06-2711 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00002711
Property Address: 49130 EISENHOWER `DR
APN: 658-290-042- -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
v Application valuation: 5000
Tiht 4 4,4"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LIC ED CONTRACTOR'S DECLARATION
I herebyaffirm under penalty of perjury's I a licensed under prow' 'ons of Chapter 9'(commencing with
Section 7000) of: Division 3 of the. si a Pr orals Code, a my, Lim is in full force and effect.
License Class: B License NoJ 862631
Dste:�r� Contractor 1
l
OWNER-91JILDER' DECLARATION
I I erebyffi
ann under penalty of perjurythat I am exempt from the .Contractoe'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
Mpermit.to file.a signed statement,that he or she is licensed pursuant.to the provisionsof 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 acid 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 (8600).:
(_) 1, as owner ofthe 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
improvemems:are not')nttended 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,ofsele.).
(_) 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;nat apply to.an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License Lew.).
1—) 1 am exempt under Sec. B.&P.C. for'this reason
Date:. Owner:
CONSTRUCTION LENDING AGENCY
1 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:
l6r6)WD1%1,1WJ
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 77777153
Date: 7/17/06
Owner:
BIRDSELL ROBERTA D
PO BOX 630
LA QUINTA, CA 922.47
Contractor:
BIRDSELL BUILDERS INC
P O BOX 630
LA QUINTA, CA 92247 O
(760)No.: 962631
Lic: No.: 862631
----------------------------Finr--------
WORKER'S COMPENS TION
r. hereby_ affirm under penalty of perjury one of the following declarations:
_ I Have and will maintain a certificate of; consent to aelf,insure for workers' compensation; as,provided
for by Section 3700 th
of the Labor Code, for e performance of the work for which this permit is
lasued-
_ I have and will maintain workers' compensation insurance, as required by Section L3700 of the Labor
Code, for the perfonnanoe.of the work for which this permit is issued. Myworkers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Number EXEMPT
_ I certify that, in the pqs?
of work for which this permit is issued, 1 shall not employ any
person in any mana subject to the workers' compensation ,laws of California,
and agree that, if co subject to the worker mpensation provisions of Section
3700 of the ll.fo lth com ly with provisions.
Date:7/7: G Aplt:11
WARNING: FAILURE TO OR RS' COMPENSATION COVERAGE.IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL -TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS (')100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3708 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 ser forth on this application.
1. Each person upon whose. behalf this application is rnade, each person at whose request and for
whose benefit:work'is performed under or pursuant to any,permlt issued as a result of this application,
the owner; and the applicant, each egreesto, and.shall defend, Indemnify and hold harmless the City
of Le Ouirna,'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 isnot commenced
within 180 drys from date of issuance of such r cessation of work for 180 days will subject
permit to cancellation.
I certify that 'I'have read this application.and state that the a ove inf matt n.is correct: I agree_ to comply with all
city and county ordinances and state laws relating to bu' i const ction, nd hereby authorize representatives
of this county to anter upon the above-mentianedprope y fo ' n pun ses..
Date:. --0-0/ ignature (Applicant or Agent):
Application Number . . . . . 06-00.0027.11
Permit . . . WALL/FENCE'PERMIT
Additional desc . .
Permit Fee 72.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
5000
Expiration Date . . 1/13/07
Qty Unit_ Charge Per:
Extension
BASE
FEE
45.00
3.00 9.000.0 THOU BLDG
2,001-25,000
27.00
-------------------------------------------------
Special Notes and Comments
200 LF 6' WALL PER CITY STANDARD
&SFD
PLANS
,4
Fee summary Charged
Paid
Credited
Due
----------------- -------- ------
Permit Fee Total 72.00
.00
.00
72.00
Plan Check Total .00
.00
.00
.00
Grand. Total 72.00
.00
.00
72.00
LQPERMTf
Bin #
City of La Quints
Building & Safety Division
P.O. Box 1504, 78-49.5' Calle Tampico
1La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: 9 3 �� _ _ 2
Owner's Name: 23,,, o , 7 /7 7 L
-
Address: �G 4� C3 Cj
Legal Description:
Contractor: L 3G! e ,1, L
Address: /-�)U a t
CityST, Zip-.:44r-va I A 7a �PZ Z q —1
Telephone:
Project Description: Q G L. f—� 7-- G 74e 4
City, ST, Zip: a Ir, 7A�f4 f Z Z 7
1'1--6 % .T
Telephone:7 Q'F 707 iJ
State Lic.:# : C 2 ( 3 City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone# of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACING ,
PERMIT FEES
Plau'Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed,,ready for corrections
Plan Check Deposit
TrussCalcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood. plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review,.readyfor corrections/issue
i
Electrical
Subcontactor List
Called Contact Person.
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3d Review,. ready for correctionstissue
Developer Impaeffee
Planning Approval
Called Contact Person
A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees