Loading...
05-3946 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253. 7 VOICE - . (60) 777 7012 FAX (760) 777-7011 BUILDING &. SAFETY DEPARTMENT :INSPECTIONS (760) 777-7153 BUILDING PERMIT y Application Number: - 5'0g`0�•ae' Property Address: s 2715 AVENIDA VILLA APN: 773 -303' -024 -11 -000000 - Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 500 Applicant: Owner: HILL JOAN 52-715 AVENIDA-VILLA LA QUINTA, CA 922581. (760)564-4966 i Contractor: Architect or Engineer. Owner Date: 9/09/05 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 Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain acertificate of consent to self -insure for workers' compensation, as provided License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Date: Contractor: issued..- - I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor i Code, for the performance of the work for which this permit is issued. My workers' compensation OWNER -BUILDER DECLARATION r I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the ins ur nce c �{,�nd_� policy number are: {���11 Q (� Carrier - �} -� 7R1tEJ�- - - - -Policy Number 7 7' m- " following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a Dermic to =M! 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,l 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 3700 of the Labor.Code, 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 ofnot more than five hundred dollars ($500).: s owner of the property, or my employees with wages as their'sole compensation, will do the work, and t. 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 Lawa. (_ 1 I am exempt under Sec.: , B.&P.C. for this reason I hereby affirm under penalty of perjury that there is a cod work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMrT AGENCY', agency for the performance of the WARNING: FAILURE TO SECURE WORKER CO ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTteS AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001. 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 underor 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 enjgLupon the above-mentioned property for inspection purposes.. Ci 09/09/2005 11:35 FAX 7603471540 STATE FARM INS' Q002 DECLARATIONS --•_-------_______________- -----.--____-- (Coverage afforded by this policy is We will provide the (provided by: insurance described in I this policy in return-for.the premium ISTATE FARM GENERAL INSURANCE COMPANY and compliance with all applicable 1900 OLD.RIVER ROAD provisions of this policy. IBAKERSPIELD CA 933=1-0001 I . 77-80-9467-6 Policy Number I ----------------------------------------IA Stock Company with Home Offices in Named Insured and Mailing Address IBloomington, Illinois. HILL, JOHN A & JOANH ------------------------------------- 52715 AVENIDA VILLA LA QUINTA,. CA 92253-3368 ----------=-------------------------------------------------------------------- The Policy Period begins and ends at IAntcmatic Renewal - If the Policy 12:01 a.m. Standard Time at the residence (Period is shown as 12 months, this premises_ (policy will be renewed auto- Imatically subjeo-t to the premiums, 05-29-2005 Effective Date Irules and forms in effect each 12 months -Policy Period Isucceeding policy period. If this 05-29-2006 Expiration of Policy Period (policy is.termizated, we will give -----------=---- ----------=------------`(you and the Mortgagee/Lienholder Limit of Liability - Section 1 (written notice in compliahce with Ithe policy provisions or as $ 145,800 Coverage A'. Dwelling Irequired by law_ I----------------------------------- -------------------------------------------IDeductibles - Saction 1 $250 Policy Type TALL LOSSES In case of loss under Homeowners Policy Ithis policy, the deductible will be Dwell Repl Cost - Similar Construction lapplied per occurrence and will be Option'ID - Increase Dwlg Up to $29,160 Ideducted from -the amount of the -------=-----------------------------------Iloss. Other deductibles may apply Location of Premises I- refer to your policy. Same as mailing address ----=----------------------------- (Policy Premium $795.00 Forms & Endorsements 438-BFU.NS LNDR LOSS PAY FP-7955.CA HOMEOWNERS POL LSP B1 LMT RPLC COST -B OPT ID COV 'A-INCR-DWLG OPT OL BLD ORD/LAW-10% Mortgagee • WELLS FARGO REVERSE MORTGAGE ITS SUCCESSORS AND/OR ASSIGNS' PO BOX 39457 SOLON, OH 44139-0457 Loan Number': 0047372834 ------------------------------------ Countersigned: September 09, 2005 By. 559-916 CA Eff. 3-97 Agent Name CONTRERAS, 82632 HWY NDIO, CA 201 -;U_ - 6 Address CARMEN ELOISA 111, STE. #A-1 (760)34-1530 ------------------ 1424 Agent's Code NORTGAGM COPY 09/09/2005 11:35 FAX 7603471540 .,STATE FARM INS 1a003 PREMIUM NOTICE STATE FARM INSURANQ6 COMPANIES. AGENT ZSSUED DsawmATIONS 559-916 CA.1 i I POLICY NUMBER I BILLING PERIOD I AGENT CODE 1 77-80-9467-6 1 FROM'05-29-2005 TO,05-29-2006 1 1424 1 LOCATION (If other than Named Insured's mailing address) INSURED PREMIUM $ 795.00 HILL, JOHN A & JOAN H 52715 AVENIDA'VILLA AMOUNT PAID $ 795.00 LA QUINTA, CA 92253-3368 AMOUNT DUE $ .00 DATE DUE MORTGAGEE AGENT NAME 6 ADDRESS .WELLS FARGO REVERSE MORTGAGE CONTRERAS, CARMEN ELOISA ITS SUCCESSORS AND/OR ASSIGNS. 82632 HWY 111, STE. #A=1 PO BOX 39457. INDIO, CA SOLON, OR 44-139-0457 92201. (760)347-1530 Loan Number: 0047372834 STATE FARM INSURANCE COMPANIES GREATER CAL REGIONAL OFFICE 900,OLD RIVER ROAD BAKERSFIELD CA 93311-0001 559-916 CAA x 4LLE TAMPICO — LA QUINTA, CALIFOF )NE (760) 777-7012 FAX (760) 777-701 OWNER/BUILDER INFORMATION Dear Property Owner: An application for a building permit has-been submitted in your name listing yourself as tli- builder of the property improvements specified. For your protection you should be aware that as "Owner/Builder" you are the responsible party 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 tD have a business license from the City or County. They are also required by, law to put their license number on a_I permits .for which they apply. If you plan to do your own work, with the exception of various -trades that you plan to subcontract, 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 work (including materials and other costs) is $200.00 or more for the entire `project, and such persons are not li--ensed 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 emrioyer and you are subject to several" obligations include 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 ire especially'serious with respect to worker's compensation insurance.. ,. For more specific information about your obligations under Federal Law, contact the Interns Revenue Service (and; if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State 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 contracts are allowed' to performl their work personally or through their own employees, without a licensed contractor or subcont-.-actor, 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' Stite 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 Calle Tampico .'. La Quinta, CA 92253 (760) 777-7012 �;.. FAX: (760) 777-7011 j.. OWNE 'S ,SI N TURE/DATE - PROPERTY ADDRESS 37 PERMIT NUMBER(S) {