06-3362 (BLCK)P.O. BOX 1504 ! VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760)777-7153
BUILDING PERMIT '
Date: 9/18/06 .
Application Number:- '0�6-00.003362 J Owner:
Property-Address: "77420 VISTA ROSA MULLIN JOHN F
r
APN: 658-220-022- - 77420 VISTA ROSA
Application description: WALL/FENCE LA QU.INTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation:—____ T�-875
`Contractor,
Applicant:_ Architect or Engineer- STARK CONSTRUCTION COMP N x'
39725 GARAND LANE, SUITE
PALM DESERT, CA 92211 r%ro 2006
h. j (760)345-9711
a Lic. No.. 577776 I,p,QU1NTA
.: CITY OF
CE DEPT.
H
FINAN
t" • LICENSED CONTRACTOR'S DECLARATION • ' • WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with - I. hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I .have and. will maintain a certificate of consent to self-insure for workers' compensation, as provided
License Cl as : B License No.: 577776 - for by Section 3700 of the Labor Code, for the per of the work for which this permit is '
issued.
' Date: Contractor. C.�C/- +. _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor `
L.-----/'�._ Code, for the performance of the work for which this permit is issued. My workers' compensation
OWNER-BUILDER' DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that) am,exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 0019497-2005
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to -.I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become subject to the workers' compensation laws of California,. -
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State - and agree that, if I should become subject to the workers' compensation provisions of Section d -
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code)or _ 3700 of the Labor Code, I shall forthwith comply with those provisions.: - that he or she is exempt therefrom and the basis for the alleged exemption. Any violation'of Section 7031.5 by �i r f�
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: App plicanr.�C�/%C
tin (_ 1 1, as owner of the property, or my employees with wagesastheir sole compensation, will do the work, and �,__,�--_. !.
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNI G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
` and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
la improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). ._ APPLICANT ACKNOWLEDGEMENT
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sea .. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,. Business and Professions Code: The Contractors' State License Law does not apply town owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with •a contractor(s) licensed ! 1. ' Each person upon whose behalf this application is made, each person at whose request and for + -
pursuant to the Contractors' State License Law.). - whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(—),I am exempt under Sec. , B.&P.C. for this reason - the owner, and the applicant, each agrees to, and shall defend, indemnify andhold 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation. r
. I hereby affirm under penalty of perjury that there is a construction lending agency.for the performance of the 1 certify that I have read this application and state that the above information is correct. I agree to comply.with all
work for which this permit is issued (Sec. 3097, Civ. C.). - • _ city and county ordinances and state laws relating to building c 76 ction, a d hereby authorize representatives -
of this county to enter-upon-the above-mentioned property sp ction p s.
• ` Lender's Name:-
Date: _Signature-(Applicant or Agent): _!Ze
Lender's Address: - - _ -- -
LQPERMIT
Application Number 06-00003362
Permit . . . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 23.00 Plan Check
Fee
.00
Issue Date Valuation
875
Expiration Date.. 3/17/07
- Qty Unit Charge Per'
-
- Extension
BASE FEE
15.00
'4.00 ., 2.0000 HND BLDG 501-2,000
8.00,
-----------------------------------------------
special Notes and Comments
------
---------------
35 LF 30" RETAINING WALL WITH 36"GARDEN
WALL ON TOP. CITY STANDARD
Fee summary Charged Paid Credited
Due
Permit Fee Total 23.0Q 00
.00
23.00
Plan Check Total00. _:00
.00
00
Grand -Total `_23.00 .00
:00
„2,3.00
LQPERMIT
Bin#
City of La Quinta
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
Permit #
2>�
Project Address: /�% A1KA
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip: /--;Po
Telephone:I WE
Address:
Project Description:
05�P �i69
City, ST, Zip:��ff
/✓� v' j �d �`� (�
/
Telephone: 3TS— 7!
State Lic. # : S%%%7la City Lic. #:
Arch., Engr., Designer,
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Name of Contact Person:
Telephone # of Contact Person:
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 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
2' Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing .
Grant Deed
Plans picked up
S.M.L
H.O.A. Approval
Plans resubmitted.
Grading
IN HOUSE:-
'n° 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
7.
Total Permit Fees