06-0667 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA,-CALIFORNIA
92253
Application Number:
06-0000066.7
Property Address:
80255 VIA.MIRASOL
APN:
772-4302006- - -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
t, Application valuation:
6250
Applicant:
1
Ta�/ 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
BOB LONN
80-255 VIA MIRASOL
LA QUINTA, CA 92253
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/15/06
FEB 15 Z006 -
Contractor: C 'p1A
JOHNSTON CONSTR INC., 4D.. FtlgA �EQU�Tq
1445 N. SUNRISE WAY, #
PALM SPRINGS, CA 92262
(760)416-1144,
Lic. No.: 699640
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of -perjury at I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin s and Professionals Code, and my License is in full. force and effect. -
License ass B ense No.: 699640
Date.
Wr Contractor: 0V, _
- ._ .ter-- _- t--•�—� -- - - ,
OWNER -BUILDER DEC RATION -
I hereby affirm under penalty of perjury I am exempt from the Contractor's State License Lawfor the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, 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 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
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 - r
` - 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, 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.).
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I 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
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the'performance of the work for which this permit is
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 which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1640856-2006
I certify that, in the perform ce of the work for which this permit is issued, I shall not employ any
person in any manner so a to become subject to the workers' compensation laws of California, -
and agree that, if 1 should b ome subject to the workers' compensation provisions ofSection '
�3700 of the Labor Code, I s all forthwith co y with those provisions.
,�",
Date:'164.Applicant:
WARNING: FAILURE TO SECURE W KER 'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI L P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND .
DOLLARS ($100,000). IN ADDITIO HE 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 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 su permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the ab a information is correct. I agree to comply with all
city and county ordinances and state laws relating to building nstruction,-and hereby authorize representatives
of this c my to enter upon the above-mentioned property for i spec -tion purpo s.
Date: ., S gnature (Applicant or Agent):
1 _
:
Application Number . . . . . 06-00000667
Permit . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 90.00
Plan Check
Fee
.00
Issue Date
Valuation
6250
Expiration Date 8/14/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
45.00
----1-1-----------------------------------------
Special Notes and Comments
250 LF 6'. BLOCK WALL PER ORCO STANDARD.
Fee summary - Charged Paid
Credited
Due
Permit Fee Total 90.00
.00
.00
---
90.00
Plan Check Total -.00 ,.:
00
.00
00
Grand Total 90.+00
.00
.00
90:00:1
i.
" LQPERMTT
Bin #
City of. La Quinta
Building & Safety Division
P.O. Boz 1504, 78-495 Calle Tampico
.La Quinta,.CA 92253 - (760) 777-7012
,Building Permit Application and Tracking Sheet
Permit #
6
Project Address: 6 . 2-95- U, 0, AA 14 q g 0 L-
Owner's Name: (3J ,(3 Uv' 1-J
A. P. Number:.
Address:.
Legal Description: l �� (P !v.
City, ST; Zip:
Contractor:
Telephone:
Project Description:
Address: tt Svr'L215
City, ST,Zip: A�.�M r7 ✓`/w5
2S O (�'j'..-�
Telephone: -7 (o o q l (. I 1 t•{ H
City Lic: #:
State Lic. # :
Arch., Engr., Designer: 4ky)&,�j 7o06,j ti arj
Address:
City, ST, Zip:
Telephone: x F
a
State Lic. #: Y
Name of Contact Person: t.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: (op UV0-3 7 6 3 -
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
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 bicked up
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 no
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
"d 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