07-0489 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 07-00000489
Property Address: 52333 AVENIDA HERRERA
APN: '773-263-029-5 -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 808
Applicant:
Tay/ 4 4 Q"
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I 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: C13 License No.: 875156
Date: Contractor:
OWNER -BUILDER DECLARATION
1 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).:
(_ 1 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.).
(X 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. , B.&P.C. for this reason
Date: _11/6,a 07 Owner: s�
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:
I..QPERMIT
Owner:
LEISKE KEVIN
52333 AVENIDA HERRERA
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/14/07
Contractor:
SAM'S FENCE INC
D
66215 HIGHWAY 86
THERMAL, CA 92274
155
�E_
( ;
(760)397-0213
FF9
` )
Lic. No.: 875156
CITY ®r-
Le, -��" : T"
�
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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 ENDURANCE INS Policy Number WEN1002130-01
1 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 provisfins.
n
�Date:J rrJ G 7/Applicant: _ 157 -------
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 inspection purposes.
-�DatejVX�40Signature (Applicant or Agent): —� c
Application Number . . . . . 07-00000489
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 23.00
Plan Check
Fee
.00
- Issue Date . . . .
Valuation
808
Expiration Date 8/13/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
4.00 2.0000 HND BLDG 501-2,000
8.00
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Special Notes and Comments
95 LF 6' WROUGHT IRON FENCE WITH MESH
VIEW OBSCURING SCREENING ALONG NORTH
PROPERTY LINE.
Fee summary Charged Paid
Credited
Due
Permit Fee Total 23.00
.00
.00
23.00
P1'an Check Total .00
.00
.00
.00
Grand Total 23.00
.00
.00
23.00
5
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LQMRMIT
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Bin.#
Permit #
City of La Quinta j
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking .Sheet
ProjectAddress.`s2333 ASG, �!..
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Owner's Name:
A. P. Number:
Req'd
Address: '
S Z3
Legal Description:
Plan Sets
City, ST, Zip: (_ �� �i ZZs 3
Contractor: Se— ti..'s e—,, e -x .,
Telephone &
Address:
Structural Cales.
Project Description: G cz
City ST Zip:
, : 7 ,:.;�
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Telephone G D) . 3 ys - 2-
Called Contact Person
State Lic. # :
S tite
Arch., Engr., Designer.
City Lic. #:
c J
C d
Address:
Plans Oicktd.ap
Construction
City, ST, Zip:
Flood plain plan
Telephone:
State Lic. #:
M
Construction Type: Occupancy:
Projecttype (circle ene): New Add'n Alter Repair Demo
Name of Contact Person: Sq. Ft.:
# Stories:
I# Units:
Telephone # of Contact Person: Estimated Value of Project: .
APPLICANT: DO NOT WR1TE'BELOW THIS UNE
#
Submittal
Req'd
Recd TRACIMG . PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount .
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calc=.
Plans Oicktd.ap
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plin
2'' Review, ready for correctionstissue
Electrical
SubcontactorUst .
d Contact Person
Plumbing
Grant Deed
picked up
SALL
H.O.A. Approval
resubmitted
Grading
IN HOUSE:=
view, ready for corrections/issue
[Dati�
Developer Impact Fee
Planning Approval.
d Contact Person
A.I.P.P.
Pub. Wks. Appr
of permit issue
School Fees
Total Permit Fees
®
Eon.
t6ction is 116t PERIU4i�S .
on the following Code Noliday
New Year's Day
Luther Kinglr. Day
Dr. Martin
President's. Day
SITE REQUIREMENTS
M'morial.Day
IHMRIOR LOT
-Independence Day
-
'
Veteran's Day :
. SIDEYARD: 5 FEET..
ThangcsgivingDay .REAKYARM.10FEET
MD41MUM EACH SIDE
Christmas Day NiI irkm.
.
A-. RE-.INSPETTCTIO.N._f"EP DF 38t
--�
WILL BE CHARG'E'D IF YNR APPRa�1M/M
PLANS AND !CB CARD ARE NOT ON.'
THE .SITE: FOR ,A SCHEDULED
.iNSPECTIGN.
:. .
NO EXCEPTIONS!.. '.
CITY- OF LA QUINT/
i
BUILDING &SAFETY DEPT.
....APPROVED.:
FOR C.ONSTRUC
DA9 ' .c7? 13Y.-.
. 1
FRONTYARD:
MEA 70 "BE
20 FEET
,
U1t1DSGAPED
.
COO*
PROPERTY .
�. .. LINES . .
CURBI;M E
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