06-1166 (BLCK)P.O. BOX 1504
•78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253
Application Number: 0-6-00001166
Property Address: 53364 VIA PALACIO
APN: 772-560-061- - -
Application description: WALL/FENCE
Property 4oning: LOW DENSITY RESIDENTIAL
'Application valuation: 5750
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BUILDING & SAFETY DEPARTMENT '
BUILDING PERMIT
Owner:
KESSLER
56364 VIA PALACIO
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/22/06
Contractor:
rF
Applicant: Architect or Engineer: A & M CONSTRUCTION
P.O. BOX 366
LA QUIrTTA, ,CA 92247222006t(760)564-4832"LiC. No.: 746198�QU�y� fCE ®�
LICENSED NTRACTOR'S DECLARATION - WORKER'S COMPENSATION DECLARATION
at se
-
hereby affirm under penalty of perjury thI am lic d under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000)ofDivision 3 of the Business and fessionals Code, ancmy License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
Lice Class,_13 0 License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Dat 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 DECLARATION insurance carrier and policy number are:
hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0092322006
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 a 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 come 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 be a 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 3700 of the Labor Code, I forthwith comply withThose provisions.
. 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).: ate: Z- " P,p ' nt:
(_ 1 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 WARNING: FAILU E TO SECURE WORK S' COMPENSATION 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 1, 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,
1 _ 1 I am exempt under Sec. BAP.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 suc4tru
cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY permit to cancellation. -
I hereby affirm under penalty of perjury that there is -a construction lending agency for the performance of the 1 certify that I have read this application and state that.the ation 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 buildiion, and hereby aut(Lorize representatives
of this ounty to enter�pon above-mentioned propertyn purposes. -
Lender's Name:
ate: ��Z�Applicant or Agent):
Lender's Address: -
LQPERMIT
Application Number, 06-00001166
Permit WALL/FENCE PERMIT
Additional desc.'.
Permit Fee 81.00
Plan.Check
Fee
..00
Issue Date
Valuation
5750
Expiration Date 9/18/06,
Qty . Unit Charge Per
.FEE.
Extension
BASE
45.00
4.00 .' 9.0000 THOU BLDG 2,001-25,000
36.00
Special,Notes and Comments
230;L.F. 6' GARDEN -WALL, ORCO SYSTEM
Fee summary Charged Paid"
Credited
Due
Permit Fee,Total 81.0.0 K-
.00
00
81.00
�.
'-Plan Check Total .00:
.00 •.00
.00
Grand Total 81".00
00,
.'00
81.00
LUERMIT
Bin #
City of LaQ uinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit .# \`�
Project Address: 'PA -1,46i D
Owner's Name:
A. P. Number: Z
Address:
Legal Description:
Contractor: f ��yt S' (� '
City, ST, Zip:
Telephone: N'
Address:
Project Description:
City, ST, Zip: ll
Telephone:
w r _
r 0 Co �ipt
/
State Lie. # : G " l 4? �.
CityLic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #: 2
Name of Contact Person: '2{.�� Q /1
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq, Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACMG
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 Cities.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan'
2rt1 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:-
'n° Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees