06-4245 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06 -00004245"""—~ --ter
Property Address: . 80637 VIA PESSARO'
APN: 772 -500 -059 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5250
T4i�v 4 4 " .
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
HARRY BEDERJIAN
80637.VIA PESSARO
LA QUINTA, CA 92253
VOICE (760) 777-7012 • �.
FAX (760) 777-7011
INSPECTIONS '(760) 777-7153
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u
DEC 11200s
I
CITY OF LA
---,,a,t pEPT•"
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Contractor:.
a
Applicant: Architect or Engineer:
FEDOR MASONRY INC, JAMES
P.O: BOX 1397
LA QUINTA, CA 92247.
(760)772-3036
r
Lic. No. 823181
.. LICENSED CONTRACTOR'S DECLARATION -
WORKER'S -COMPENSATION DECLARATION
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I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingwith r
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I hereby affirm under penalty of perjury one of the following declarations:'* w:
Section 7000) of Division 3 of the Businessand 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 j
License Class: C29 License No.: 823181
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
n
-Date:
-) - Q� Contractor: - - - -
_ 1 have,and will maintain workers' compensation insurance; as required by Section 3700 of the Labor "A
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 o perjury that I am exempt from the Contractor's State License Law for the
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Carrier VIRGINIA SURETY Policy Number WVS0017674 - O1 r ,
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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
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person in any manner so as to become subject to the workers' compensation laws of California, -
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1 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 become subjec to the workers' compensation provisions of Section
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License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or -
3700 of the Labor C d , I shall forth comply with those provisions. -
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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 ($5001:
Dater Applicant: - "
,
1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and'`..
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the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
,
WARNING: FAILURE TO SEC E -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 T 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
.t�
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.) -
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/7`'APPLICANT ACKNOWLEDGEMENT
• (_ I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application ishereby 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
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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,
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(_) 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 "
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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
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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. '
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 above information 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 bui 1 g construction; and here y authorize representatives
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of this county to enterupon the above-mentioned pro rty r inspection pur o
Lender's Name:
-Q. Signature (Applicant-or_Agent): -1�
Lender's Address:
LQPERMIT - -
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Application Number . . 06-00004245
Permit WALL/FENCE PERMIT
,
Additional desc
Permit. Fee 81.00
Plan Check
Fee
00
Issue.Date
Valuation
5250
Expiration Date 6/09/07
Qty 'Unit Charge Per
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
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Special Notes and Comments
os. 210 LF'6' BLOCK WALL PER ORCO STANDARD
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& COURTESY INSPECTION OF 210 LF UP TO
2' RETAINING WALL.
Fee summary,- Charged Paid
Credited
Due
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Permit Fee'Total 81..00
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.00
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.00_
81.00
Plan Check Total .'00-
..00
00:
00 -
'Grand Total 81'.00,
.00
00
81.00
tip
LQPERMIT
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Z
Project Address: E50- 3 7 114-1-
Owner's Name:
A. P. Number: L0-' Q
Address: S s
Legal Description:
City, ST, Zip:
Contractor:
- 4soNst '
Telephone:
Address: P-0- Bo r. *1
Project Description:
City, ST, Zip: 1 NTP " ? -2 a y %.
a&k< L l l e O ) -c�
Telephone:760ZO
IF u . -1/
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
r
O
Address:
` 6N
City, ST, Zip:
Telephone: I
P t
State Lic. #:
Name of Contact Person:l;; N iZ
Construction Type: (4s'0N/-'Ipccupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
#Stories:
. #Units:
Telephone # of Contact Person:
00
Estimated Value of Project: L 0 U �'
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 correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees