05-4290 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO -
LA QUINTA, CALIFORNIA 92253
Application Number:.
c05 000'04-29.0-
Property Address:
80120 VIA PESSARO
APN:
772 -550 -020 -
Application description:
'Property Zoning:
WALL/FENCE t
LOW DENSITY RESIDENTIAL
Application valuation:
3000
Applicant:
Y --
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
PRESTWICK DEV
- P 0 BOX 980
LA QUINTA, CA 92253
Architect or Engineer:-
VOICE (760) 777-7012
FAX(760)777-7011
'INSPECTIONS (760) 777-7153
Contractor:
WHEELOCK MASONRY,_S.'K.
WCC: STATE FUND
WC: 1744382-2005 06/3
CSLB:.. 381984 07/3
Date: 9/23/05
SEP 231005 I�JI
CITY OF LA QUINTA
FINANCE DEPT
- LICENSED CONTRACTOR'S DECLARATION-
- - _ - WORKER'S,. COMPENSATION DECLARATION ,
.I,hereby affirm under penalty of perjury that I am licensed unde rovisions of Chapter 9 (commencing with
I hereby affirmunder penalty of perjury one of the following declarations: -
Section 7000) of Division 3 of the Businessland Professiona de, a my License is in full and effect. _
_ I have and will-maintain_a certificate of consent to self -insure for workers' compensation, as provided. .-
_force
License Class:- ense -
/q�•
ate: ��+ '"V�omract :
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
.. 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 C29' Policy Number - - - - - - - - - - - - - - - - -
'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
. personin 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 b me subie he w ers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of>e e Labor Cod all f rth ompl It those 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)::
- D®ta: pplicarlf ze
(_ 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: FAILURE TO SECURE WORKERS' 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 bf 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 personupon 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 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 Ouinta, 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 to cancellation:
_ I hereby affirm under penalty of perjury that there is a construction lending agency forthe performance of the
I certify that I have read this application and state that the above information�i orrect. 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 constructio9,a her - authorize representatives
'
of thi unty to enter upo he above-mentioned Prppert sp tiorip pos
•
D te: (i nature (Applicant or Agent):-
gent):Lender's
Lender'sAddress:
LQPERMIT
Application Number 05-00004290
Permit . . . WALL/FENCE PERMIT
Additional desc
Permit Fee 54.00 Plan Check Fee
.00.
Issue Date Valuation . . .
3000 - o
Expiration Date 3/22/'0.6.
Qty Unit-Charge Per
Extension
BASE FEE
45.00
1:00 9.0000 THOU. BLDG 2,001-25,000
9.00
- Special Notes and Comments
120 L.F.- 6' GARDEN WALL, ORCO SYSTEM.
Fee 'summary. Charged Paid Credited
Due
Permit Fee-Total 54.00 .00 .00
54.00
Plan Check 'Total .00 00 ; 0.0
.00
Grand Total 54.00 00 00
54.00
LQPERMIT
# Submittal
Plan Sets
Structural Calcs.
Truss Cales.
Energy Cates.
Flood plain plan
Grading.plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
Recd
City of. La Quinta
---...----- Building -BL -Safety Division.._._......... ----..__.... --------
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
uilding Permit Application and Tracking Sheet
A�Z J Owner's Name:
Address:
City, ST, Zip: �i�[�t// ei7i C_x
Telephone:
:� �..
Project Description:
Lic. #:
Construction Type: Occupancy::
Project type (circle one), New Add'n Alter Repair Demo
Sq. Ft.: # Stories: .__T# -Units:
Estimated Value of Project:
'LICANT: DO NOT WRITE BELOW. THIS LINE
TRACKING
Plan Check submitted
Reviewed, ready for corrections
Called Contact Person
Plans picked up
Plans resubmitted
2"" Review, ready for corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
A.I.P.P.
Total Permit Fees
Amount
Bin #
B
Per tt #
Z
Project Address: Q� .. Zo
A. P. Number: L;,'j 2,4, 6r0 it /1" �•
Legal Description- .
Contractor: c �`�` � 0 C'e
Address:
City, ST, Zip:
Telephone: 760 7 Z
City
State Lie. # : 3 �� FT
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Cales.
Energy Cates.
Flood plain plan
Grading.plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE:-
Planning Approval
Pub. Wks. Appr
School Fees
Recd
City of. La Quinta
---...----- Building -BL -Safety Division.._._......... ----..__.... --------
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
uilding Permit Application and Tracking Sheet
A�Z J Owner's Name:
Address:
City, ST, Zip: �i�[�t// ei7i C_x
Telephone:
:� �..
Project Description:
Lic. #:
Construction Type: Occupancy::
Project type (circle one), New Add'n Alter Repair Demo
Sq. Ft.: # Stories: .__T# -Units:
Estimated Value of Project:
'LICANT: DO NOT WRITE BELOW. THIS LINE
TRACKING
Plan Check submitted
Reviewed, ready for corrections
Called Contact Person
Plans picked up
Plans resubmitted
2"" Review, ready for corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready for corrections/issue
Called Contact Person
Date of permit issue
PERMIT FEES
Item
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
S.M.I.
Grading
Developer Impact Fee
A.I.P.P.
Total Permit Fees
Amount