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04-6597 (BLCK)OCT. 0 5''2G, 4 -�-� Q l.tl Y Y alio. l.14 lYtiYWS Yd1 . FINANCE DEPT BUILDING SAFETY DEPARTMENT P.O. Box 1504 (760).777-7012 OFT9 78-495 CALLE TAMPICo P FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT. Application!Number . . ?0'4-00006597 Date 10/04/04 Property Address 52030 AVENIDA VILLA .APN: 773 -234 -001 -22 -000000 - Application description. WALL/FENCE Property Zoning . . COVE RESIDENTIAL Application. valuation 3217 Owner Contractor'. SMITH SETH B OWNER 52-030 AVENIDA VILLA LA QUINTA CA 922534 Permit WALL/FENCE PERMIT Additional desc Permit Fee 63.00 Plan Check Fee .00 Issue. -Date Valuation 3217 Qty Unit Charge. Per' Extension BASE FEE 45.00 2.00. 9,.0000 THOU BLDG 2-, o b, 1 5" H 01 18.00 - Special Notes and Comments;. 7.0 LF 6' VINYL FENCE AT SIDE P/L PLUS 50 LF '61 VINYL 'FENCE WITH 24" RETAINING r WALL ALONG REAR P/L AND 10 LF 5' BLOCK WALL AT SIDE P./L 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 P.O. Box 1504 • VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT / Application Number: Applicant: Applicant's Mailing Address: Architect or Engineer: Architect or Engineer's Lic. No.: BUILDING PERMIT DECLARATIONS Date: LICENSED CONTRACTOR'S DECLARATION I 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. License Class License No. Date Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 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 Contractors' 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).): U 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 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 or 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.). U 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.). U I am exam t and r Sec. BA P.C. this r s Date G D wnorccoe rnruoeuce nu nano . I hereby affirm under penalty of perjury dne 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 Policy Number 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 forthwith comply with those provisions. Date Applicant 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. 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 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 id 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 rea this application and state that the above informal is correct. I agre o comply wief, city and county ordinances and state laws relating to building construction, a her by authorize representatives of this county to n pon the bove- tioned prop inspection purposes. Date Signature (Applicant or Agent): IX r ,F t �� lj Y "� i'tf '5r St r•1r, rz• q'� sv. .J,.;C' a ro• :,✓ �.� �' �y..r i' !" A� o-� rs' 4 t % '� y Lis 1y �'s '' � ,iri}r f _ jra'''>ltt .Cyd' �y„r { I✓/r o Y . }J•r Ci ' ° t 1 Y ro r•,.u�'t „I t R >�! Y � ¢.. rd s d < y " '+^- , ei..;�l ^ T L 4.� Y`ss'rt �yJ% f 4 Y r <:F'" '1• ` 's-Jr� T r A � j' ♦ } .'is^v-^'�'R'!, � }��'° / r'1 ` A . •T .e�".� .. t�\'. `r� '�y'•.ft p ., r ' .rn ` I' y -� tis- T!'u r ' 1 '- 3'4 : ? / �jl: >r �' '. ,. � lL - „q, 'Yr �¢�.eu✓E ri t' h � i -.. � i Ai � S -{ 'Tt �4 s t� i• t""' e . y �.."'�'+.�.. /% � LfS, .'ri1'� - �•`Y{�Y� w .t•I _.. ✓ r � ! 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O ^fi "1 r s d +S •1 � }, n 1 l/�41.yJ/F{4; /!' r. {' X11 -J T } rill ri 4•i si! .J is tl r� f♦ i �d�.4ar� \..:� -\ ' " n r r l r i > � J i I �.f ,,�Y /H '� r r•• } r I '_,!!1 r �1 s � a td .fir r .f � r }I .� N/ aory} 4fr .1 I_• 7r .r�Y f r YY/ it f1 I ! .S l• r r I *y�� ,/fir ® > r -r✓: r !/ / rTrf / ///i/1 + iI�'lJ a• IrY t� /Ir}` KI �J a '�� a1Ji ��6,6:) NStSJY T I %L II �' e � r' .yr r(�rl /f �l{y :J rt',. / A ri•�{rr/i. tl -'tr) r � / y�. r /.,5t1 frs fr,� i. ,..i !p 1,!_.J i. // r J/ r/, i }/a< ,! ,.mal r � \� / !%� I,a• P d !�-'>("�r-1t 1 t' t r.fe. .t//" ., '.YI /.. ..n K.yl � {.. g4r•4�. rta,f p�l,1h'n J1rr-I':1 S.t L• t.!',. uT..-..��' ... 1•. J 0,- OWNER / BUILDER INFORMATION Dear Property Owner: An application fora building permit has been submitted in your name listing yourself as the builder of the property improvements specified. - For your protection you should be aware that as "Owner/ Builder" you are the responsible par=y of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being .performed by someone other than yourself, you may protect yourself from "possible liability if that person applies for the proper permit in his or her name.. Contractors are required by law to be licensed and bonded by the State of California and to have'a business license from the City or County. They .are. also required by