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07-0431 (BLCK)P.O. BOX 1504 N ^�. VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA'44QUINTA; CALIFORNIA 92253 .' ; 4 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 2/07/07 Application Number: 07-00000431; Owner: 'Property Address: ' 53315 VIA MALLORCA HARRISON RESIDENCE APN: 772-420-999-42 -298943 53 -315 -VIA MALLORCA yy' Application description: WALL/FENCE LA QUINTA, CA 92253. { - Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 8400 { `, f` Contractor: ': ,;•- , Applicant: Architect or n ineer: TESERRA P.O.-BOX 1280, v Iv COACHELLA, •CA 6 (760)398-9222 i. Lic. No.: 65612 r - pF E - =- - - -- - - -- - -- --- -- QPZ -. LICrNSED CONTRACTOR'S DECLARATION WORKER'S COMP SA•T•tON ECLARATION - r .'I hereby'-affirm"under penalty of perjury Ij am licensed under provisions of Chapter9 (commencing with Ihereby affirm under penalty of perjury one of the owing declarations: - ', Section 7000) of Division 3 of the Bu nesa nd 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 f' . - , `•' '` .License Class: 12 C27 C29 j; License No.: 656128'x. - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ issued. _ !ate, v ntra_Tctor. �� ,l - '' -s. _ I have and will maintain workers' compensation insurance, as required by Section.3700 of the Labor- • - 6` -•,, Code, for the performance of the work for which this permit is issued. My workers' compensation t OWNER -BUILDER DECLARATION .insurance carrier and policy number are: hereby affirm under penalty of perjury that;l am exempt from the Contractor's State License Law for the Carrier SEABRIGHT Policy Number - BB 1070510 following reason (Sec. 7031.5, Business and Professions Code: Any city -or county that requires a permit to _' 1 certify that, in the performan a of the work for which this permit is issued, I shall, not employ any • construct, alter, improve, demolish, or repairjany structure, prior to its issuance, also requires the applicant for the person in any manner so a to become subject to the workers' compensation laws of California, 'permit to file a signed statement that or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I sho come 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 o e, I h I 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: G Applicant: �? r • •. (_) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and, -1 the structure is not intended or -offered for sale (Sec. 7044; Business and Professions Code: The WARNING: FAILURE TO SECURE WORK RS' 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 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 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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) licenseda . -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 Quihta, 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 applicaton becomes null and void if work is not commenced b - _ - within 180 days from date of issuance of s ch permit, or cessation of work for 180 days will subject - - CONSTRUCTION LENDING AGENCY permit to cancellation. �1lII 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 th 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 t d ? ing construction, and hereby authorize representatives - • of this c nt o enter upon the above -mention rope for insp tion purposes. - Lender's Name: - - -' I Dat Signature (Applicant or Ag ntl: ' Lender's Address: t,..`_. LQPERMIT - Application Number . . . . . 07-00000431 Permit . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . 108.00 Plan, Check Fee .00 Issue Date Valuation 8400 Expiration Date 8/06/07 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 - 46' LF X 6' HIGH W/2'-8" RETAINING WALL (ORCO) 1251LF X.6' HIGH (ORCO) 135' X 8' HIGH NON RETAINING WALL -2' WILL BE BURIED ON BOTH SIDES. 30' LF X 6- HIGH CITY STANDARD. Fee summary Charged Paid Credited" Due --------- Permit Fee Total 108.00 ---------- 00 -------- .00 -- 108.00. Plan Check Total. .00 .00 .00 .00.,: Grand Total 108.00 00 .00 108.00 LQPERMIT - Bin # , City of. La Quinta Building u Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico ' 1 La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address53- I V kC�-. Owner's Name: _ 1�2 ' A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: , � �- 5 �- lZ-Z i� • Telephone: Address: [2 ProjectDescription: LQCi�'C.J ILL City, ST, Zip: CoI�C �l.l �Z.Z3 Telephone: C1-ZZZ (ZSLFX�o ed State Lie. # : 656 City Lic. #: Ui4l -Z �.► / Bc vii a -Al Arch., Engr., Designer. E►K Co � ,` F , & • - \ Address: City, ST, Zip: Telephone: Construction Type:, Occupancy - State Lic. #: Project type (circle one): New •Add'n Alter Repair Demo Name of Contact Person: �C-k_X1DSq. FL: #Stories: # Units: Telephone # of Contact Person: 50_ ,Z a- Estimated Value of Project: $ p© 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 Ian Check Deposit Truss Cales. Called Contact Person Plan Check Balance Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading. plan t 2'a Review, ready for correctioosrissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted' f Grading IN HOUSE:- ''a Review, ready for correctionsfissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks.gppr Date of permit issue School Fees -Total Permit Fees