06-2722 (BLCK)Rc
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
06-00002722
53600 AVENIDA HERRERA
774-124-006-19 -000000-
WALL/FENCE
COVE RESIDENTIAL
1537
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 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 thanfivehundred dollars ($500).:
(_ 1 1, 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 imp vement is sold within
one year of completion, the owner -builder will have the burden of proving that he o he did not build or
improve for the purpose of sale.). '.
1 _ 1 I, as owner of the property, am exclusively contr c 'ng with licensed contractors hie
the project (Sec.
7044, Business and Professions Code: Th o tractors' State License Law do of apply to an owner of
pro,,PPerty who builds or improves thereon, d ho contracts for the projects a contractor(s) licensed
pt1►suant i the ConVa_ctors' State Licens La
I ) 1 am empt Ander Sec. B.&P.0 is r
Date:
Owner:
t 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:
LQPERNIIT .
Owner:
GARCIA SCOTT
53600 AVENIDA HERRERA
LA QUINTA, CA 92253
Contractor:
Owner
----------------- ---J--
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/17/06
JUL IS
f 006
WORKER'S COMPENSATION DECLARATION - r•,
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.
_ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the wo which this permit is issued.
y My workers' compensation
insurance carrier and policy number e:
Carrier Poli mber
_ I certify that, in the performance of th w rk for whi h this permit is is d, I shall not employ any
person in any manner so as to bec subject t e workers' co ensation laws of California,
nd agree that, if I shoul m bject t ers' comp sation isions of Section
7 0 of the Labor Code, I shall with c wn�hi/t/� e ^p,9,6—ns
.
Dater �� 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$100,0001. 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 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 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 beco as ull and void if work is not menced
within 180 days from date of issuance of such per it, r cessation of work for 1 days will subject
per it to cancellation.
I certify t t I h e read this application and state that the nformati s cor ect. I a' ee to comply with all
city and unt ordinances and state laws relating to ing nstructi0 by a orize repr tatives
of this c my aemter upon the above-mentioned prope nspa rp
Date (/)6 Signature (Applicant or Agent):
M
Application Number . . . . . 06-00002722
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 37.00
Plan Check
Fee
.00
Issue Date
Valuation
. . .
. 1537
Expiration Date 1/13/07
Qty Unit Charge Per
Extension
BASE FEE
15.00
11:00 2.0000 HND BLDG 501-2,000
-
22.00
-------------------------------------------------------------
Special Notes and Comments
--------------
71 LF 5' BLOCK WALL PER CITY STANDARD
TO FORM FRONT COURTYARD & PROPANE
ENCLOSURE
Fee summary Charged Paid
Credited.
Due.
Permit Fee Total 37.00
.00
.00
37.00
Plan Check Total ..00
.00
.00
.00
Grand Total 37.00
.00
.00
37.00
LQPERMIT
Bin #
City of La Quints
Building U Safety Division
y P.O. Box 1504, 78-495 Calle Tampico
La Quinta,.CA 92253 = (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
_
Project Address:
Owner's Name: X
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip: N
Telephone:
Address:"
Project Des ription: l l
City, ST, Zip:
Telephone:
-
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy-
State Lic. #:
Name of Contact Person:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections •
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading,plan'
2nd Review, ready for corrections/issue
Electrical
Subcon'tactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub..Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNER/BUILDER INFORMATION
Dear Property Owner:
An application for a 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 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 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 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 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 employer 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 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 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 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 QUI A
DEPT. OF BUIL NG D SAFETY
78-495 Calle T pi o
La Quinta, CA 2 3
(760) 77
F .:- 760) 1
OWNER'S SI/GNATUJR�EE/D�ATE
PROPERTY ADDRESS
PERMIT NUMBER(S)