08-0647 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 08-00000647.
Property Address: 52705 EISENHOWER DR
APN: 773-295-026-10 -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 2200
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
- D
Applicant: Architect or Engineer:
=APR2
(1 CI FINANCE DEPT. QUINTA
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 is in full force and effect.
License Class: License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'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
permit to file a signed statement that he or she is licensed pursuant to the provisions of 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 and the basis for the alleged exemption. Any violation of Section 7031.6 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars IS5001:
(/ X I I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
111777TTT 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 .
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 ave the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ I_ I, as owner of the property, am exclusivel ontrac m it licensed contractors to construct the project (Sec.
7044, Business and Professions Co : The C ntr or. State License Law does not apply to an owner of
property who builds or improves t reon, an wh on acts for the projects with a contractor(s) licensed
pursuant to the Contractors' Stat License w.). '
( I I am exempt under Sec. .&P.C. f this s
Date: W, 2 3 -O caner.
• [NSTRCTIONLENDING AGENCY
I hereby affirm under penalty of perjury that thea construction lending agency for the performance of the
work for which this permit is issued ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/21/08
Owner:
CANO GUILLERMO
52705 EISENHOWER DRIVE
LA QUINTA, CA 92253
---------------------------------
--------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
_ I have a ill maintain a certificate of consent to self -insure for workers' compensation, as provided
forction 3700 of the Labor Code, for the performance of the work for which this permit is
I h e an will maintain workers' compensation insurance, as required by Section 3700 of the Labor
ode, or the pert ante of the work for which this permit is issued. - My workers''compensation
insur ce c and policy number are:
CarrierPo'c Number
I at, in the performanc f t w rk for which this permit is issued, I shall not employ any
pe on in any manner so to a subject to the workers' compensation laws of California,
and agree that, if I sho be m sub ct to the workers' compensation provisions of Section
3700 of the Labor C e, I s all rth th co ly with those provisions.
ate: '� plicant:
WARNING: FAILURE TO SECUR ERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PE LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 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 set forth 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 the City
of La Quinta, 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 beco n d void if work is not commenced
within 180 days from date of issuance of such p it, r as tion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the ove in r do is correct. I agree to comply with all
city and county ordinances and s ate laws relating to buil ng cons ru i n and hereby authorize representatives
of this c umy to enter upon t above-mentioned probe y for ins e o urposes.
22 \ r
te: a J 0 VS' ature (Applicant or Agent):
,_ • 2
Application Number •. . . . . 08-00000647
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 54.00 Plan Check
Fee
.00
Issue Date Valuation
. . .
. 2200
Expiration Date 10/18/08
Qty Unit Charge Per
Extension
BASE FEE'
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and -Comments
REPLACE WOOD FENCE Q SIDES & REAR OF SFD
WITH 88 L•.F..61 BLOCK WALL, CITY
STANDARD
Fee summary Charged Paid Credited
Due
Permit Fee Total 54.00 .00
.00
54.00
Plan Check Total .00 .00
.00
.00
Grand Total 54.00 .00
.00
54.00
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TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNERBUILDER 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.
IYyou are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include 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.
J
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). 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 contracts 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 Ca I o
La Quint , C
(760) 7 7 70 FAX: 601 7 7
NATURE/DATE
��- 705
PROPERTY ADDRESS
09-
PERMIT NUMBER(S)
3400417 BURRTEG WASTE 07:38:18 a.m. 04-21-2008 213
Bin #
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Q11e Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet.
Permit #
Prej tct Addrcss: .5 x.70 ISE OrtrE
Own6r'sNwine: C-twoC1 1l Col
A. P. Number.11-5
Address: !!;A - 70ak El-csEA.Wou)OR— 4)9-
La-rea ci-10 -Vbw-.1 5-O&A ts -0 ta
Lcgid Description:
City, ST, Zi'
P: Lt.,, Q01&--)T-A CA
Contractor pj
Telephoav: ,
Address:
Project Description: C; i>C_,CSL C'j
city, ST, Zip:
piff 51 ben, Woo-clf—' I?
Tel,T-hone:
C.%-- Lkj I--. L -(-
Stag Lic- 4
City Lie. 4.
Arch., Engn, Designer:
fac C,6 P- k4�IfE7- 6TI)I'GN-
Address:
/b C -i -T-D#%"'�!
City, ST, Zip:
Telephone:
State Lic. ig,
............
C�o ction Type:i-3 L 0-upancy:
-(circleone): NeNv Add'n Alter Repair D—o
Pmject typL
Name of Contact Person: �
Sq. FL:
4 Storics:
s Units:
Iciephone k of Contact Person:
Estimated Value of Proica. Zo o C) 'S
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ra'd
TRACKING
PERMIT FEES
Pfau Sets
Plan Check submitted
Item
Amount
Siructural Caics.
Reviewed, ready ror corrections
Plan Check Deposit
Trass Caics.
Called Contact Person
Plan Check Balance
Tide 24 Calm.
Plans picked up
Construction
Flood plain plain
Plans resubmitted'
Mechanical
Grading plan
r" Review, ready for currections/issue
ElectricM
silb,oulaclok. Uhl
Called Contact Person
riumbiag
Grant Deed
Plans picked up
S.M.I.
K.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.-
Review; ready for corrteftaOssur
Developer Impact Fee
Pis nniogg Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date ofptroait issue
SLIOU01 Fees
F—