04-5598 (BLCK)BUILDING &' SAFETY DEPARTMENT
P.O. Box 1.504 (766).717-7011
95 CALLE, TAmnco. FAX (7,60.) 777-7011
UINTA, CALIFORNIA 9225,3 INSPECTION REQUESTS (760),777-71153
AUG
0 2 2004 BUILDING PERMIT
ii7y-&i —�ultaTA
er 04-0D065151,98, Date 7/23/04
Property "o5,0680, EISENHOWER DR.
APN:, 773 -370 -029 -
Application description WALL -/'FENCE
Property
rty Zoning
ing MEDIUM. DENSITY RESAppli,Ca�tdon valuation '2'250
Owner
Contractor
---------------- --------
LANDAQ INC,
LUCAS GENERAL CONTRACTING CORP
559.20' PGA BLVD!
1111 QUAIL STREET
LA QUINTA
CA ;922'5. 3 PALM DESERT
CA, 9,226'0
(909) 474,.0,221,
WCC: STATE 'FUND
01-1 01,/ 0 5
WC:: 17,14,98,8
01/01/05
CS.LB - 758,785
012/28/05
CCC: B
*
Permit . . . . . . .
---------------- ----------
WALL/FENCE PERMIT
-------
Additional desc
Permit Fee
54.00 Plan Check Fee
Is8ue Date
Valuation
2250
Qty Unit Charge,
Per
Extension
BASE' FEE,
14-5.00
1.00 9�.0600
--------------------------
THOU BLDG 2, 0,01 -21 .
,0 GO
9.00
---------
.Spec:ial Notes And Comments
9`0 LF RETAINING I WALL
PER STUCTURAL CAICS
ANDAPPROVED PRECISE
-------------------------------
'Other
GRADING PLAN.
Fees
-------- -------
. . . HOURLY PLAN CHECK
52.50
Fee summary
------------
Permit Fee 'Total
Plan Check Total
Other. FeeTotal
Grand Total
Charged Paid - Credited
------------ - -----------
54.,06 .'o,o .00
.00 00 .070
52-5.0 O:Q
10'6'..50 .00 .00
Due
54.00
.00
52.50
106.50
P.O. BOX 1.504W 'VOICE (760) 77:7-701:2
78-495 C'ALLE TAMPICO TiffFAX (760) 7.77-7011.
LA gUINTA, CALIFORNIA 92253 INSPECTIONS, (766) 777,=7153
'BUIL'DING& SAFETY DEPARTMENT
Application Number: Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:,
Lic.- No.:'
BUILDING, PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I.hereby.affirm under penalty of perjury that,l am licensed under provisions of Chapter 9 (commencing wifh'Sectlon 7000) of Divisiom3:of the Business and Professionals
,Code, and my Licens full force 9nd effect
License Class. - Qs License No. 2S % Fl S
Date Contractor
OWNER -BUILDER DECLARATION
I hereby affinnunder penalty of perjury that I am exemptfrom the Contractors' State Llcense.Law forthe,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 prior to its issuance; also reguires`tf re applicant for the perrnitto file a signed
statementthathe;orshe-is licbnse6pursuant:to the provisions of the Contractors"Stste License: LaW(Chapter9 wf
(commencing fh;Section 7000),of Division 3 of the Business
and PPfessions:Code r tf ,he'oY she is exempttherefrom and the'basi forthe Wleged exemption. 'Anyviolation of'Secabn 7031.5 by,any;applicont4ora permit subjects
thea licantto.a civil penalty of not more than five hundred dollarw($500).):
(, 1,:asvwnerof(the property, or my employees�with,wages as their sole oompensationi will.do the work,and the structure is nWn, tended or:offered for sale (Sec. 7044;
Business and Professions. Code: The,Contractors' State License Law does not apply to an owner ofproperty,who builds or mproves thereon, and Who does the work
gemployees,=p. provements•are not intended or offered for sale:. If,.however, the building orimprovement is
himself or herself or throw h.his w her own rovided�lhatthe im
sold withinone yearof completion, the owner bulider will have the burden okproving thathe or she did not build.oi improve forte* purpose of sale.):
U L 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 notapply bo an owner of property'who builds orimproves thereon;;and.who contracts• for the projects -with a;contractor(s) licensed pursuant to
the Contractors' State .License Law.).
(, I am exempt'.undersecz _ BA P'C' for'this reason
Date Owner
WORKERS' COMPENSATION; DECLARATION
I hereby affirm under penalty of pedury'one-of the,foliowing declarations:
_ 1'have:and will maintain a certificate oPconsent to;self-insure.fdr,workers' compensation', as'provided4br by Section.3700,ofthe Labor Code, forthe;perfonnance
of:the work for which this:penmit is -issued.
_ t have and will maintain workers' compensation insurance, as'sequired by Section 3700,of the•Labor Code, for the perfomnance of thewoik for which thss'permit',is
5. gears' ppn mer an li
M wo com cation insurance .ca d�yfnpscapq
Carrier s n, ' Policy Number, !
I'cerlify that, in'the perfomrance.of the'w,ork forwhich this pennitis issued,.l;shall not'employ, any person In any manner so;awto,become;subject'to,the workers'
compensation laws o(California, and agree that, if I should,become�subjectto the workers' compens#on, provisions-of.Section 3700 of the Latior, code,, l,shell,
J�(/ 'forthwith comply with those provisions.
natsk ;GJ: e 'OnniiMnf
WARNING: FAILURE TO SE CURE'WORKERS`COI
CIVIL FINES UP TO ONE HUNDRED THOUSAND C
SECTION'3Z08'AF'THE:LABOR CODE, INTEREST;
,GE IS'UNLAW FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIEV AND.
ADDITION TO.THE COST OFCOMPENSATION, DAMAGES AS:PROVIDED.'FOR IN
CONSTRUCTION LENDING!AGENCY
I hereby affirm under penalty of perjury thatthere is a construction lending,agencyforthe performance of the work,for which this permit'is issued (Set.3097; Civ. C:j.
Lender's Name
Lender's Address
APPLICANT` ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to;the.Director of.Building and Safety fora,permit subject'tat he'condidons and.restricoong set forth,on'this'application.
1. Each person upon whose behalf this; application is made; each person;at whose request and for whose benefitwork is performed under orpursuant to any, permit
issued as a result of thisTappiication, the owner; and the applicant, each)agree Ito, and the[(., defend;; indemnify and hold harmless the Cily of La'�Uinta, its
officers, agents and employees for any act or:omission related1to1he work,being performed underorfoilowing issuance of this.penmit.
2. Any permit issued as a,result of this application becomes null and void; if work is noccommenced.within 180 dsys'from date,of,issuance of such permit, or
cessation of work for 180 days'will subject permit to cancellation.
I, certify that have.read this application and state thattheabove information'Is`oorrect. I:agree to compiy;wilh all cityand'county ordi_nances�andztate laws eleting.to building
construction;,and'herebyauthonze"representatives of Ehiszcountyto enter upon the;above-menfloned'property forinspection purposes.
c
Da 6 -Signature; (Applicantor Agent):