06-3239 (BLCK),c,f
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA,92253
Application Number:
06-00003239
Property Address:
56465 VILLAGE DR
APN:
764 -040 -012 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
6025
Tiht 4 4 Q"
Applicant: Architect or Engineer:
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am lice d un provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busi s and Prof ion de, and my License is in full force and effect.
License Class: B is : 710230
Date Contractor:
OW -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 1$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 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.).
(_ 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:
AL CHITTICK
19738 OCEANAIRE CIR
HUNTINGTON BEACH, CA 92648
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/05/06
----------------------- - - - - -- ------------
WORKER'S COMPENSATION DEC ATION
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 ich this permit is issued, I shall not employ any
person in any manner so as to become sub' to the workers' compensation laws of California,
and agree that, if I should beco subja the the
compensation provisions of Section
` 700 of the Labor , I sh rth omply with those provisions.
Date: of Applican
WARNING: AILURE TO SE RE WORKERS' C PENSATj N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO TH OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTE EST, 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 ces ion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abo ' for tion is correct. I agree to comply with all
city and county ordinances and state laws relating to uildin st n, and hereby authorize representatives
of this county nter upon the above-mentioned r ' s cti purposes.
Date: — Signature (Applicant or
COntrartor,
BOVENZI HOMES
Z
P.O. BOX 1714
y'n
O
TRUCKEE, CA 96160
O
(530)613-1173
010
Lic. No.: 710230
�IZ
-1
1 chi
----------------------- - - - - -- ------------
WORKER'S COMPENSATION DEC ATION
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 ich this permit is issued, I shall not employ any
person in any manner so as to become sub' to the workers' compensation laws of California,
and agree that, if I should beco subja the the
compensation provisions of Section
` 700 of the Labor , I sh rth omply with those provisions.
Date: of Applican
WARNING: AILURE TO SE RE WORKERS' C PENSATj N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO TH OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTE EST, 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 ces ion of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the abo ' for tion is correct. I agree to comply with all
city and county ordinances and state laws relating to uildin st n, and hereby authorize representatives
of this county nter upon the above-mentioned r ' s cti purposes.
Date: — Signature (Applicant or
Application Number . .. . . . 06-00003239
Permit . .
. WALL/FENCE PERMIT
Additional desc .
.
Permit Fee . . .
. 90.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 6025
Expiration Date .
. 3/04/07
Qty Unit Charge Per
Extension
BASE FEE
45.00
5.00 9.0000 THOU BLDG 2,001-25,000
45.00
----------------------------------------------------------------------------
Special Notes and
Comments
241 LF 6' BLOCK WALL PER APPROVED SFD
FLAN. 200 LF ,36"
WALL. CITY STAIMARL.
Fee summary
-----------------
Charged Paid
Credited
Due
Permit Fee Total
--------------------
90.00
----------
.00
----------
.00
90.00
Plan Check Total
.00
.00
.00
.00
Grand Total
90.00
.00
.00
90.00
�1
I
i
LQPERMIT
Bin #
City of La Quints
Building u Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
V
Permit #
_
Project Address:
Owner's Name: A
A. P. Number: 7 &0 0 y o - 1 Z
Address: 9 730 oc eA/JAi .-I r;
Legal Description: 01, q 9 T/Aac 1 2- 9 S3
Contractor: JS D JC --IJ Z; AtoM LS
Ci ST Zi ^ /
CA, qZ&Y8
Telephone: 7J q - 7 q
Address: -'9&Q-2 P4 Lm s .DA,
Project Description:
City, ST, Zip: LA CA . 9 Z 2 s 3
.11wo G i S 106 JP/1 D CA"
Telephone: C 5 30 (01k
- // 73
Latk VJp t,(,S w AM,A-)
State Lic. # : 7/ Z 3 p
City Lic. #: 6 90- 5'
Arch., Engr., Designer: _ �SJqS Doe -
_Address:
Address:
® r—
City, ST, Zip:
t{ 1
Telephone:
State Lic. #:
Name of Contact Person:114A 4- So ✓t:/�%Z
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: $3z� (oi - 13
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2n° Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees