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07-0453 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 07-00000453 Property Address: 53663 VIA DONA APN: 772-420-999-36 -298944- Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1250 Applicant: (00 0, C)Ok c&ht 4 4 Q" Architect or Engineer: 0 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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: B C29 License No.: 463407 Date: -13 Contractor: _ OWNER -BUILDER DECLARATION 1 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 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 _ 1 1, 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 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.). f _) 1, ac ­,r,r,, of rhn prgpgrty, am gnoluoi -sly aantraminy tv .....buu idle yivJeu (3eu. 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.). (_) I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: NRI CCP I C/O NRI CCPI 81100 AVENUE 53 LA QUINTA, CA 92253 Contractor: DRURY CONSTRUCTI0 73807 MASSON STREET4 PALM DESERT, CA 922 (760)346-7227 Lic. No.: 463407 VOICE (760) 777-7012 FAX (760) 777-7012 INSPECTIONS (760) 777-7153 Date: 2/13/07 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 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 issued. My workers' compensation insurance carrier and policy number are: Carrier PREFERRED INS Policy Number WKN1157594 I certify that, in the performa a of the work for which this permit is issued, I shall not employ any person in any manner s as o becomes t to the workers' compensation laws of California, and agree that, if I sho Id ecome ject to the orkers' compensation provisions of Section 3700 of the Labor C I shall orthwith comply ith those provisions. DaYe"� Applicant: WARNING: FAILURE TO SECURE WORKERS ATION 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 ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT ifviF6F%TAIv 1 Npyin;auwi Is ileleuy nlaue to Ude ulrecior of uulming ano Satety to? a 066 id sublect 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 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 thea ation is correct. I agree to comply with all city and county ordinances and state laws relating to buil g nstructi and hereby authorize representatives of this county to enter upon the above-mentioned propelr inspection rposes. Application Number . . . . . 07-00000453 Permit . . . WALL/FENCE PERMIT Additional desc ... Permit Fee . . . . 31.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1250 Expiration Date . . 8/12/07 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 2.0000 HND BLDG 501-2,000 16.00 ---------------------------------------------------------------------------- Special Notes and Comments 50 L.F 6' GARDEN WALL PER ORCO Fee summary Charged ------------------------------------- Paid Credited Due Permit Fee Total 31.00 ---------- .00 ---------- .00 31.00 Plan Check Total .00 .00 .00 .00 Grand Total 31.00 .00 .00 31.00 LQPERMIT Bin # City of La Quinta' Building U Safety Division Permit # P.O. BOX 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: O NtiL'� Owner's Name: /S/-1✓,�/� A. P. Number: 5/�2 Legal Description: Address: 5 3 la/v3 VI -A Do�vva City, ST, Zip: 44 Q�i�.✓ - Contractor: /.�.E' 'T ,D2CJl1 L - Telephone: S' hen Addos ress: - 8 O 7 'J %. Project Description: 2 City, ST, Zip: C� 922100 Telephone: &- -77.-2-7 G ��2G�.0 w,4GL State Lic. # : p 7 DMZ o 5�lzGS , • City Lir. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Consttuctioa Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: SUCJ G� APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACWNG Plan Sets PERMIT FEES Plan Check submitted Structural Calcs. Item Amount . Reviewed, ready for corrections Truss Calp. Plea Check Deposit Called Contact person Energy Cales. Plan Chick Balance Plans Picked up Flood plain plan Construction Plans resubmitted Grading. plan' Mechani:al 2" Review, ready for correedens4ssue Subeontactor List . Electrical Called Contact Person Grant Deed Plumbing Plans picked up ILO.A. Approval S.M.L Plans resubmitted IN HOUSE:- Grading ''' Review, ready for.corrections/iasue Planning Approval Developer Impact Fee Called Contact Person Pub. Wks. Appr A.LP.P. .Date of permit Issue School Fees Total Permit Fees