06-2751 (BLCK). .-- - gml
'&' y 4 Q
P.O. BOX 1504•_ - VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/20/06
Application Number . _ 0.6=0'0002753=,— Owner: .
Property Address: 44355 VIA CORONADO GOODRICH WAYNE
APN: 604-211-015-36 -23971 - 44355 VIA CORONADO
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL _...
Application valuation: 1125 D p
Contractor:
Applicant: Architect or Engineer: LATHROP DEVELOPMENT, INC. JUL 20 2006
72.912 WILLOW STREET
LA QUINTA, CA 92253
(760) 324-5154 CITY G; I /aQUINTA
'
Lic. No.: 745690 FINANCE DEPT.
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Busin d Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B Z. - License No.: 745690 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 ofthe work for which this permit is issued. My workers' compensation
G V*y
UILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of ppt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 10886 -
following reason (Sec. 7031.5, ns Code: Any city or county that requires a permit to - _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, dem hture, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statemen or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
_ License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. -
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).: ,Date:`�L*pli.__
(_ 1 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 WARNING: FAILURE TO SECURE WO CE ' COMPEN TION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRI I A ENALTIES AN CIVIL FINES UP TO ONE HUNDRED THOUSAND
and•who does the work himself or herself through his or her own employees, provided that the DOLLARS 1$100,000)- IN ADDITI O THE COST O COMPENSATION, DAMAGES AS PROVIDED FOR IN _
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CO E, INTEREST, D ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT `
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who'builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application;'
(_) I am exempt under Sec. , B.&P.C. for this reason 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. -
Date: Owner: - 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjurythatthere is a construction lending agency for the performance of the - I certify that I have read this application an the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - city and county ordinances and state laws relating =od hPlPw P� �•n!,l��o representatives
ntioned
of this county to enter upon the above-meproperty rinspection purposes.
Lender's Name:. -
Dat e_'���ure..(Applicant . or -Agent):.
Lender's Address:
LQPERMI
Application Number . . . 06-00002751
;. Permi-t - WALL/FENCE PERMIT
Additional desc .
Permit Fee. 29.00 Plan Check
Fee
..00
-. Issue.Date Valuation
. . .
1125
Expiration Date 1/16/07
Qty Unit Charge Per
Extension
�t BASE FEE
15.00
7.00 2.0000 HND BLDG 501-2,000
14.00.
---------------------------------
Special Notes'and'Comments __,__
45 LF 6' BLOCK WALL PER ORCO STANDARD.
Fee summary Charged Paid Credited
Due
Permit Fee Total 29.00 :00
00
29.00
Plan Check Total .00 00
.00
.00
Grand Total 29.00 .00
.00
29.00
Bin #
City of La Quinta
Building U Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # s-
l�J
Project Address: IfU/4 e�arz—iL 9 J
Owner's Name: JA)A , Ilrl, Cr0pD 2 /If /li .
A. P. Number:.
Address: '1j 3 V / Co fzo!A-A0 a
Legal Description:
Contractor: / A7"
City, ST, Zip: /� t li �,��.. �j¢ G�' 22,5-
_7
Telephone: .
Address: 2 % Z LL d W -S
Project Description:
S 1.,�� � C �1 ew o^,/City;
ST, Zip: /L-, J f S �'Q—�—
1��
W 1- (O
Telephone: 260 3 2 Y
MEMO=
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: #Units: .
,Name of Contact Person:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r }
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