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07-0738 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 07_00000738 _5 Owner: Property Address: 44775 VIA MIRABEL MARK BROWN APN: 6.04-032-999-35 305212- 44775 VIA MIRABEL Application description: WALL/FENCE LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1250 Contractor: - Applicant: Architect or Engineer: M J & G MASONRY ~ 10226 VIREO CIRCLE LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force. and effect.. License Class: C29 /` LicenseNo.: 827707 Date' 1 L/_-Cont?actor:✓�(,1 �'Z�i`Iy� (/ .. , OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the . following reason ISec. 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 (5500).: (_) 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 impioves 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.). (_) 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 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 - VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: .3/12/07 D° MAR 1'"Ut WY OF iA QU NiTA_ 7F1 FINAL ICE�1�! PT_ FOUNTAIN VALLEY, CA -92708 (760)343-6193 • Lic'.No.: 827707: - ------------------------------------------------- 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 1769682-2006 I certify that, in the performance of the work for which this permit is, issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: '1�1..I?ant: �� S/ —WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 county to enter upon the above-mentioned property for inspection purposes. r y Date:7 r�L (Signature (Applicant or Agent) Application Number . . . . . 07-00000738 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee 31.00 Plan Check Fee .00 Issue Date Valuation 1250 Expiration Date 9/08/07 Qty Unit Charge Per Extension BASE FEE 15.00 8.00' 2.0000 HND BLDG 501-2,000 16.00 -------------------------- Special.Notes and Comments ----------------- ------ --------- ------ 50 LF 6' BLOCK WALL IN FRONT YARD 30' BACK FROM.P/L PER ORCO STANDARD. Fee summary Charged Paid Credited Due Permit Fee Total 31.."00 .00 .00 31.00 Plan Check Total. .00 .00, 00 .00 Grand Total 31.00. 00 ., 00.. 31.00 �ti • LQPERMIT Bill U Permit # t Project Address:' A. P. Number. CityofLa Quinta Building &-Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92 Building Permit ..253 - (760) 777-7012 Application' and Ttacking.Sheet Owner's Narne: Address: Legal Description:. -------- City, ST, Zip: 14 &1111 4-4 IYAS011V le Y - -------- /,.4 Contractor: . 21a— Telephone: Address: /.0022(, C Cii 2Ea Project Description: Cz itySTIZiD: e—J-4 I/-//- Telephone: . 70 - 7 V3 -6113 -lam State Lie. #': 2,70-7 CitV Arch., jEngr.', Designer. City; ST, Zip: Tel; 6 phone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: Plan Sets StructuralCaics, Truis Galea. Energy Cities. Flood plain Plan Grading, plan' Subcoiitxetor List Grant Deed H.O.A. Approval IN HOUSE -,- Planning Approval Pub. Wks. Alipr School Fees* It. Lic. Total Permit Fees Constriction Type: OCCUIM7: ftoject type (circle Pao): New -Add'n 'Alter Repair Demo - # stories:- 17 I Units: Estimated Value OtProject:oj*_0,13- APPUCANT: DO NOT WRITE BELOW THIS UNE Reed UACIONG PERM FEES Plan Check submitted Item Amount Reviewed, ready for corrections Plan Check Deposit Called Contact Person Plan Check Balance Plans Picked. up Constructiod Plaits resubmitted Mechanical 2" Review, ready for correctiousj%sue Electrical Called Contact. person Plumbing Plans picked up S.KL Plans resubmitted ------- Grading Review, ready for.correcdoWL"ue Developer Impact Fee Called Contact Person Date of permit issue ------- Total Permit Fees 64, 92!70-' F