08-1543 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 0"8-'00001543
Property Address: 53731 VIA MALLORCA
APN: 777-390-016-2 -33654 - -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5413
Tiht 4 4Cl"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
MIKE JEHA
3089 SANDSTONE ROAD
ALAMO, CA 94507
(
Contractor:
Applic t: Architect or Engineer: JEHA CONSTRUCTION, MI
�?3089 SANDSTONE ROAD
ALAMO, CA 94507
(925) 250-4038
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/09%08
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Lic. No.: 410408 v Q C'
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------ ---- ---------------------------------------'--------------------=r"��- �'------ - - - - --
LICENSED CONTRACTOR'S IhPfRR ON ON WORKER'S COMPENS' RA ION _ _ -
Ihereby affirm under penalty of perjury that I am licensed under isions 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 Profession ode, and my License is in full force and effect. - I have andwill maintain a certificate of consent to self -insure for wor rs compensation, as provided
License Cla : B License No.: -4 10 4 08 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is "
- r---� issued. -
�Date_ 4 Contractor _ _ 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
-BUILDER DECLARATIONinsurance carrier and policy number are:I hereby affirm under penalty of perjury that I aJN
e pt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 238-0002300-06
following reason (Sec. 7031.5, Business and Pr fe ions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair an ructure, 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 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 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.).
1 _ 1 I, 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.).
(_) I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
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
_ I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
personin any manner so as to become subject to the workers' compensation laws of California,
a d agree that, if I sl become subject to th pensation provisions of Section
0 o he Labor ode, I all f rt ly with those provisions. _
—Dater pplicant:
WARNINF 1LURE 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 ATTORNEY'S FEES.
- "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, 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 the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this coun to enter upon the above-mentioned pr or ' spec ' purposes.
'-Da ` nature (Applicant orAgehtl: t .
Application Number . . . . . 08-00001543
Permit WALL/FENCE PERMIT
Additional desc.... BLOCK•WALL ORCO STANDARD
Permit Fee .. 81.00 Plan Check
Fee
00
Issue Date Valuation
.5413
Expiration Date 3/08/09
Qty Unit Charge Per.
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
Special Notes and Comments
BLOCK WALL PER ORCO STANDARDS 250 LN FT
X S.FT HT
Fee summary Charged Paid Credited
Due
Permit Fee Total 81.00 00
.00
81.00
Plan Check Total .00 .00
.00
.00
Grand Total 81:.00 .00 _
.00
81.00
LQPERMIT
Bin #
City of La Quinta
Building 8I Safety Division
P.O. Box 1504,.78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
J t�i i 2
Project Address: 67J _ 7 3/
Owner's Name: t
A. P. Number:
Address: Offl y 5
Legal Description:
Contractor: �r /�G
,
City, ST, Zip: ��
Telephone: -t, — �j� b
Address: ho
Project Description:
City, ST, Zip:
Telephone: 2S
State Lic. # : 16 419"-, City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #: A. 0
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person: Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Plan Sets
Req'd
Rec'd
TRACKING
Plan Check submitted
PERMIT FEES
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
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
M 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