law" to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subco-itract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the wore (including materials and other costs) is $200.00 or more for the entire "project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal Government as an emplowr,and you are subject to several obligations including State and Federal income tax withholding, federal social security taxes, worker's compensation insurance, disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these'risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under Stare Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work, personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street, Sacramento, California 95814. .Please_complete_and return the enclosed -owner- builder verification form so that we can confirm that you are aware -of these matters. The building permit will not be issued until the verification is returned. Very truly yours, CITY OF LA QUINTA DEPT. OF BUILDING AND SAFETY 78-495 C Tampico / La Oui . CAA2253 A W14P/ TY ADDRESS PERMIT NUMBER(s) s. Building Address � (/ Owner I P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 APPLICATION ONLY /' / �' BUILDING: TYPE CONST: OCC. GRP. Mailing Address A.P. Number Legal. Description Project Description City JZip Tel. 5�ellel c Address _G- S City Zip Tel.. State Lic._ City _ & Classif. ' 2 � � � �. Lic. # 5S Sq. Ft. No. No. Dw. ��. Size A -Stories Units. Arch.*Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address ' v Tel. nU .r City Zip State - Lic. # LICENSED CONTRACTOR'S DECLARATION. I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C ,d and my license is in full force and effect. i SIGNATURE DATE —�WNERrBUIL'DEA DEC ARATON— I hereby�aftirm that exempt from the Contract �s License Law for the following reason: (Sec. 703'1:5,Business and -Professions_Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also•_ requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he 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). 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees. provided that such 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 did not build or improve for the purpose of sale.) Estimated Valuation PERMIT r AMOUNT •�,.. " Plan .Chk.–Dep.- •. •. Plan Chk. Bal. OL I ; , •.. Const. - - ti' :. t )) - Mech. ` Electrical - \% f Plumbing I'1 I, as owner of the property, am exclusively contracting with licensed contractors to con- IA struct the project. (Sec. 7044, Business and Professions Code: The Contractor's" License Law does nota 1 to an owner o!propertywho builds or improves thereon, and who contracts for PPY P - such projects with a contractors) licensed pursuant to the Contractor's License Law.) • 1-1 1 am exempt under Sec. B. & P.C. for this reason S.M.I. � - Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION c I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company " Copy is filed with the city. O Certified copy is hereby furnished. TOTAL �- CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. - - Date Owner NOTICE TO APPLICANT: IL after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ZONE: BY: Minimum Setback Distances: Front Setback -rom Center Line Rear Setback f-om Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Seback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback hom Property Line Lender's Name " Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. FINAL DATE INSPECTOR 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 city to enter the above-. mentioned property for inspection purposes. Issued by: Validated by: Date Permit Signature of applicant Date Mailing Address Validation: City, State, Zip t BUILDING DIVISION CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO. FT. @ $ 2ND FL, SO. FT, fv POR. SO. FT. @ GAR. SO. FT. @ CARP. SO. FT. @ WALL SO. FT. @ SO. FT. @ ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET 1 YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FOUND. REINF. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED HEATING (FINAL) LAUNDRY TRAY AIR HANDLING UNIT CFM I KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB LUMBER GR Ir !1 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11/. c SEWAGE DISPOSAL ROOFING SO.FT.GAR @ 3/.c HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK 00, GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT [tip WATER HEATER SERVICE FINAL INSP. BOND BEAMto, WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR Ir !1 FINAL INSP. LL FRAMING , G!� �1 �-71j`i JJ FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION C 2 Z CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL