06-4255 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00004255 `_
Property Address: 80753 VIA PESSARO
crr. - -
- APN: 772-500-068- •
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 4400
VOICE (760) 777-7012
FAX (760) 777-7011
13WILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
r.
BILDING PERMIT
Ci
Date: 12/12/06
Owner:
MONARCH HOMES
LA QUINTA, CA 92253
•. 4
LQPERMIT
Contractor:
Applicant: Architect or Engineer:
MONARCH HOMES DESERT DIV; INC.
73290 EL PASEO, SUITE #4
PALM DESERT, CA 92260'
(760)568-3905
_.
Lic. No.: 457228
Air
•> LICENSED CONTRACTOR'S DECLARATION
-WORKER'S COMPENSATION DECLARATION -
I hereby affirmunder penalty ofperjurythat I 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 full force and effect.
_-I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
- License Clas t B ,,//�� License /No/.,:C 457228
D e �ontractor:.�-y `7./�✓V�%%ii�T !� f%{%7
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
_ 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: - -
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 229-29796-06
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 ` -
u
person in 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 the provisions of the State
_ and agree that, if I should become 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
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by -
3700 of the Labor Coe, shall forthwith comply with those provisions.
-
1.o
(..Ie
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
:-
(_) 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 improvementissold 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
- (_) 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 requestand 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,
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 to cancellation. -
' I 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 abov ' formation 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 buildin struction, e//r�� aut�horizee representatives
-
" of thiscoun y to ter upon the above-mentioned prope insp ion r se9�
Lender's Name: - -
-
_ - __
_ _ ----------- o\
/ Signatures (Applicant / ✓
-. Lender's Address:
Date�� ,5 or Agent):
LQPERMIT
Application Number . . . . . 06-00004255
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 63.00, Plan Check
Fee
; .00
Issue Date . . ._ Valuation'
3250
Expiration Date.. 6/10/07
"For
Qty Unite Charge Per
Extension
BASE FEE
45.00
2.00 0000 BLDG 2,001-25,000
00
L
_-- ----------------(>=---,---------
_-------
-_--
---18_
Special Notes and Comments
55 LF .6' BLOCK WALL/121 LF COMBO 1'
RETAINING WITH 6' GARDEN WALL. ORCO
STANDARD.
Fee summary. Charged- Paid Credited
----------
Due
Permit Fee Total 63.00 -:00
----------
.00
63:00
Plan Check Total 00 00
00
00 -
Grand Total 63.00 00
.00
63.00
LQPERMIT
-
,
Bin #
City of La Quin a
Building SL 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: o 7.S 3 .0w feSA -(1,9
Owner's Name: /1Olw✓ ec/7 brl7 e5
A. P. Number:
Address:',3 0 e,16 Sz°
Legal Description:
City, ST, Zip: /f7 -fSt Z Z
Contractor: 1,;q6/Ge I-C/-{ #0-771 e
Telephone: 40 S � Y?-P,5
Address: 73,7-9,9 L� sib w! J e
Project Description:
City, ST, Zip: 1? ,o, 40 -ts t, qG
D
State Lic. # : D9G City Lic. #:f-/ Ae-
Arch., Engr., Designer:
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.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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 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.I.P.P.
Pub. Wks. Appr
Date of permit.issue
School Fees
/oc,K
L
70
Total Permit Fees