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06-3691 (BLCK)P.O. BOX 1504 VOICE (760).777-7012 .78-495' f;cALLE TAMPICO FAX (760) 777-7011 LA„ QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT `. ` Date: 10/17/06 Application Number: 06-00003691 Owner: Property Address: 80235 VIA MIRASOL HIDEAWAY LOT 7 APN: 772-430-007- - - 802035 VIA MIRASOL Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: 'LOW DENSITY RESIDENTIAL " Application valuation: 5000 ttE -Contractor:Applicant: Architect"or Engineer. CALIFORNIA PZ006 (J P.O. BOX 128 COACHELLA, C 9223MTYOFLAQUINTA (760) 398-922L PINANCE DEPT. Lic.'"No.: 656128 LICENSED CONTRACTOR'S DECLARATION- - - WORKER'S COMPENSATION DECLARATION 1 hereby affirm under 'penalty of perjury that I am icensed under provisions of Chapter 9 (commencingwith. I hereby affirm. under penalty of perjury one of the following declarations: 'Section -7000) of Division 3 of the Business and ofessionals 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: C8 C27 C29 License No.: `656128 _ for by Section 3700 of the Labor Code, for the performance of the work for which this permit is _ on- issued. Date:" Ctractor: - 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 NER-BUILDER DECLARATION- _ - insurance carrier and policy number are: I hereby. affirm under penalty of perjury that I am a mpt from. the Contractor's State License Law for the - Carrier SEABRIGHT Policy Number BB1060510 - - 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 come 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 bec 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 37 0 of the Labor Code, s ort ith complywith 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 (5500).:'. —Date: �� � _��Applicant:-+ - • - (_ 1. I, as owner.of the property, or my employees with wages as their sole compensation, will do the work, and . �v� _./ - the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' OMPENSATION 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 PENA TIES 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 1$100,0001. IN ADDITION TO THE OST 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 (_) 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, (_ 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 Quina, 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 Fesult of this appAon null and void if work isnot commenced l within ,186 days from date of issuance t 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 1 have read this application and state thation is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county dinances and state laws relating to• ucti , and hereby authorize representatives of this co ty t en upon the above-mentioned prc 'on urposes Lender's Name: (/f(/� - - "'" Data fes' Signature (Applicant or Agent): Lender's Address: j' • LQPERMLT . - Application Number . . 06-00003691 Permit . . . WALL/FENCE PERMIT Additional des.c . Permit Fee-Ch63.00 Plan eck Fee 00 Issue Date Valuation 3450 Expiration.Date_ 4/15/07 Qty ..Unit Charge Per Extension BASE FEE 45.00 - 2:00 9.0000 THOU BLDG"2,001-25,000 18.00 --------------------------------------------- Special Notes and Comments ; BLOCK WALL 801LF X"6' (ORCO) BLOCK.WALL 58'LF.X 6' (CITY STANDARD) PER APPROVED•PLANS" . Fee summary Charged Paid" -Credited Due. Permit Fee Total 63.00 .00""" -- .00 - - - - - -- 63.00 PlaneCheck Total :00 i00 .00 .00 Grand Total 63.00, .00 .00. •63.00 " LQPERMIT Bin # Clty of. L _a pinta.. Building 8i Safety Division Permit # P.O... Box 1504, 78-495 Calle Tampico n� U Quln6 CA 92253: (760) 777-7012 Building Permit Application and Tracking •Sheet Project Address:— Owner's Name:e.�, A. P. Number: cQ Address:$U :235— mac.. Legal Description: • l Contractor\� CityST, Zip: :.:., yam' t :,.,Telephone: • Ad"dress: ?�© 2 CP — Project Description: City, ST, Zip. eA, . . Telephone: 39(?­�ZZ Z f State Lic. # : Z City Lic # G 'c. co _Udw ex"C Arch., Engr., Designer: r Address: - City, ST, Zip: Telephone: .. Construction Type: Occupancy; State.Lic. #: 9jqct type (circle. one): Add'n . Alter Repair Demo Name of Contact Person: Sq. Ft.:77777 #.Stones: #Units: Telephone # df.Contact Person: 77 ..Esti unated Value.ofProject: $- p Od .. APP..LICANT DO NOT WRITE BE.LOW.THIS LINE # Submittal Req'd Reed TRACI�1 G Plan Sets : '77777.. "Plan Check PERMIT FEES Structural Calcs. Reviewed, ready for corrections Item Amount Plan Check Deposit Truss Calcs. Called Contact Person . Plan Check Balance Energy Coles. Plans picked up Construction Florid plain plan Plans resubmitted Mechanical Grading. plan' rd.. 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 IN 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 r