04-5683 (BLCK)15.04
ALLE TAMPICO
rA, CALIFORNIA 9.2253
BUILDING PERMIT
r . . .
iption .
Property Zoning . . .
Application valuation .
BUILDING & SAFETY DEPARTMENT
(760).777-70.12
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
04-0-0'005683 Date 7%2.6/04
50660 EISENHOWER DR
773-370-028-3 =000!000-
WALL/FENCE
000!000-
WAL-L/FENCE
LOW DENSITY RESIDENTIAL
40:50
Owner
Contractor
LANDAQ INC
LUCAS GENERAL CONTRACTING CORP
55920 PGA BLVD
1111 QUAIL STREET
LA QUINTA CA 922.53
PALM DESERT
CA 92260
(909) 474-0221.
WCC: STATE FUND
0,1/01/05
WC: 1714988
01/01/05
CS -LB: 7587°85
02/28/'05
CCC: B -
Permit . . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee. 72.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . . . .
405.0
Qty Unit Charge Per
Extension
BASE
FEE
45.00
3.00 9.0000 THOU BLDG
2,001-25,000
27.00
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Special Notes and Comments
22 LF 6' EQUIPMENT ENCLOSURE/8 LF
6'1'
BLOCK WALL FOR OUTDOOR SHOWER/132
LF 6,'
BLOCK WALL TRASH ENCLOSURE. ALL PER
ORCO
FOOTING DETAIL AND APPROVED PRECISE
GRADING PLAN.
Fee summary Charged
`Paid Credited
Due
Permit Fee Total 72.00
.00� .00
72.00
Plan Check Total .00
.0,0 .00
.00
Grand Total 72.00
.0.0 .00
72.00
P.O. BOX 1504 VOICE (7.60) 777-7012
78-495 CALLE TA'MPICO FAX (760) 77740.11
LA QUiNTA, CALIFORNIA, 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: ID V_-_ j"R 3 Date:
Applicant: I 1 Architect or Engineer:
Applicant's
Architect or Engineer's Address: .
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
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 � r.,� m full force and effect. d
License Class L] License No. �a S
Date Contractor !/"'LL•�1 /�
OWNER 3UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a pemnit to. construct: alter, improve, demolish„or repair any structure, prior to its issuance, also requires the applicant for the'permh Willie a signed
statement that he or Is licensed pursuant to the provisions of the Contractors' 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 permitsubjects
the applicant to a civil penalty of not more than five hundred dollars ($500):);
U 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 town owner of property who builds or Improves thereon, and who does the work
himself or herself or 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.).
V 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The.Contractors'
State Lloense-Law does notapgly to an ownerof property who builds or improves thereon, and who contracts for the projects witha coniactor(s) licensed pursuant to
the Contractors' State License Law.).
U 1 am exempt•under Sec: B.3 P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have and will maintain a certificate of con nt to sett -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance
�of
� i ur: is e m tion insurance; as required' by Section 3700 of the'LaborCode, for thePerfornance ofthe work for which this permit is
rkers°compensation°insurence:carrier aryl
Cartier 0- Policy Number /�'Y
1 q rtify th t, 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 tD:the workers'
compensation lawsof California, and agree that, 01 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,- I -shall
forttrwith comply with those provisions.
INC—
DateApplicant__AV2Z0 I
P IF
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'4100,000), IN ADDITIOMTO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION3706 OF`THE LABOR CODE, INTEREST; AND ATTORNEY'S FEES.
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.).
Lenders Name
Lenders Address
APPLICANT ACKNOWLEDGEMENT
iMPORTANT Application is hereby'made to the Director of Building and Safety for a pemdt subject to the. conditions and restrictions.setforth 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 ftCity.of Le Quirts, its
officers, agents and employees for any,actor omission related to the work being performed under or followingtssuanoe of this,pemtft.
2. Any permit issued.as a result of this application becomes null.and void if work is not commenced within 160 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 thatthe,atwve information is correct. I agree to comply with all city and county ordinances and state laws relating to building.
constriction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
J! ..C-00,
—
Date 7 Signature(Applicant or Agent): r•`�'��'