
20 LF 4' BLOCK WALL PER C ASD V F•
' EQIUPMENT ENCLOSURE
TYPE OF INSPECTION _ DATE ,INSP.
TEMPORARY POWER ., s
SETBACKS f
U/G PLUMBING/ WASTE, '
U/G ELECTRICAL/ GROUNDING
FOOTINGS / STEEL—, t
CONCRETE SLAB `
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED _
ROOF NAIL/ PRE—ROOF f ►
r. OKAY TO WRAP
,FRAMING COMBINATION
ROUGH ELECTRIC i
ROUGH PLUMBING t
ROUGHMECHANICAL t
INSULATION
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL i
-EXTERIOR LATH i
GAS TEST
SEPTIC ABANDONMENT 6
SEWER CONNECTION — t
SEPTIC / GREASE.INTERCEPTOR 1
MASONRY INSPECTIONS
FOOTINGS / STEEL !
BOND BEAM-
POOL/
EAM-POOL/ SPA/ WATER FEATURE INSPECTIONS
r+
PRE—GUNITE /SETBACKS +
U/G PLUMBING
U/G GAS
U/G ELECTRICAL . . - I
PRE—PLASTER ALARMS / BARRIERS
FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL _ , I
PLUMBING r
MECHANICAL - . t
PUBLIC WORKS DEPARTMENT I
COMMUNITY DEVELOPMENT DEPT. }
FINAL/ JOB COMPLETED $
ABOVE APPROVALS DO NOT INCLUDE RIGHT TOS.
' TURN ON UTILITIES OR OCCUPY BUILDING