06-2129 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO .
LA QUINTA, CALIFORNIA 92253 ,
Application Number:X06-00002129 i
Property Address: 51620' VIA ROBLADA
APN: 772-270-010-23 -311231'-
Application
311231=Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 5625
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
VISTA LA QUINTA PARTNERS,'LLC
223 E. DE LA'GUERRA
SANTA BARBARA-, CA 93140.
VOICE (760) 777-7012
FAX (760).777-7011
INSPECTIONS (760) 777-7153
Date: 5/23/06
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U, ctor:
Applicant: Architect or Engineer:'A� AV ERMAN CONSTRUCTION, RA
,v!
6'ry®®�o BOX 5909.1
... C��.
'
.L U QUINTA; CA 92247
QF
13I,/�h 60) 771-8191
F'�ANCF U p� No.:
L'c. 681660
' LICENSED CONTRACTOR'S DECLARATION ..
- - WORKER'S COMPENSATION DECLARATION
' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
I. hereby affirm under penalty of perjury one of the fallowing declarations:
Section 70001 of Division 3 of the Business and 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
License Class: B License No.: 681660 -
for by Section 3700 of the Labor Code, for the performance of the work .for which this permit is
/ - -
' ate: �`� ontractor
issued.
have -and -will -maintain -workers -compensation -insurance, -as -required -by -Section 3700-of-the-L-abor -
_ _I
Code, for the performance of the work for which this permit is issued. My workers' compensation
' OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier STATE FLTND Policy Number 7560000002•
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 become 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 become 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
0 of the Labor Code, I shall forthwith c rth 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).:
at pplicant: .
1 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
WARNING: FAILURE TO SECURE W RKERS. C MPENSATION 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 15100,000). 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.). -.
r' 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 andrestrictions set forth on this application. .. -
• property who builds'or improves thereon, and who contracts for the projects with a contractors) 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,
I am exempt under Sec. , BAP.C. for this reason
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.
' Date: Owner:
'" 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
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 I have read this application and state that the 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 to building construction, and hereby authorize representatives
• -
of this court y toe er upon the above-mentioned property f spe rposes.
• Lender's Name:
.IV ri,.-
ted ignature (Applicant or A
Lender's Address: -
- -
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Application Number 06-00002.129
Permit WALL/FENCE PERMIT
Additional.desc .,
Permit Fee 81.00 Plan Check
Fee
.00
Issue Date Valuation
5625"
" Expiration.Date -11/19/06"
-
Qty Unit Charge Per
Extension
BASE .FEE..
45.00
4.00 9.0000 THOU BLDG 2,001-25',0b0
36.00
-- - - - - - - - - - - -- - -- - - - - - - - -
Special Notes and Comments
- -
225 L.F. 6' GARDEN WALL,.ORCO SYSTEM
Fee summary ChargedPaid Credited
Due
Total .81.00 . 00 --
-Permit. Fee .
.00
81.00 <?
Plan Check Total' 00' .00
.00,
.00
Grand Total 81.00 00
00;
81.00
LQPERMIT