08-0271 (BLCK)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: 2/06/08
pplication Number: 08-00000271 Owner:
roperty Address: 53635 VIA MALLORCA WHITE DAVE &'LIELA
PN: 772-420-999-52 -298943-
53-635 VIA MALLORCA
W.—pplication description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL ( ® `
Application valuation: 8425
Contractor.-,• `�
Applicant: Architect or Engineer:. CAL -TECH DEVELOPMENT CORP
78150 CALLE TAMPICO STE 2 r 5A�
-•v : LA QUINTA, °CA 92253
(760) 771-3738y�:
Lic. No. 683969
r
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 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.r' _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: B LicenseNo.: 683969 - ` - - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
.� ,1^4 �♦ _issued.
ontraor.DaZ=L V&Cct
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 '
. OWNER -BUILDER DECLARATION. - f.- insurance carrier and policy number are:
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1768839 _
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 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, 1 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 '• 1, '
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Da eta Applicant:,. '
(_) 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 ah owner of property who builds or improves thereon, SUBJECTAN'EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herselfthrough 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 is sold 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
(_ 1 1, 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 contractorls) 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,
1 _ 1 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 perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that 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 to building construction, and hereby authorize representatives
• - of this county to enter upon the above-mentioned property for inspection purposes.
Lender's Name: 4C— S -1, lfl — . — I '
=-Date: ~Signature (Applicant or Agent):
Lender's Address: -
LQPERA11T
Application Number . . . . . 08=00000271.
• Permit . . . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee 108.00
Plan Check
Fee
.00
Issue Date . ..
Valuation
8425
Expiration Date 8/04/08
Qty Unit Charge Per
Extension
BASE
FEE
45.00
7.00 9.0000 THOU BLDG
2,001-25,000
63.00
----------------------
Special Notes and Comments
---------------
-------------------
.
337 LN FT X 6 FT HT GARDEN -WALL
PER CITY
STANDARDS & APPROVED PLANS
Fee summary Charged"
Paid Credited
Due
Permit Fee Total 108.00
----- ----------
.00
----------
.00
108.0.0"
Plan Check- Total- .00
.00
.00
.00
Grand Total 108.00
00
00
108.00
Bin #
�-
-
-City ,of La*,Quinta
4 Building & Safety Division '
P.O. Box 1504, 78-495 Calle Tampico'
La Quinta, CA 92253 -'(760).777-7012 _
Buildin Permit Application and Tracking Sheet
Permit #
Project Address:' S -6,35 1 R '10 ,41 Die C.4
Owner's Name:�./c d kIFL4 W 14 i 7-6
A. P. Number: -
Address:•s : (� ?� s {%�•¢ 1W L Gat c4
Legal Description:
Contractor: (4 L - r ee N `0EVEi .
City, ST, Zip: (f()
Telephone: ®4 s� 3 N0 35 9 3
Address: %8 - /-50 C4) -4 e -'
Project Description:
City, ST,ZipG OU til moi}. Qzz
C E.
Telephone- 7&o 7?/ 3-738
,
�T _ /GI "C.W.f Y,O tJ ✓T 4 CLa
State Lic. # : I g 3 &
City Lic. #:
Arch., Engr., Designer:�KL(e/ cr sokn/
Address: D %30 X z �`ldd/ .:
City, ST, Zip. 4*J-7—¢ ;3.4Q$pe.*
Telephone: � • ��
p 8o S' 962 sa
State Lic. #: C /2 /.4/&R / '
Name of Contact Person:Sq.
- /_
Coristruction Type: $LOuk 09•1Wccupancy: ! CS•
Project type (circle one) New Add'n Alter Repair Demo
F 33 7
#Stories:
#Units:
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 Calcs.
Called Contact Person,,
Plan Check Balance
Energy Calcs:
Plans picked up ' r.• ` .
Construction
Flood plain plan
Plans resubmitted `
Mechanical
Grading. plan'
2"" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing _
Grant Deed
Plans picked up
S.M.L.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval •.
Called Contact Person.
A.LP.P.
Pub. Wks. Appr
,
Date of permit issue
"
School Fees
r -
Total Permit Fees