07-3253 (BLCK)P.O. BOX 1504-
78-495 CALLE TAMPICO
LA.QUINTA,..CALIFORNIA 92253.
�A-Acation Number: 07-00003253
Property Address:'- 52201 AVENIDA VILLA
APN: 773-233-024-9 -000000.=
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 21'/
Applicant:
• 0
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or Engineer:
------------------------- -------------------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 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 Contractor's 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 tofile 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 70311.5 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, 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.).
.( VI 1, 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 Lawdoes not apply to an owner of
property who buildsor improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
( .I I am exempt under Sec. B.&P, for this reason
�Date: Owner:00,
ONSTRUCTION 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:
LQPERAIIT
VOICE (760) 777-7012
FAX (760) 777-7011
'TIONS (7.60) 777-7153
Owner:
SOSA, SAMUEL & KARINA
52201 AVENIDA VILLA
LA QUINTA; CA 92253
-------------------------
Contractor:
Owner
2/22/08-
WORKER'S COMPENSATION DECLARATIONI
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 Policy Number
certify that, in the performance of the work .for which this permit is issued, I shall not employ any
personin 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 Cod1,6 shall forthwith comply h th provisions.
'Date:Uy71`O� 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 1$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 sefforth 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 c ruction, and hereby authoriz esentatives
of this county to enter upon the above-mentioned property, or section purposes.
�Date4�4—, Signature (Applicant or Agent):
'Application Number 07-00003253
P 'ermit WALL/FENCE PERMIT
,. Additional desc 5 FT GARDEN X 10 LF
` Permit Fee 15.00 Plan Check
Fee.
.00
Issue: -Date Valuation
217
Expiration Date. 8/20/08
Qty Unit .Charge Per.
Extension
BASE FEE
-
15.00
- - - - - - - - - - - - - - - - - - - - - - --- -- - - - - - - - - - - - - - - - - - - - - - - - - - - -
Special N6tes, and Comments
- - - - -
- - - - -
10 LIN. FT. OF -5 FT HGT. GARDEN WALL AT
SIDE PROPERTY LINE AT THE NORTHWEST
CORNER. -(THIS WALL REPLACES AREA OF'
DEMOLISHED UNPERMITTED GARAGE SEE PERMIT
07-3252):2001 CBC
Fee summary Charged Paid Credited
Due
----------------- ---------- ---------- ----------
Permit Fee Total 00 .00
----------
.00
15.00
�15.
e. Plan Check"Total .00' .00
.00
.00
• Grand Total 15.00 .00
.00
15.00