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06-0269 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 06-00000269 53356 VIA STRADA 772-520-053- - WALL/FENCE LOW DENSITY RESIDENTIAL 3150 Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 CI ss: B cense /No.: 231712 Date: Contractor: C /7 R Z5 R I S 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).: (_ 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 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 improve for the purpose of sale.). (_ 1 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. , 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 work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: CHRIS HARRIS 2127 PALOS VERDES DR N LOMITA, CA 90717 Contractor: HARRIS HOMES INC 2127 PALOS VERDES DRIVE NORTH LOMITA, CA 90717 (310)325-6355 Lic. No.: 231712 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/18/06 ----------------------------------------------— 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 ' 1773515-2006 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 G 3700 of the Labor Code, I shall forthw• h comnplly with those provisions. Date: / �O Applicant: C 15 �C/ 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 Pity and county ordinances and state laws relating to bu5ildi��d hereby auth rize rejresentativesof this co ty t enter upon the above-mentioned propeoses. Date: �V �t9 Signature (Applicant or Agent): fs I LQPERMIT Application Number . . . . . 06-00000269 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee. . . . . 63.00 Plan Check Fee .00 Issue Date . . . . Valuation . . 3150 Expiration Date . . 7/17/06 Qty Unit Charge Per Extension BASE FEE 45.00 2.00 9.0000 THOU BLDG 2,001-25,000 18:00 ---------------------------------------------------------------------------- Special Notes and Comments 124 LF 6' BLOCK WALL PER ORCO STANDARD. Fee summary Charged ----------------- Paid Credited Due ---------- Permit Fee Total ---------- 63.00 ---------- .00 ---------- .00 63.00 Plan Check Total .00 .00 .00 .00 Grand Total 63.00 .00 .00 63.00 Bin # City of La Quinta Building U Safety Division Permit # P.O. Box. 1504, 78-495 Calle Tampico La Quinta, CA 922.53 -.(760) 777-7012 Building Permit Application and Tracking Shppt Project Address: 3SZ0 °% STeAL.W A. P. Number: Legal Description: Contractor: Address: Jd17 City, ST, Zip:LONI/ 7-4 CA- 90,7/1% /V Designer. Name of Contact Person: Telephone # of Contact Person: Owner's Name: C I 5 Res %� Address: o? Ian' / p/>'Z� s. V�1' 2, /1IWIZ City, ST, Zip: Z©M/ 7A- C/i— q4ql' l APPLICANT: DO Nt # Submittal Req'd Recd IT WRITE-BELOTHIS UNE W TRACKING , PERMIT FEES Plan Sets Item Plan Check submit r corrections Structural Calcs. Plan Check Deposit Reviewed, ready fa Truss Cates. Called Contact Per Construction Energy Cates. Plans.picked up Flood plain plan Electrical Plans resubmitted .on Grading, plan Plumbing 2°' Review, ready t Subcontactor List Called Contact Per Grading Grant Deed r corrections/issue Plans picked up H.O.A. Approval A.I.P.P. Plans resubmitted IN HOUSE:- Review, ready fa Planning Approval Called Contact Per Pub. Wks. Appr Date of permit issu, School Fees Owner's Name: C I 5 Res %� Address: o? Ian' / p/>'Z� s. V�1' 2, /1IWIZ City, ST, Zip: Z©M/ 7A- C/i— q4ql' l Telephone: 3/0 - 3o?6--& 3 W- Project Description: Construction Type: lvl—�Gr Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Estimated Value of Project: IT WRITE-BELOTHIS UNE W TRACKING , PERMIT FEES ted Item Amount r corrections Plan Check Deposit son Plan Check Balance Construction Mechanical )r corrections/issue Electrical .on Plumbing S.M.I. Grading r corrections/issue Developer Impact Fee on A.I.P.P. Total Permit Fees