05-2197 (BLCK),1
\ P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: f,05-00002197
Property Address:
78711 DEACON
APN:
770 -230 -011 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY
Application valuation:
375
DR E
RESIDENTIAL
Architect or Er
P I I
T4ht 4 4& Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CO OR'S DECLARATION
hereby affirm under penalty of perjury that I am licens under ovisions of C pter 9 (commencing with
Section 7000) of Dimon a Busin s nd Profess als C e, and m icyis In fyll r�d effect.
License Class: `' nse No.: '7
te: ci Conroe
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 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).:
(_) 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.).
(_ 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.).
I _ I I am exempt under Sec. , B.&P.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:
LQPERA11T
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/07/05
Owner:
WILSON
78-711 DEACON DRIVE E
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06
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 C8 C27 C29 C53 Policy umber
- - -
- - - - - - - - - - - -
I certify that, in the performance of the rk for whic this permit is issued, I shall not employ any
person in any manner so as to becom s ject to t e workers' compensation laws of California,
and agree that, if I shout ecome su jeCt t he orkers' compensation provisions of Section
3 00 of the Labor C e I hall forth ith co y with those provisions:
Date: t=om' O �SApplicant:
WARNING: FAILURE TO SECURE W KERSCO PEN 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 nul n id if work is not commenced
within 180 days from date of issuance of such permit, or c sation f work for 180 days will subject
permit to cancellation. r
I certify that I have read this application and state that the above informa i is rrect. I agree to comply with all
city and co my ordinances and state laws relating to bu'ldi onstru io n ereby authorize representatives
of this c%myde ter upon the above-mentioned pr erty for insp do pu s.
Dat : l'J O r� &nature (Applicant or Agen : _
Application Number . . . . . 05-00002197
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee
15.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 375
Expiration Date
12/04/05
Qty * Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special,Notes and
Comments
15 L.F. 6' BLOCK
WALL, CITY STANDARD..
Fee summary
-----------------
Charged Paid
Credited
Due
Permit Fee Total
--------------------
15.00
----------
.00
----------
.00
15.00
Plan Check Total
.00
.00
.00
.00
Grand Total
15.00
.00
.00
15.00
LQPERA1IT
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road ¢ BERMUDA DUNES O
rn RANCHO MIRAGE d
Date 10/22/04 La Quinta, CA 92253 INDIAN WELLS
�. PALM DESERT .y
No. 26568 (760) 771-8515 LA
QUINTA 607
. �OINDIODIO y�
Owner Steve Wilson APN.# 770-230-011
Address Jurisdiction La Quinta
City Zip Permit #
Tract # Study Area
Type Single Family Residence No. of Units 1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 78711 Deacon Drive East 3777 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho
mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 3,777 S.F. or $8,460.48 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC/1 st Bank - Joni Fernie Check No. 74817
Name on the check Telephone 771-4722
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exemptedb Sharon McGilvrey Payment Recd
$8,460.48 Over/Under
Signature C)ylj
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the DistrictCs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy - Applicant/Receipt Copy -Accounting