07-0053 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA
92253
Application Number:
07-00000053
Property Address:
52551 VIA SAVONA
APN:
772 -410 -999 -9 -298943 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
CAP -Application valuation:
6000
T,ityl 4 4 QuAk
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT .
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
1 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 apd Professionals e, and my license is in full force and effect.
License Clas B o.: 683969
DaterContractor:
`-- - - _
_
N;1 -BUILDER DECLARATION
1 hereby affirm under penalty of ry m exempt from the Contractor's State License Law for the
following reason ISec. 7031.5. siness a d 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 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
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
i 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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 _ 1 I am exempt under Sec. , BAP.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
w6rk for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
M/M BRIAN LONG
52551 VIA SAVONA
LA QUINTA, CA 92253
Contractor:
CAL -TECH DEVELOPMENT
78150 CALLE TAMPICO
LA QUINTA,.CA 92253
(760)771-3738
Lic. No.: 683969
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/05/07
�p D
JAS! 0 8 2007
G
SIE
CITY OF LA QUINTA
FINANCE DEPT
-----------------------------------------------
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 1768839
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:- _Applicant:
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 ($100,000). 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.
:Date:. -- Signature_(Applicant or Agent):
Application Number . . . . . 07-00000053
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 81.00
Plan Check
Fee
00
Issue Date
Valuation
. . .
. 6000
Expiration Date 7/04/07
Qty Unit Charge Per
Extension
` BASE
FEE
45-.00
4.00 9.0000 THOU BLDG
2,001-25,000
36.00
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Special Notes and Comments
240 LF 6' BLOCK WALL PER ORCO DETAIL
y
Fee summary Charged
Paid
Credited
Due
Permit Fee Total 81.00
.00
.00
81.00
Plan Check Total .00
.00
.00
.00
Grand Total 81.00
.00
.00
81.00
4
r4
LQPERMIT
Bin #
Pennit 1! i15
. Oo - 0�
Project Address:
A- P. Number:
Contractor. CQ`-fj
Address: 7R—/,0:p>
City, ST, Zip.
Telephon=
State Lie. #
Arch., Engr.; Designer �%�
Address:
City, ST, Zip:
TeEephotLe: �f�.�/�,�
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person;
N S4obmlttal
Plan Seta
Straclwnl Calcs.
Truss Coles.
Energy Calea.
F199d ptaia Plus
Grsdlug. plan-
Swbcoartaator Last
Gnwt Deed
$OA Approval
Rf HOUSE:.
Planning Approval
Pub. Win. Appr
School Fees
°7 ' ZI 1
City of La Quinta
. Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Nam=
Address:
City, ST. Zip:
Lk. #:
Construction Type: Occupancy.
Project type (circle one): New. .Add'n Alter Rep* Demo
Sq. Ft: #Stories #Units:
Bsdaratcd value of Project:
APPLICANT: DO NOT WR[rE BELOW TMS LINE
Reed mo...v. —
•vtevftd'
PLarCbcdksubmitted "
Called Contact Person '
Plans Picked err
Pleas resubmitted
2" Wye w, ready for eaereedontAsaue
Called Contact Perron
Plans picked up
Plana resubmitted
*' Review, ready for.sorreedons%sut
Called Contact Person
Date of permit tore
"
Pisa Geek Deposit"
plan Check Balance
Coastr•etioa
Mechanical
)N]ettrical
Plumbing
S.MX
Gradlag
Developer Impact Fee
A.LP.P.
Total Periait Feer
Asoaut
z'd FLEE'TLL-oqL duo0 quawdoianaa goal—ie0 WdLC:01 L002 90 uer