05-4279 (BLCK)P.O. BOX 1504 VOICE (760) 777-7012 Ir .
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 4xi l
BUILDING PERMIT
Date: 9/22/05
Applioation Numbor: (0E,7_0 0 0 0 4 XZ671 Ownon
Property Address: 56877 VILLAGE DR STRUIKSMA
APN: 764-050-029- - - 56-877 VILLAGE DRIVE
Application description: WALL/FENCE _ LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 728
Contractor:
Applicant: Architect or Engineer: CALIFORNIA POOLS & SPAS
WCC: SEABRIGHT INS
WC: BB1050510 01/01/06
CSLB: 656128 10/31/06 O
p
TO
----------------- ��
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 Di ision (
f the Business and Professionals Code, and my Linse is in rc full n effect.
License Class: T License No.: �(7 �O
Contractor•
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 isnot 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.).
(_) 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
1 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
WORKER'S COMPENSATION DECLA
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 wo kers' com1 ,,,,,�,,N{�., ,prtfvided
for by Section 3700 of the Labor Code, for the performance of th work for wh 4vris permit is
_1<issued.
I have and will maintain workers' compensation insurance, as required 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 C8 C27 C29 C53 Policy Number - - - - - - - - - - - - - - -
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 Co e, 1 s all forthwith comply with those provisions. `
�Z.311_'O0o�'Applican .
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.Ouinta, its .officers, .agents.and.employees. for . anyact 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 inspect rposes.
DaSe ignatuie (Applicant or Agent):.
r
Application Number . . . 0.5-00004279
f`..
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 21.00 Plan Check
Fee
.00
Issue Date Valuation
728
_ Expiration Date 3/21/06
Qty Unit Charge Per
Extension
BASE FEE
15.00-
3.00, 2.000.0 HND ;BLDG 501-2,000.
6.,00
-------- ------------------------------------
Special Notessand Comments
95 L.F. 3' WROUGHT IRON FENCE WITH 5
L.F. 39" BLOCK.COLUMNS.
Fee summary Charged Paid Credited
Due
- ----------- ---------- ----------
Permit Fee Total 21.00 .00
----------
.00
21.00
Plan -Check Total .00 .00
.00
.00
Grand Total 21:00 .00
.00
21.00
LQPERMIT - -
- -
r
VILLAGE .AT THE ]PALMS H.O.A.
Avail Property Management
P.O. Boz 1032
Palfin Desert,- CA 92261
760=568-2717
August 3, 2005
Mr. Ed Stiviksma -
14 Running Brook Drive .
Coto.De Caza, CA 92679
RE: 56-877 Village Drive Lot 68'
Dear Mr. Straiksma:
Your request to install a wrought iron fence across your rear property facing the golf course. was reviewed
and approved by the Architectural Committee as submitted with the following conditions:
• No materials will be stored on the golf course or in the front street.:
All debris will be cleaned from the front yard on a daily basis.
• Any -damage to the common areas or surrounding lots will be your responsibility to repair and/or
replace.
• As you drawing indicates, there will be NO gate or other access to the golf course.
• If you grow shrubbery along the fence, the HOA encourages you to.allow the shrubbery togrown
'through the fence, as to. have the fence blend into the landscaping and `disappear'.
Thank you for your cooperation in this matter.
Bin. #
city 6t L q uin ta
ct
Building & Safety Division
"'Review, ready for corrections/issue
Called Contact Person
Date of peyznit issue
P.O. Box 1504, 78-495 Calle Tampico
Permit # ,,
-La Quinta, CA 92253 - (760) 777-7012
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0,5-
Building Permit Application and Tracking: Sheet
Project Address:
Owner's Name:
A. P. Number:
Address: -5-(p— �Z
Legal Description:
City, ST, Zip: (�� C I� , ;2,2 3
Contractor: Telephone: t-:•:.�<:
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Project Description:
Address:
Total Permit -Tees
City, ST, Zip
Telephone: e
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State Lic. #
City Lic. #:
Arch., Engr., Designer:
Address: "
City,, ST, Zip:
Telephone: -
{. Construction Type: Occupancy:
State Lic. #:
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�•Project tYPa circle one)� NAdd'n Alter Repair Demo '
Name of Contact Person: Lb• A)
�' Sq. Ft.:
# Stories:
F#Units:*
Telephone # t)f Contact Person:
5'.r/d 4p'—O,�Lt/ Estimated Value of Project: • 00
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd
Reed TRACKING PERMT FEES
Plan Sets
Plan Check submitted q L I Item Amount
Structural Cales.
Reviewed, ready for corrections Plan. Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance.
Title 24 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"" Review, ready for corrections/issue Electrical '
Subcontactor List
Called ContactPerson Plumbing
#
..
H.O.A. Approval
Pians resubmitted
Grading
1N HOUSE:- .
Planning Approval
Pub. Wks. Appr
"'Review, ready for corrections/issue
Called Contact Person
Date of peyznit issue
Developer Impact Fee .:
A•1•P•P•
School Fees
Total Permit -Tees