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05-1736 (BLCK)�Z s BUILDING & SAFETY DEPARTMENT c . BOX 1504 760 777-70 ( _ ) 12 IOTA 7 7495 CALLE TAMPICO FAX (760) 777-7011 FINAIMCE DEPT. L QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . 05-00001736 Date 5/06/05' Property Address . . . . . . 53716 VIA PALACIO APN: 772-560-053- - - Application description WALL/FENCE Property Zoning.. LOW DENSITY RESIDENTIAL Application valuation. 8875 Owner Contractor --------------------------------- -------------------- =------------ NAGY DALE/KATHY DRURY CONSTRUCTION, MARGARET 53-717. VIA PALACIO WCC: PREFERRED INS . LA QUINTA, CA 92253 WC: WKN1157592 06/01/05 CSLB: 463407 09/3.0/06 CCC: B-C29 ---------------------------------------------------------------------------- P.O. Box 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO FAx (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: % Date: J " 69 OS Applicant: I Architect or Engineer: Applicant's Mailing Address: ptvri?,4C TCW Architect or Engineer's Address: Lic. No.: A/, i BUILDING PERMIT DECLARATIONS 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 Ade, and my License is in full force and effect. License Class License No. -/Y 6 3`-% (0-70 Ojp OSS Contractor Ara ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Cors' 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 Contractors' State License Law (Chapter 9 (commencing with Section 70.00) 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).): U 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 or 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.). U I, 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 with a contractor(s) licensed pursuant to. the Contractors' State License Law.). U I am exempt under Sec. , BA P.C. for this reason Date WORKERS' 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, T polic n r�be� a e' framer 'f Y2Y� F 1�1'UC/� Policy Number✓ W %�00 (4j 4 Z _ 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, I shall forthwith comply with thoseprovision Qpt�.� Applicant/epUJIv WARNING: FAILURE TO SECURE WORKERS'E OMPENSATIO OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSA D DOLLARS ($ Q000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirn 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 Lenders Address APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a 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 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 certify that I have read 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 constructiola, and hereby authorize representatives of this co7tor upgrf tqe above-mentioned property for inspection purposes. t 5_ V Date Signature (Applicant or Agent): ---------------------------------------------------------------------------- r Application Number . . . . . 05-00001736 ---------------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 108.00 Plan Check Fee .00 Issue Date Valuation . . . . 8875 Expiration Date 11/02/05 Qty Unit Charge Per Extension BASE FEE 45.00 7.00 9.0000 THOU. BLDG 2,001-25,000 ---------------------------------------------------------------------------- 63.00 Special Notes and Comments 250 L.F. 2' RET & 6' GARDEN WALLS AND 95 L.F. 6' GARDEN WALLS, ORCO SYSTEM. 100 L.F. 2' - 3' PLANTER WALLS (COURTESY INSPECTION). Fee summary Charged Paid Credited Due -----------,------------- Permit Fee Total 108.00 ---------- .00 ---------- .00 108.00 Plan Check Total .00 .00 .00 .00 Grand Total 108.00 .00 .00 108.00 IX Bin # Permit # 4.�- %30 Project Address: —48�� City of La Quinta Building S Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777.-7012 Building Permit Application and Tracking Sheet Y'1 N �A LAC t L-3 Owner's Name: • A A. P. Number: b%3 - ?� nn Address: 6:3 -117 V I a P4,UqC,'O [City. Legal Description: ST. Zip: L4-7 1! i} 9Z25 3 Contractor: ►�(Z C ��v FTelephonc: Address: 7-3-80-7 AAASS04 1Project Description: City ST, Zip: �AI.IM Det 51 �( A C/22 0 o 4)c ,J UJA C�..S Telephone: 7(a 7 2-L-1 LA-4-l.L. State Lic. # : 4 City Lic. #: Arch., Engr., Designer: Address: City. ST, Zip: Telephone: State Lic. #: Name of Contact Person: v:.:_,;, - onstruction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 250 -�2Q2["Estimated Value of Project: 000 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING 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 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontaetor 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 correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.1.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees