09-0026 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
09-00000026
Property Address:
56445 VILLAGE DR
APN:
764 -040 -011 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2511
c&ht 4 4 Q"
Applicant: Architect or Engineer:
CIO
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed un_000rovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Prof sio de, and my License is in full force and effect.
License Class: B cense No.: 710230
Date: '! Contractor: A -)/ -
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 (5500).:
(_) 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 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
punuent to the Cantraala;a' Clal6 U....— L.,...).
(_ 1 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
Owner:
COOMBS,RICHARD
56445 VILLAGE DRIVE
LA QUINTA, CA 92253
(707)837-7554
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
1/12/09
Contractor:
BOVENZI HOMES
50002 CANYON VIEW DRIVE
PALM DESERT, CA 92260
(530)613-1173
Lic. No.: 710230
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 EXEMPT Policy Number EXEMPT
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 subj to the workers' compensation laws of California,
and agree that, if I should become bje o the workers' compensation provisions of Section
�/1 37_40 of the Labor Code, I shat rtomply with those provisions.
Date: j_/ ` � 7 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 (5100,000). 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
wnuse ueneln worK Is pe"ormen Bnaer or purtuant t0 a6y perhiit 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 constructio ,and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspecti pur es.
Date: Signature (Applicant or Agentl'
Application Number . . . . . 09-00000026
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 54.00
Plan Check
Fee
.•00
Issue Date . . . .
Valuation
. . .
. 2511
Expiration Date . . 7/11/09
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and Comments
116 LN FT X 5 FT HT GARDEN WALL & 30"
FT
HT X 82 LN FT GARDEN WALL TO CITY
STANDARDS & APPROVED PLANS.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00.
Fee summary Charged Paid
-------------------------------------
Credited
Due
Permit Fee Total 54.00
----------
.00
----------
.00
54.00
Plan Check Total .00
.00
.00
.00
Other Fee Total 1.00
.00
.00
1.00
Grand Total 55.00
.00
.00
55.00
LQPERMIT
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Bin #
City of La Quinta
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
1
Project Address: �� L� s �' 1,el-4(e—
Owner's Name: 2t G 4/a L-00YOZ6
A. P. Number: —0c/0 _ol1
Address: 9'9 eJO1 �TLoOIJ CST
Legal Description: q& -T-11AC7—i O
Contractor: F3 oVSNZ 1 14Me5
City, ST, Zip: , o O CA ! 9
Telephone: 107-S3-7- %-�;
Address: 540( -0 � � `e
Project Description:City,
`o
ST, Zip: Ppl-t 9 Z�d
13koe-k (, J,4Q—
Telephone:
State Lic. # :
City Lic.
Act-
Arch., Engr., Designer: COC -A Op to
Address: 11j (p-1 s DZ7nJN1GL P14 A,
MAL
City, ST, Zir—l;? U Jee- (ol
Telephone -5-30 ��') -7513
Construction Type: Occupancy:
State Lic. #: t✓ /1>8q)
Project type (circle one): New Add n Alter Repair Demo
Name of Contact Person: Alk- 9011EPizi
Sq. Ft..
T# Stories:
#Units:
Telephone # of Contact Person: LS3dJ bl 3-11 %
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'' -d
Rec'd-
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Chect Deposit
Truss Calcs.
Called Contact Person
Plan Chect Balance
Energy Cales.
Plans picked up
Constructon
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
3`" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,►,p,p_
Pub. Wks. Appr
Date of permit issue
School Fees
Total Pernit Fees
51--61, A]*-,7&lfq--
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