06-1035 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
` . LA QUINTA, CALIFORNIA 92253
Application Number: 106-00001035 'I
Property Address: 53443 -VIA `MALLORCA
APN: 772-420-999-46 -298943-
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 7000
Applicant:
Tiht 4 4'0"
Architect or Engineer
.PIP
BUILDING & SAFETY DEPARTMENT
. BUILDING PERMIT
Owner:
MONARCH HOMES,
73290 EL PASEO STE. 4
` PALM DESERT, CA 92260
Contractor:
MONARCH HOMES DESERT DIV, I
73290 EL PASEO, SUITE 44
PALM DESERT, CA 92260
(760)568-3905
LiC. No.: 457228
1 C.
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/15/06
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 Business and 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 License No.: 457228
-
_
'. for by Section 3700 of the Labor Code, for the performance of the work for which this permit is'
ate:
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 whichthis permit is issued. My workerscompensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FUND Policy Number 0028122-2005 -
following reason (Sec. 7031.5, Business and Professions 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, demolish, or repair any structure, 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 statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I s ould beco bjectto 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 sh II forth i ply 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).:
plican
(_) 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 CRIMINAL PENALTIES AND 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN.
_ improvements are not intended or offered for sale. If, however, the building or improvement issold within
_
SECTION 3706 OF THE LABOR CODE, INTEREST, AND 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—) 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 ouinta, 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. '
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state at the above information is correct. 1 agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). - -
city and county ordinances and tate laws relatiri to b .. g tructio , and hereby authorize representatives
of this ounty to enter upo eabove-mentioned erty f insp es.
Lender's Name:
L _
.:
ignature (Applicant o em):
Lender's Address: Filf,-
e
LQPERMIT
Application Number . . . . . 06-00001035
Permit .. . . WALL/FENCE PERMIT
Additional desc .
Permit Fee ._ 90.00
Plan Check
Fee
.00
Issue Date . .
Valuation
. . .
." 7000
Expiration Date 9/11/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
5.00, 9.0000 THOU BLDG 2,001-25,000
45.00
---------------------------------------------------
Special Notes and Comments
280 LF 6' BLOCK WALL, ORCO SYSTEM.
Fee summary Charged Paid
Credited
Due
Permit Fee Tctal 90.00
.00
.00
90.00
Plan Check Total .00
.00
.00
.00
Grand Total 90.00
.00
.00
90.00
LQPERMIT .
Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:' S�3 r- T �.� Y/ �4 M,�rupr2�q
Owner's Name:
A. P. Number:
Address: 7 '3 LiO 5+e 14
Legal Description: '
City, ST, Zip: P Z Z 60 .
Contractor:
Telephone:"
Address:
Project Description:
City, ST, Zip:
% LF 4,"
Telephone:
D "O
State Lic. # :
City Lic. #:
Arch., Engr.,' Designer:
Address:
311 t7(,,
City, ST, Zip:
Telephone:
e' .
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter* Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person: Zee.
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
3 !
Item
Amount
Structural Calcs.
Reviewed, ready for comet ions
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
1rd 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