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08-1972 (BLCK)P.O. BOX 1504 �T4'yln ^' VOICE (760) 777-7012. 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT "' INSPECTIONS (760) 777-7153 s BUILDING PERMIT . Date: 12/22/08 Application Number: Q08'00001972 Owner: Property Address: 529.90 AVENIDA`VILLA PACIFIC HOMES 'APN: 773-334-013-14, -"000000 42665 WASHINGTON STREET #F Application description:" WALL/FENCE' PALM DESERT, CA 92211 Property Zoning: COVE RESIDENTIAL, Application valuation: 2613. D Contractor: d Applicant Architect or Engineer: PACIFIC HOMES rj ST S DESERT, CAWASHINGTON T F 921 PALM�ry �Oo (760)408-3495 Lic NO.: 782324 -•��✓�(�0Oil —-———————---—----—----------—------——--———---—---------------------——-=———-----———-----——-------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that 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 Divisio 3 of the Band 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 B icense No.: 782324 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is r _ter. issued. - • Date:, f olMfractor: _ 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 ' 1576557-2008 _ 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 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 pursuant to the provisions of the Contractor's 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 700 of th Labor ode, I shall forthwith comply with 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).: - Date: L plicant: (_ ) 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—) 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 (if Building and Safety for a permit subject to the 7044, Business and Professions Coder The Contractors' State.LicenseLaw 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 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 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 issuedas 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. - 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 ordina es and state laws relating to buildi g construction, and hereby authorize representatives ' ' - , - > - t• of,this count to ente upo eabove-mentioned property r i ction purposes ' Lender's Name: - • - - Dat 2 iare (Applicant or Agent): Lender'sAddress: - - - -� - �_ ---- - - .. z LQPERMIT • " . - - - . Application Number . . . . 08-00001972 Permit WALL/FENCE PERMIT Additional desc . Permit Fee 54.00 Plan Check Fee -. .00 Issue Date• Valuation . . 2613 _ Expiration Date 6/20/09 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 '80 L.F. 5' GARDEN WALL, CITY STANDARD & 115 L.F. 5- WROUGHT IRON FENCING Fee summary'. -Charged Paid Credited Due Permit Fee Total 54.00 ..00 .00 54.00 Plan Check Total .00 .00 .00 .00 •Grand Total 54.00 .00 .00 54.00 LQPERMIT r ®oBBu■■■■■■■■■■■B■■■■■■■■■s■BB■■u■uuBBBmuw■u■uu■nun■nu■■■ ■■ ■■■■■■■■■ei■■■■■■■■■■uula® e■m■■■■■■■■■■■■■■■■■■■■■■■■■■■BNB■■�■■■■■■■e■■■■eBmoa■■sae■e■a■■■■■■■■■■■■■■■■■■■■■■■■■■■®®mB ■■■■■■■■■■■■■■■■■■■■■■■■■■e■BBeB■e■■BB■■■■■e■■■BNB■■a■NeBs■■B■a■■■■■■■■■■■■■■■■■Neo■■■■■■■Oe nm■B■■■■■■■■■■■■■■■BB■■N■■Mee■BBB■e■BB■BB■Be■B�Bena■a■B�vB■BBBB■Be■®n■■■�■■o■IB<r�P■■■�■■■■®e® -■Mee 1 noun Omanr Bane r..• .. _ .i..�._......... .._ ._ _ I .. ._ .... � -�.... Beam mono smile BONN w ) ■won ' AIMEN ■1011 ■M®m c _ MONO ®■■m smals Sao - LL : 2*d Oman �.1..�✓ M _ f , . N _ , h- _�. noun noon MUBm - r ■mus .. r---.•*•,- �:� Oman -- L uuue Boom Ise Ing vB an .BB En ■® 1 oB IB■ �• L� JOB } Ino Inn - t ` 4 0 Ing d Ing Ing N IeB e r • IBB IBB i �-- ZIP ----7i,, I■. • r -- ■■Be ■■BB uau:)liN Mau 1n0X „£ = sa,onbs (lows :;i 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 # Project Address: 5Z ` Owner's Name: VA G A. P. Number: s Address: Legal Description: (, Z (ZCe, I City, ST, Zip: Telephone: Contractor: AGL=LeQ Address:4.'L.,1W W #Gmt Project Description: Jfb V G4- DV l •_`. fkoue- LAV I3 thaL A fes\ City, ST, Zip: Ck ct12-2-*1 f Telephone: Og' c-4Y . C F A ,e l � 1 c c..) Ni+ v�7 Iv State Lic. # City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: I L S C 6Ptt Sq. Ft.: # Stories: # Units: Telephone # of Contact Person': 40 g— 3 ¢ . Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Ree'd TRACKING PERMTT 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 Cates. Plans picked up Comtruction Flood plain plan Plans resubmitted Mectianical Grading plan 2'd Review, ready for corrections/issue Elecrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.MI. H.O.A. Approval Plans resubmitted Gra#ing 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 Total Permit Fees