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04-6327 (BLCK)P.O. Box 1504 7_g 4495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760).777=7012 FAX (760) 777-7011 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT ��Application;Number . . . . 04-00006327 Date 9/16/04 ;-Property Address . . . . . ...78080 CALLE ESTADO \�APN: �;�"� 770-151-003- - - Appli°cation description . . . WALL/FENCE P--roperty Zoning . . . . . . VILLAGE COMMERCIAL Application valuation . . . . 1325 Owner Contractor MARVIN WELLS L BARAJAS MASONRY, JOHN 78080 CALLE ESTADO STE 201 42901 LIMA HALL ROAD LA QUINTA CA 92253 INDIO CA 92201 WCC: STATE FUND WC: 00064762004 01/01/05 CSLB: 446180 09/30/05 CCC: C29 -------------------=-------------------------------------=-_----------------- Permit . . WALL/FENCE PERMIT Additional desc Permit Fee 33.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1325 Qty Unit Charge Per Extension BASE FEE 15.00 9.00 2.0000 HND BLDG 501-2,000 18.00 ------------------------------------------------------------------------------ Special Notes and Comments 53 LF 6' BLOCK WALL FOR TRASH ENCLOSURE PER CITY STANDARD Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 33.00 .00 .00 33.00 Plan Check Total .00 .00 .00 .00 Grand Total 33.00 .00 .00 33.00 P.O. Box 1504ICE VOICE (760) 777-7012 78-495 CALLS TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: e 41 —/,9:3c`9-7 Date: Applicant: I I Architect or Engineer: Applicant's Mailing Address: Bim% Architect or Engineer's Address: lu//.Af — Lic. No.. BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION 1 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 j.� I I force and effect. u License Class "L License No. -i I a Date 1 Z I /o 4 Contractor Jo�-)4 I�AR�►.�►aS Kk%0A =1l( OWNER -BUILDER 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 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 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U I, 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 to an 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.). U 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 License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). U I am exempt under Sec. BA P.C. for this reason Date WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Chis ued. w rkers' compensation insurance carrier and poli%y% ber are: Carrier 6; RU Policy Number s fpY7 �Zo _ I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date 1 Applicant 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 ($100,000), 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 affirm under penalty of perjury that there is a construction tending agency for the performance of the work for which -this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address 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, indemnity and hold harmless the City of La Ouinta, 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 becomes null and void if work is not commenced within 180 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 that the above information is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. Date a�r: Signature (Applicant or Agent): 7pz OCT -28-04 THU 02:18 PM MARVIN HOMES FAX N0, 7607715057 CITY OF Lq, QUINTA BUILDING & SAFETY DEPARTMENT 777-7012 INSPECTION REQUEST LINE 777-7153 OwnerMARV1N N(MES__ . �ContractorjDJEN W AJAC MASONRY Permit Number31 POST ON JOB IN CONSPICUOUS PLACE . . INSPECTOR MUST SIGN ALL APPLICABLE SPACES \ JOB ADDRESS -1U- 40 CALLS ESTADO 53 LF 6' BLOCK WALL FOR TRASH ENCLOSURE PER CITY STANDARD TYPE OF INSPECTION DATE INSP. U/G PLUMBING / WASTE U/G ELECTRICAL / GROUNDING FOOTINGS / STEEL CONCRETE SLAB DO NOT POUR CMCA ETE ROOF NAIL/ PRE -ROOF OKAY TO WRAP FRAMING (COMBINATION ROUGH ELECTRIC ROUGH MECHANICAL I I INSULATION ABOVE SIGNED INTERIOR GYP. BD. (DRYWALL EXTERIOR LATH �� GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTEFCEPTOR MAEONAY INSPECTIONS FOOTINGS / STEEL �J BONO BEAM d POOL / SPA / WATER FEATURE: INSPECTIONS PRE-GUNITE / SETBACK U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER (ALARMS 1! _FI TEMP. USE OF PERMANEI ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPART COMMUNITY DEVELOPW FINAL/ JOB COMPLETE P. 01 WMIr - PPPOW _)T INCLUDE RIGHT TO )CCUPY BU _DING