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07-0326 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Q 07-00000326 Property Address: 53571 VIA STRADA APN: 772-540-037- - `� Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 9250 A - T-it!t 4 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT -------------------------------------------------- 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 license No.: 497804. �/-E?7 C Da[e7ontractor. zzz --'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 (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).: (_) 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 improves thereon, E 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 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) 771-7011 INSPECTIONS (760) 777-7153 Date: 2/01/07 Owner: JAMIE SHENNAN 75 KILROY WAY ATHERTON, CA 94027 D Contractor: FEg o 12001 ELLINGTON MASONRY, ST E 68675 PANAROMA ROADof QVINTA CATHEDRAL CITY, CA 92 34 C F NCEO - (760)320-9481 LiC. No.: 497804 ----------------------------------------------- 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 0007283-2007 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 3.700 of the Labor Code I shall fort ' A2omply with those provisions. Date: -� ® Applican WARNING: FAILURE TO SECURECOMPENSATION 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 f ' spection purposes. o7 Signature (Applicant or Agent 4:r 1 fr 1 LQPERMIT Application Number . . . . . 07-00000326 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 117.00 Plan Check Fee .00 Issue Date . . . . Valuation 9250 Expiration Date 7/31/07- /31/07Qty QtyUnit Charge Per Extension BASE FEE 45.00 8.00 9.0000 THOU BLDG 2,001-25,000 72.00 ---------------------------------------------------------------------------- Special Notes and Comments 370 LF 6' BLOCK WALL PER ORCO DETAIL & SFD GRADING PLAN Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total ---------- 117.00 ---------- .00 ---------- .00 117.00 Plan Check Total .00 .00 .00 .00 Grand Total 117.00 .00 .00 117.00 Bin # City of La Quinta Building 8L Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address:,SV%j4 Owner's Name: , j /0 419 / C A. P. Number: Address: ] iC J 6 � Y Legal Description: _ City, ST, Zip: �/c�(�-� yy C,,O, Contractor: S rGA-' CL G // Y'6 %ry qzos y v, �r Address:6t67Siyc��ypyy>,p.� City, ST, Zips"_ �1�►J�/Ir �, G/ T)- C,Q � ZZ Z Telephone: Z d 5 y� State Lic. # : 41 S'7 �-oq City Lic. #: Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Telephone # of Contact Person: # Submittal Plan Sets Structural Cala. Truss Gla. Energy Cale. Flood plain plan Grading.plan• Subcoutactor List Grant Deed H.O.A. Approval IN HOUSE: - Planning Approval Pub. Wks. Appr School Fees Project Description: /5 ' G/(%� 0/2—C -b csYS T� yyi Construction Type: fyj10&_r,1/W Occupancy: PrOject hype (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Estimated Value of Proiect: APPLICANT: DO NOT WRITE BELOW THIS UNE Recd TRACKING Plan Check submitted Reviewed, ready for corrections Called Contact Person Pians ticked up Plans resubmitted 2-' Review, ready for corrcedons/issue Called Contact Person Plans picked up Plans resubmitted Review, ready for. correctionsrssue Called Contact Person Date of permit issue PERMIT FEES Item Plan Check Deposit Plan Check Balance Construction Mechanical Electrical Plumbing S.M.I. Grading Developer Impact Fee A.I.P.P. Total Permit Fees Amount