06-2527 (BLCK)P.O. BOX 1504..
.78-495. CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253. BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number. 06-00002527 Owner:
Property Address: 54899 WINGED FOOT MR. GEORGE ORTIEG
APN: 775-330-015- - - 54$99 WINGED FOOT
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL. !e
Application valuation: 176 ,
Applicant: Architect or Engineer:
Contractor:
CAL-NEV POOL, INC.`
P.O. BOX 2222
RANCHO MIRAGE, CA 92270
(760)883-5561'
Lic. No.: 777601
VOICE (760) 777-7012
- FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/27/06
--------:-----------------------------------------------------------------------------------------
• LICENSED CONTRACTOR'S DECLARATION
t WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that.) am licensed under provisions of Chapter 9 (commencing with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in ful force and effect.
_ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
_License Class C53 License No.: 777 1
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
- D_ ate• Contractor:`
-
_ 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
OWNER -BUILDER DEC ION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 179559605 '
' following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subjec 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
that, if I should becomesubjectthe worker mpensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
f the Labor Code, I sh com i ose provisions.that
he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 byj�any
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
4andree
Date. -epplicant:
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
WAR IN . FAO SEC RE WORKERS' COMPE TION COVERAGE IS UNLAWFUL, AND SHALL
' Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN '
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
APPLICANT ACKNOWLEDGEMENT _
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the „
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and restrictions set forth on this application..
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1. Each person upon whose behalf this application is made,.each person at whose request and for
;. pursuant to the Contractors' State License Law.).
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
l _ 1 I am exempt under Sec. , B.&P.C. for this reason
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.
Date: Owner: -
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
CONSTRUCTION LENDING AGENCY
permit tocancellation.
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 inform I agree t mply with all
work for which this permit is issued (Sec. 3097, Civ. C.).
city and county ordina ces and state laws relating to building nstruct , and reby autho repont
eatives .
•
of this coun to ant upon the.above-mentioned property f ,n
Lender's Name:-
.
% Da ignature (Applicant or Agent):76�
Lender's Address:.
10%11�1 lop, 1140"
LQPERMIT
- 'Application Number 06-00002527
" Permit . . . WALL/FENCE PERMIT
-Additional desc .
Permit, Fee 15.00
Pian Check
Fee.
.00
Issue Date
Valuation
- `,...
17.6
Expiration Date 12./24/06
Qty Unit Charge Per -'
Extension
BASE FEE
15.00
- Special Notes and Comments
ELEVEN LF 4''BLOCK WALL PER CITY
" STANDARD FOR EQUIPMENT ENCLOSURE.
Fee summary Charged Paid
.Credited
Due
Permit Fee Total. 15.00
.00
.00
15.00
Plan.Check Total .00
.00
00
.00_
" Grand Total 15.00
.00
.00
15.00
f
q
Bin #
City of La ui n
Building u Safety Division
P.O. Box 1504,78-495 Calle Tampito
La Quinta, CA 92253 -.(760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:"—Owner's
A. P. Number:
Name:
Address: 5 '
� V
Legal Description:
Contractor:
C
City, ST, Zip:
Telephone:,
fr.
Address:
Project Description:
City, ST, Zip:.
Telephone:
State Lic. # :
Arch., Engr., Designer: "
City Lic. #:
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.:
# Stori ,-s:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACHING ,
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading. plan ..
2"' Review, ready for corrections/issue
Electrical
Subcontactor. List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
,
H.O.A. Approval:
Plans resubmitted "
Grading .
IN HOUSE:-
'`" Review, ready for corrections/issue.
Developer Impact Fee
Planning Approval
Called Contact Person
A.IP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees