04-5661 (BLCK)®m
)x 1504
CALLE TAMPICO
NTA, CA41FORNIA 921253
ty Address
4&4"
BUILDING &'SAFETY DEPARTMENT
(760)_777-701 2
FAX (760) 777-7011
1NS-PEcTi0N"kEQU,ESVS (160) 777-71-53
BUILDING PERMIT'
APN:
Application description
Property Zoning . . . . . . .
APP141cation valuation
04-00'H56161
506810 EISENHOWER-DR
773-37-0:-029-
WALL/FENCE
MEDIUM DENSITY RES
8 75
7,/'26/04
Owner
Contractor
LANDAQ, INC-
LUCAS GENERAL CONTRACTING
CORP
5592,'0 PGA BLVD
11,11 QUAIL STREET
LA QUINTA CA 92-253
PALM DESERT
CA 92260:
(9�0,9) 4;7'4 -02 2
WCC. STATE FUND
01/01/05
17'14 9'8.8
01/01/015
CSLB': 715,8785'
'02/28/0'-5
CCC:i
--------------
Permit. . . . . WALL,/.FENC,8!
PERMIT -
-------- 1:
Additional desc'
'Permit Fee . . . . 23.00
Plan Check Fee—
.00*
Issue Date . . . .
Valuation . . . .
$75
Oty Unit Charge Per
'EXtension
BASE
FEE
15.0,0
4.. GO 2.0000 HND BLDG
5011-2,0 10 0
'
8.00
Special Notes and Comments,
--------------------------
35 LF 6! BLOCK WALL TRASH ENCLOSURE PER
ORCO STANDARD AND APPROVED PRECISE,
GRADING 'PLAN
Fee summary charged
-----------
Permit Fee To al 23. GO
Plan. Check Total .010
.Grand Total 23.0'.0
Paid credited Due
.00 .,00 23 i 0,0'
.00 .00 .00
.00 .00 '2;3.00
P.O. BOX :1.504 VOICE,(7.60) 777-7012
78-4,95 CALLE TAMPICO FAX (760) 777-7011
LA QuINTAi'CALIFORNIA 92253 INSPECTIONS (760) 777=7133
BUILDING & SAFETY. DEPARTMENT
Application Number: 0 Date:
Applicant: —T Architect;or Engineer:
Applicant's Mailing Address: Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
I hereby affirnunderpenaltyW perjury that'I,ani,licensed under;,provisions of -Chapter 9'(commencing wilh'Section 7000);,of Division 3 of the Business and Professionals
Code,And'my L'icensq is in'fult force and effect:
License!'Class LS License No.
;Date 1 d Contractor
OWNER-BUILDERMECLARATION
Thereby affirm under penalty of perjury thatl am sxempt*orn the Contractors' State License,Law for the following reason (Sec. 7,031:5, Business°,and Pmfessionstodw, Any
city or tour that -
county requires: a pertnit;td construct; alter, improve, demotish,::or:repairsny structure, prior to its issuance, aleo,require8 fhe. applicant for the pertnk,to,file a signed'
statementthafhe.or she' is;licensed pursuant.to,the provisions of the Contractors' State License "Law:(Chapter 9 (commendng with;Sectiori 7000) of,DMelon.3'of'4wiBusiness
and�Professlons' Code),orthat he or'she is exempt therefrom and the basis for, the alleged exemption. Any violation of Soction1031.5 by any applicant for a permit subjects
the applicant o a civil penalty of not more4han five;hundred dollars 000:):
U 1, as owner of the property; or my, employees with wagewas their sole compensation; will do the work, and the structure;ts not 'intended or offered.for,sale (Sec. 7044,
Business an&Professions Code: the Contractors`+State License Law:does not,apply to amowner or through his�or her own employees, provideof'proper%who builds or.improveslthereon. and who does the work
himself.orherself d that: the1miprover►ients are not1ntended or ffered..forsale.: If„however,,.the.building orImpiovement is
sold'wittin one:year of completion, the owner -builder will have the'burden of proving ftt he. or she did not build or, improve for;the purpose of sale.).
() 1; as,ownerof the property, am excluslyely contractingwith-licensed contractors to construct the project (Sec.'7044. Business and ProfessioneGode: The,Contrectors'
- State License Law does not apply to an ownerof,property who: builds or improves thereoni and, who contractsfor the projects with e,contractor(s) licensed pursuant W
the Contractors' State: License Law).
d:am exempt under Sec. „ BA P.C.Jor this reason
Data Owner_
I hereby affirm,under penalty of perjuryo
_ I have and will maintain a ce
of the work for which this I
_ I Have andwill,maintain,worl,
'
-*-Sma- yvorker mml
Perrier, 10—folz
I certify that, • in,the i performai
compensation laws,of Cal
forthwith comply with thos
DSip
`i Applicant_
.WARNING: FAILURE TO;ISECUREWO
CIVIL, FINES UP TO ONE444 DRED'Tl
SECTION 3708 OF THE LABOR CODE,
WORKERS' COMPENSATION DECLARATION__'
of the following.deciarations:
tate pf,consent'to selMnsure:for workers' compensation, as provided for by Section:3700 of the,Labor Code,,for the performance
mitis issued.
copensstion insurance; as Mquired''.:bySection, 3700 of,the.Labor Code, for tie peftfmance,of the:work for -which this,pennit is.
0hsurance carrier and policy numbs are:.
Policy Number / -w y���
i of the work for which this pernk'is issued, I shall not employany person Imany.manner;so as to become subject,io the workers'
ria; and"agree that; if'I should become subject to ttie workers''o0mpensation provialone of section 3706.of,the Labor Code, I shall
GEIS UNLAWFUL,.AND'SHALL SUBJECVAN.EMPLOYER TO CRIMINAL PENALTIES,ANO
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS'PROV.D..ED FOR.IN
CONSTRUCTION: LENDING AGENCY
Thereby affirm under penalty of perjury that there is a construction,lending agency for the performance of the work for whichiils"pemut is issued (Sec. 3097; Civ: C.).
Lender's Name
Lendoes'Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT'Application;is nerebymade 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;atwhose request,andfor whoselbenefit work is:perforned under or pursuant to any -permit
issue&as a:result of this application.7the owner, and the applicant, each agrees to, snd'shall, defend, indemnify and hold, harmless the Cityof ha duinta; its
officers;;agents and employees for anyactorromission related to the work-being;perf6inwd,under:orsu
icllowingisance of this permit.
2. An permit issued as, a result of thiwapplication becomes;null and',void if workas not commenced wflhin'180 days fromdaIbe of Issuanceofsuch pemdt,;or
ceseation,of work for 180Aays;will .subject pernit,to cancellation..
•1 certify that I have read this application;and.state thatthe above information is correct. I agrebAh,comply with;ali city and county ordinances and state1awaselating1
to,building.
construction, and hereby authorize representatives of this county to enter upon the above-mentioned roperty.for inspection purposes.
Dated 2 �. Signature (Applicant or Agent);: G'