08-1116 (BLCK)C4.
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08-00001116
Property Address:
56192 VILLAGE DR
APN:
764 -030 -018 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
671
T-iht 4 4 Q"
Applicant: Architect or Engineer:
)0</ 0/A
UV
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED ONTRACTOR'S DECLARATION
I hereby affirm under penalty of peri that I am lice a under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the ess and Pro i als Cod and my License is in full force and effect.
License Class: 13 Lic a No.: 867583
/Date: �O ontractor:
OWNER -BU R 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 1, 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 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_) 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:
BUSSMAN
56192 VILLAGE DRIVE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Contractor:
MORRIS CONSTRUCTION INC, ROPER
51200 CALLE PALOMA
LA QUINTA, CA 92253
(760)272-9292
Lic. No.: 867583
Date: - 6/30/08
JAL 08 2083 �
City
F/N 0FL4
------------------
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 performan o the work for which this permit is issued, I shall not employ any
person in any m n so as t come subject to the workers' compensation laws of California,
and agree that i I s ould b c'o a sub' t he workers' compensation provisions of Section
3(i7�00 of the La r ode, Is all with omply with those provisions.
e: 1' TiV V cant:
WARNING: FSA URE TO SECUR W RKERS' 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 pei5uo upon whose behalf this application is made, each prrsnn 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 nulld void if work is not commenced
within 180 days from date of issuance of such permit, or ces anon of work for 180 days will subject
permit to cancellation. AAA
I certify that I have read this application and state that above inIarrltia is corre I iee to comply with all
city and county ordinances and state laws relating to bu ing construct n, nd h by a hors representatives
of thunty to enter upon the above-mentioned prgp for inspectio pu
(Applicant or Agent):
`1•
LQPERMIT
Application Number . . . . . 08-00001116
Permit . .
. WALL/FENCE
PERMIT
Additional desc .
.
Permit Fee . . .
. 19.00
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 671
Expiration Date .
. 12/27/08
Qty Unit Charge Per
Extension
BASE
FEE
15.00
2.00 2.0000 HND BLDG
501-2,000
4.00
----------------------------------------------------------------------------
Special Notes and
Comments
31 L.F. 5' GARDEN
WALL, AT COURTYARD,
CITY STANDARD
Fee summary
-----------------
Charged
Paid
Credited
Due
Permit Fee Total
--------------------
19.00
----------
.00
----------
.00
19.00
Plan Check Total
.00
.00
.00
.00
Grand Total
19.00
.00
.00
19.00
FINISH GRADE
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0 CONSTRUCTION APROXIMATE ONLY LOC
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1OMITTED FOR
1-01' OF A SEWER MAIN. FOR -rHLI 1,QVNI-IONS, ETC, ZZ; DRAINAGE FLOW
RINKLER HEADS THAT ARE PROPER FOR
" 'm -iQVPLY WITH ALL UTILITY COMPANY REQUIREMENTS. PROVIDE ALL RELATED
.TED. IRRIGATION SYSTEM SHALL BE ON AN
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IDE YARDS FOR FUTURE LANSCAPING. (ZKfllACTOftN;IAU- VERIFY ACTUAL DEPTH AND LOCATION OF ALL EXISTING UTILMES
ID ADJUSTED SUCH THAT THEY DO NOT COVER PMK)n TO CONSTRUCTION.CALL UNDERGROUND SERVICE ALERT (TOLL FREE 800-642-24441
pnion *rQ TRENCHING. GR G, EXCAVATING, DRILLING, PIPE PUSHING, PLANTING TREES,
�S ON BUILDING WALL SURFACES AND WINDOM, 040IN13 FENCE POST HOLES EY WIl1
SUPPLY INFORMATION OR LOCATE AND MARK
DWTH OF THE TFIl' 50 10 NOT INHIBITED. AW UNDERGROUND FACILITIES.
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\KrjjFY CONNECTION POINTS FOR POWER TELEPHONE AND CABLE TV SYSTEMS PRI
0 CONSTRUCTION APROXIMATE ONLY LOC
SE VARETY. LOCATIONS INDICATED FOR TRANSFORMER ONE BLOCK
1OMITTED FOR
1-01' OF A SEWER MAIN. FOR -rHLI 1,QVNI-IONS, ETC, ZZ; DRAINAGE FLOW
RINKLER HEADS THAT ARE PROPER FOR
" 'm -iQVPLY WITH ALL UTILITY COMPANY REQUIREMENTS. PROVIDE ALL RELATED
.TED. IRRIGATION SYSTEM SHALL BE ON AN
',IQ I' 1 8, PULL BOXES AND REISERS.
,014t)W r
ly.
IDE YARDS FOR FUTURE LANSCAPING. (ZKfllACTOftN;IAU- VERIFY ACTUAL DEPTH AND LOCATION OF ALL EXISTING UTILMES
ID ADJUSTED SUCH THAT THEY DO NOT COVER PMK)n TO CONSTRUCTION.CALL UNDERGROUND SERVICE ALERT (TOLL FREE 800-642-24441
pnion *rQ TRENCHING. GR G, EXCAVATING, DRILLING, PIPE PUSHING, PLANTING TREES,
�S ON BUILDING WALL SURFACES AND WINDOM, 040IN13 FENCE POST HOLES EY WIl1
SUPPLY INFORMATION OR LOCATE AND MARK
DWTH OF THE TFIl' 50 10 NOT INHIBITED. AW UNDERGROUND FACILITIES.
33 ROOT BALL,I
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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 #
Project Address: v ; 11
Owner's Name: ���5 •Si x h h/
A. P. Number: O I
Address: $ (a r `/i 1A v L -
Legal Description: `C1 q6 yr(-;" 90433,
Contractor: Poe ✓ / 4 owls ataSk j;VC
City, ST, Zip:Lu ihl G'� /v�5
Telephone:
Address: S'1900 C f e :P0 ` c 44t y
Project Description:
City, ST, Zip: Gc. %C/� W t ✓�}
01' �/ I
Telephone: "N, 0 '
lokof o 1!J-wv j'aP Al �4]G
State Lic. # :j, 8
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIU NG
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2wd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'r° 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