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07-2521 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00002521 Property Address: 53025 AVENIDA VILLA APN: 7.74-063-013-1 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 2242 Tityl 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. Licensee+Class: B C36 .C42 icense No.: 205031 Date:'f �„Z Contractor: OWAR-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason ISec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for 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 ($500)": 1 _) 1, 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 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.). ( 1 I am exempt under Sec. , BAP.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I 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: DOUGLAS BELKNAP 53-025 AVENIDA VILLA LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/12/07 D Q Contractor: BELKNAP, DOUGLAS W SEP 1 2 2007 P.O. BOX 297 PALM DESERT, CA 9226 CITY OF LA QUIN (760) 902-7444 FIN gNCE DEPI Lic. No.: 205031 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 STATE FLTND Policy Number 1576785-2006 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 as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall (fcomply with those provisions. Date: / L Applicant: 116-1p WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for insc purposes. 9,1 I Date: 6 /I Z Signature (Applicant or Agent): 1�' Application Number Permit . . . Additional desc . . Permit Fee . . Issue Date . . . . Expiration Date . . . 07-00002521 WALL/FENCE PERMIT 54.00 Plan Check Fee . . .00 Valuation . . . . 2242 3/10/08 Qty Unit Charge Per Extension BASE FEE 45.00 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ---------------------------------------------------------------------------- sr4:ial N toc and rgmmanto 65 L.F. X 6' HIGH GARDEN WALL (ORCO DETAIL) 10 L.F. X 5' HIGH GARDEN WALL (ORCO DETAIL) 25 L.F. X 4' GARDEN WALL (PROPANE TANK) (ORCO DETAIL). Fee summary Charged Permit Fee Total 54.00 Plan Check Total .00 Grand Total 54.00 LQPERMIT Paid Credited Due' ---------- ---------- .00 .00 54.00 .00 .00 .00 .00 .00 54.00 oMI5510N5 appear In the d cxVgs, locunents, the 6ENERAL Cao ACTOR ,of such error or omisslon. ONTR 4TOR Palls to glve such notke Wm of the work THE 6ENERAL GON- iIBLE to the result of cig errors, d15- 2st of rectifyhg the Same. 3.- � 'tf ORE yoL' Call: TOLL FREE UP o G+ 1-800 227-2600 TWO WORKING DAYS BEFORE YOU DIG VERIFY CONNECTION POINTS FOR POWER TELEPHONE AND CATV SYSTEMS PRIOR TO CONSTRUCTION APPROXIMATE ONLY LOCAD INDICATED FOR TRANSFORMER LOCATIONS, I COMPLY WITH ALL UTILITY COMPANY REQUIREMENTS. PROVIDE ALL RELATED CONDUITS, PULL BOXES AND RISERS. CONTRACTOR SHALL VERIFY ACTUAL DEPTH AND LOCATION OF ALL EXISTING UTILITIES PRIOR TO CONSTRUCTION... CALL UNDERGROUND SERVICE ALERT (TOLL FREE PRIOR TO TRENCHING, GRADING, EXCAVATI PIPE PUSHING, PLANTING TREES, DIGGING F THEY WILL SUPPLY INFORMATION OR LOCAL ANY UNDERGROUND FACILITIES. -;NS RUCTION H Ebctober I st - April 30 Mouday - Friday: 7:00 a.n Saturday: 8:00 a.m. tl Sunday: None Government Code HoRda) May Ist - September 30th Monday - Friday: 6:00 a.tt Saturday: 8:00 am. It Sunday: None Government Code Holldal BLOCK WALL EXj5TIN6 6'81.0% WALL PROPERTY LIM 5' H16H BROYW BLOCK WALL L24- BO � IAASSTTM O�PH1M'LINA 5-I 6ALbARGBUA (ak-OHOIDES 't TERY') Bin # I Ci �f L � • City a Quinta. Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253.- (760) 777-7012 Building Permit A [ication d Trac in pP Sheet Permit # �� 2� Project Address: 53- OSS Owner's Name:",Ad& Y)Q P&94. 1 A. P. Numbed: 13 Address: L Legal Descri tion: S —S..� � City, ST, Zip: 9� 5 Contractor: Address: Tele " Telephone( 60) �S7a Project Description: City, ST, Zip Telephone:. O 1 90 /C ell P State Lie. # : City Lc. #: c s, Engr., Designer: Address: City, ST, Zip: oA Telephone: State Lic. #: Name of Contact Person: Construction . ype:. Occupancy: P cY= Project type (circle one): New Add'n Alter Repair Demo . Sq. Ft:: #Stories: #Units: Telephone # o Contact Person: Estimated Value of Project: APPLICANT: DO NO . RITE BELOW THIS UNE # Submitt, 1 Req'd Recd TRACKING . PERMIT FEES Plan Se Plan Check submitted Item Amount Structural Calcs. Reviewed, ready -for corrections Plan Check Deposit Tress Ci Its. Called Contact'Person Plan Cheek Balance Energy alts.. Plans picked up Constvction Flood ph in plan Plans resubmitted D4echznical Grading. lan 2" Review, ready for eorrections/issue Electrical Subcont ctor List Called Contact Person PlumUng Grant Deed. Plans picked up S.M.I. H.O.A. A proval Plans resubmitted Gradiig IN HOU E:- ''' Review, ready for corrections/issue Developer Impact Fee Planning �pproval Called Contact Person A.I.P.r . Pub. Wks. Appr Date of permit issue School Fees Total ?ermit Fees 9