07-0878 (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: 3/23/07
Application Number: "o 7 0 0 0_&8-7&w-�=-" Owner:
Property Address: 77420 VISTA ROSA MULLIN JOHN F
APN: 658-220-022- - - 77420 VISTA ROSA
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1850
Contractor:
Applicant: Architect or Engineer: STARK CONSTRUCTION COMPANY INC
q• 39725 GARAND LANE, SUITE E D
ca PALM DESERT, CA 92211
(760)345-9711
Lic. No.: 577776 MAR 23 20017
------------------------------------ ---------------------------------------
---- - --7- _--�¢ ----
LICENSED CONTRACTOR'S DECLARATION _ - WORKER'S COMPENSATION DECLARATIO
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 arp Profes 'ovals 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 Clas B License N 577776 - _ - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is -
�,�p issued. - -
�y DaterContractor: .- /C/"�` V- _ Ihave 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
OWNER -BUILDER DECLARATION - insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1834492-2006
. 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 to become s bject to the workers' compensation laws of California,
. . - permit to file a signed statement that he or she is licensedpursuant to the provisions of the Contractor's State - and agree that, if I sho ecome s e to the workers' compensation provisions of Section
License Law. (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor d s all f h th 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 - - - -
any applicant for a permit subjects applicant to a civil penalty of not more than five hundred dollars ($500).: Dat? Applica
(_)
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 - - WARN G: FAILURE TO SECUR KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
.Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJ CT AN EMPLOYER TO CR NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the'work himself or herself throughhis or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN '
improvements are not intended or offered for sale. If, however, the buildingor 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 -
1 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 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 to an 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,
(_ 1 I am exempt under Sec. , B.&P.C. for this reason 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 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 isnot 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. -
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above informati 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 struct nd hereby authorize representatives -
of this county to enter upon the above-mentioned propert i pe ses.
Lender's Name: �r, ��7
Date: / 6 Signat re (Applicant or.Agent):
Lender's Address: - .f„r-- ---- ='^•-tib'
LQPERMIT - .
Application Number, . . . . 07-00000878
" 'Permit" 'WALL/FENCE-PERMIT
Additional d_esc .
Permit Fee 43.00 Plan Check
Fee
00
- Issue Date Valuation
. . .
1850
Expiration Date 9/19/07"
Qty Unit Charge Per
Extension
BASE FEE
15.00
14.00 2.0000 HND BLDG 501=2,000
28.00
--------------------------------- ----------------------------------------------
Special Notes and Comments
44 LF 6' BLOCK WALL/ 30 LF COMBO 3'
RETAINING WITH 3' GARDEN WALL. COURTESY
'INSPECTION OF 90 LF 2! RETAINING AND
114 LF OF <36" WALL. PER CITY STANDARD
& APPROVED PLAN.
Fee summary Charged Paid Credited
Due
..
Permit Fee Total - 43.00 .00
-
.00
43:00
Plan Check Total :00 .00
.00
.00
Grand Total 43.00 :00
00
43.00.
LQPERMIT
Bin #
City of La Quetta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Permit Application and Tracking Sheet
Permit #
��
/Building
Project Address: `l" — v ;�12 /6A
Owner's Name:
A. P. Number:
Address: _-9 70 1,1,1s714
Legal Description:
City, ST, Zip: Z A
Contractor`] 7-,;4.Q/'—'
Telephone:
Address:397,05'
Project Description:
City, ST, Zip2A2,,;N
Telephone: 3V.s — 5P%` 1�
2
State Lic. # : s%�7 �� . City Lic. #:
Arch., Engr., Designer:
611,
if
Y 3
Address:
0 3 1Y-r 4,,-A 3
City, ST, Zip:
Telephone:
• r i
State Lic. #:
Name off Contact Person: �i ��� ��i6 �y�
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
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.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