06-0367 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 XP Q"'.
Application Number:
'06-00000367
Property Address:
80147 VIA PESSARO
APN:
772-550-027- - -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
750
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am ' nsed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busines d.Profe sionals Code, and my License is in full force and effect.
License Class: B C29 License No.: 4634'07
Date: J 2 4Contractor.
- OWNER -DECLARATION
I hereby affirm under penalty of perjury that I am exerp <omthe(Contractor's State License Law for the
-following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires apermit to
construct, alter,. improve,demolish, or repair any structure, prior to its issuance, also requires theapplicantfor 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 (5500).:
(_) 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 ISec. 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 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 _) 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.). . -
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY -
1 hereby affirm 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:
Lender's Address:
LQPERMIT
Owner:
M/M HOUSTON
80147 VIA PESSARO
LA QUINTA, CA 92253
Contractor:
DRURY CONSTRUCTION;
73807 MASSON STREET
PALM DESERT, CA 9226
(:760)346-7227
Lic..No.: 463407
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/25/06
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 PREFERRED INS Policy Number WKN1157592
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 a subject to the workers' compensation laws of California,
and agree that, if I s Id-bec a su ct to the workers' compensation provisions of Section
3 00 of the Labor C de, II forth ith comply with those provisions.
Date: Applicant:
r �
WARNING: FAILURE TO SECURE WORKERS' COMP ATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND, CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). 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
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 1.80 days will subject
permit to cancellation. _
I certify that I have read this application and state . e above information is corre : I agree to comply With all
city and county ordinances and state laws rela ' bui g construction, and h y authorize, representatives
of this county to enter upon the above-mgrni property' r inspectionpurp s.
Date: A—MG& Signature (Applicant an.
J?
,. Application Number . . . 06-0000.0367
-
Permit' . . .. WALL/FENCE PERMIT
Additional desc .
Permit Fee 21.00 Plan Check
Fee
.00
Issue.Date Valuation
. . .
750
Expiration Date 7/24/06
Qty "Unit Charge Per
Extension
BASE FEE
15.00
3.00 2.0000 HIND BLDG 501-2,000
6.00.
------------------------------------------------
Special Notes and Comments
------
---------- -�-- --
y
30•LF 6' BLOCK WALL PER ORCO SPECS
Fee summary Charged Paid Credited
Due
Permit Fee Total 21.00 .00
.00
21.00
Plan Check Total .00 .00
.00
:00
Grand Total 21.00 .00
.00
21.00
l
LQPERMTT
Bin #
Permit fl.
Project Address:
A. P. Number:
Legal Description:
C
City of La Quinta -
Building u Safety Division
P.O. Box. 1504, 78-495 Calle Tampico
La Quinta, CA 922.5"3 -.(760) 777-.7012
Building Permit Application and Tracking Sheet
1114
Owner's Name:
Address: 7 -
City,
.City, ST, Zip:
ontractor. /�2�✓v � _
e04(IS Telephone:
Address:
City, ST, Zip: Ly1,v�✓ia�jlit�i e',4- 92z�(7
Telephone: 3c�/�_--7 Z �
State. Lie..#
Arch., Engr-, Designer:
Address:
City, ST, Zip:
C
Project Description: /J
I . I Total Permit Fees
Telephone:
Construction Type:
Occupancy,
State Lic. #:
"
Name of Contact Person:
Project tyPe (circle one): New Add'n Alter 'Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone #9f Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE-DELOW THIS
.
#
Submittal
Req'd
Recd.
UNE .
TRACIMG"_
Plan Sets
PERMTI FEES
Plan Check subiuitted
Structural Cxlcs.
Item
Amount
Reviewed, ready for corrections
Truss Calcs.
Plan Check Deposit
Called Contact Person
Energy Calcs.
Plan Check Balance
Plans•picked.up
Construction
Flood plain plan
Plans resubmitted " "
Grading. plan'
Mechanical
V Review, ready for"correctioasrssue
Electrical
Subcontactor List
Called Contact Person
Grant Deed
Plumbing
Plans picked up
H.O.A. Approval
Flans resubmitted
S.M.I:
IN Ii0C1SE:-
''" Review, ready for corrections/issue
Grading
Planning Approval
Developer Impact Fee
Called Contact Person
Pub. Wks. Appr
A.I.P.P.
Date of permit issue
School Fees
I . I Total Permit Fees