04-3606 (BLCK)BUILDING &
SAFETY DEPARTMENT
- P.O. BOX 1504
(760)•.777=7012
c�lpp�lti9 78-495 CALLS TAMPICO .
FAX 760 777-7011
LA QUINTA, CA6FORRIA 92253 INSPECTION REQUESTS
(760)777-7153
Application Number BVILDIN94-�MA606 >
Date 4/21/04
Property Address 5.1941 EZSENHOWER DR
APN: 773-174-022-10 -000000-.
Application description'. WALL/FENCE
Property Zoning . . . . . . . ,COVE RESIDENTIAL
Application valuation -1750
Owner Contractor
GERMAN.A PEREZ OWNER
51941.EISENHOWER DRIVE
LA QUINTA CA 9.225.3
Permit .. .-WALL/FENCE PERMIT
Additional. desc
:
Permit Fee 41.00 Plan.Check Fee:.-.. .00
Issue Date . "... Valuation.
.. 1750.
Qty Unit Charge Per
Extension
BASE FEE
15.00
13.00 2.0000 HND BLDG 501-2,000
26.00
Special Notes and Comments
70. LF 6' BLOCK WALL PER CITY'STANDARD
ALONG SIDE P/L.
Fee summary Charged Paid. Credited
Due
Permit Fee Total 41.00 .00 .00
41.OQ
Plan Check Total .00• .0.0 .00
.00
Grand Total 41.00 .00 .00
41.00
4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLS TAMPlCO FAX (760) 777-7011 `
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: (9!4— 36� O 6 Date: y�y
o
Applicant ��f�✓ � %>�Z- Architect or Engineer��
Applicant's Mailing Address:_ Architect or Engineer's Address:
z1- 152.. Qk
Lic. No.
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affrm under penalty of perjury that I am ionised hander Wovisioiu of Chaplet 9 (com menc:ing wish sedan 7000) of Division 3 of the Business and Prolessbnets
Code. and my Eberst i= in U tare and effect
License Class Llmxnse NO.
Dale - Corhoracior
OWNER -BUILDER DECLARATION
J hereby alum Under penalty of perjury that 1 am *amp( from the Comtracfone Stab I3oanse Law for the tolowli mason (Sec. 7031.5. Business and Processions Code: Any
oily or county that requires a Permit b concbumd, alter. improve, demolish, or repair any stnra3ure. prior b lts tssrrance, also requires the appiant for ths permlt b fie a sigrme0
'statement chat he or she k icenseu* pwsuant b to provisbm of the ContracloW Stab lloen:e Law (Chapter 9 (commencing with Section 7000) of Division 3 offt Business
and Professions Code) or that he or she is exempt theretron► and'" basis for to alleged exeamptiom. Any violation of Section 7031.5 by any applicant for a Derail subjects
the oppicard to a dvi penalty of not more than fire hundred doiars (UWr
N1i 1, as owner of the property. or my employees with wages as Ihek sole compensatim wN do the work and ane structure Is not intended or offered for sale(Sec. 7044.
7� Business and Professions Code: The Contractors' State' Law does not apply to an owner of property who bands or improves thereon. and who does the work
himsea or herself or trough his or her own employees, provided that the improvements are not Herded or dim for sale. a, however. the DuM V or improvement is
sold within one year d completion, the owner4 iMer will have the burden of p ovirp shat he or she did not bu1d or improve ler she purpose of sale.):
U Las owner of .the property. am emdusivoly — h ocfirq with licensed oorhtra N o s b construct the project (sec 7014. Business and Professions Code: The Contractors'
State License Law does not apply to on owner of property who builds or improves ttmeieor►, and who contracts tot the ptrjects with a oontractoe(s) licensed pursuant to
the Contractors' Static license Law.).
U I am exempt order sea . B.1L P.C. for this reason
Date (1– Obi owner � /hUif/�if�
WORKERS• COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury ane of the Mowing declarations:
_ 1 have and will maintain • certi.Chcate of consent b sell-IMAe for workers' tonpensa5om, as provided for by section 3700 o(aoe Labor Code, for the performance
of the work for which this permit is issued.
.—
I have and w1I maintain woruedkers' compensation insurance, as required by Seton 3700 of the labor Code. for the performance of the work ler whicth this permit is.
Carrier iss. My workers! compensation insurance carder and policy number are:
Policy Number
_ 1 oertily that, in the Performance of the work ler which tis permit is issued. l shah not employ any person to any marcher so as b Decant subject to to workers
compensation laws of Caribmia, and agree that, 91 should become subjed to the workers' compensation provisions of section 3700 of the Labor Code. l shall
b Mvwth.uxr#y with terse provisions..
Date -) q — L/
WARNING: FAILURE TO SECURE WORKERS' COIvpE MMON COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CML FINES UP TO ONE HUNDRED THOUsmiq DOLLARS (t/00.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. .
CONSTRUCTION LENDING AGENCY
I hereby rm wider penalty d perjury that is a construction lending agency for the performance of the work ler which this permit is Issued (sea 3097, Cin. C.).
nd
Leers Name A 11
Lenders Address
IMPORTANT Application Is hereby made b the Director of APPLICANT ACKNOWLEDGEMENTitsubject
tote
1. Each person upon whose behalf this Building and sorely ler a permit abject b the conditions and restrictions set forth on tis application.
Issued e s •result of this a app Is made. taco person at whose request and for whose benefit work is performed under a pursuant b any permit
officers. 3 8 res and employees 5PPfi (oar any the Owner.d or scion related to the woo each agrees b, and shall, defend, indemnify and hold harmless the City of La Oukmta, its
2 Any permit issued as a result of this appkation becomes nuo and void k work �a not commenced enced within 160 ormed under or following
from date or Issuance of this � of such pertNt, or
cessation of work for 160 days wW subject permit to cancellation.
I certify that I have read this application and state that the above information is correct 1. agree to comply with alt city and county ordinances and stab laws relating b building
con and hereby authorize representatives of this county to enter upon the above.imermtioned property for inspection purposes.
Site Requirements for:
Fencing Requirements
REAR and EXTERIOR SIDE YARDS
must be completely enclosed and screened
by a MMTM Five (5) Foot High
View -obscuring fence or wall.
CHAIN-LINK FENCING
IS PROHIBITED.
Minimum. Required
FPnrine
Fences and walls can be a
maximum of Five (5) feet high
in the Front -and Street Sideyards,
Six (6) feet high in the Rear and
Interior Sideyard.
All fences and walls must be
maintained in good repair.
- i_A QUINTA.
WIC.MNG & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE ger
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 including 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 Adminstration). 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 contractors 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 QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760)777-7012
FAX: (760) 777-7011
ER' S SIG TUBE /DATE
PROPERTY ADDRESS
0 ` _ Mob
PERMIT NUMBER(s)