06-0639 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 06-00000639
0755—VI TS A
Property Address.
BONITA TR
APN:
772-280-013- - -
Application description:
WALL/FENCE
Property Zonina:
VERY LOW DENSITY RES
Application valuation:
17101
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
A&M HOME BUILDERS
C/O JOHN J CLAPINSKI
P O BOX 366
T,A QTTTNTA, (--A 92253
Contractor:
Applicant: Architect or Engineer: A & M CONSTRUCTION
P.O. BOX 366
LA QUINTA, CA 92247
(760)564-4832
Lic. No.: 746198
LICEN D CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that IP1.1censed under pt4_visions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business aofessionals Code, and my License is in full force and effect.
License Cl a s: 13 C10 License N
9 -� a -- ---
Date` contractor:
��
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 ($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 _ 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.).
(_) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/14/06
tFEB14 1006
CITY OF LA QUINTA
FINANCE DEPT.
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 STATE FUND Policy Number 0092322006
1 certify that, in the performanc f the work for which this permit is issued, I shall not employ any
person in any manner so as become subject to the workers' compensation laws of California,
and agree that, if I should me subject to the worftw' compensation provisions of Section
3700pof the Labor Code, II forthwith comply with thosEieiee®
WARNING: FAILURE TO SECURE WORKORS' 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 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 em6loyees 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 a/ofh
n becomes null and void if work is not commenced
within 180 days from date of issuanpermit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state above information is correct. I agree to comply with all
city and county ordinances and state laws relatingng construo6on, and hereby authorize representatives
of this county to epter upon the above-mentionedfor inspection pub
—
.LQPERMIT
Application Number . . . 06-00000639
Permit . .
. WALL/FENCE PERMIT.
Additional desc .
.
Permit Fee . . .
. 189.00
Plan Check
Fee ...
.00
Issue Date . .
.
Valuation
. . .
. 17101
Expiration Date .
. 8/13/06
Qty Unit Charge
Per
Extension
BASE
FEE
45.00
16.00 9.0000
THOU BLDG
2,001-25,000
144.00
----------------------------------------------------------------------------
Special Notes and
Comments
126 LF 3' WALL/303
LF 5' WALL/341
LF 6'
WALL. ALL PER ORCO
& APPROVED SFD
PLANS.
Fee summary
Charged
--------------------
Paid Credited
--------------------
Due
-----------------
Permit Fee Total
189.00
.00
.00
189.00
Plan Check Total
.00
.00
.00
.00
Grand Total
189.00
.00
.00
189.00
~ v-
;;.. '-�• CITY OF LA QUINTA
BUILDING & SAFETY DEPARTMENT L
" 777-7012
INSPECTION REQUES�Lj&E �
777-7153
' M HOME BUILD � 2S -
Contractor A & M CONSTRUCTIO
Permit Number _
POST ON JOB INSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
80- 765 V �S-TA BONITA TI L
JOB ADDRESS
126.LF 3' WALL/303 LF 5' WALL/341 LF G'
WALL. ALL PER ORCO & APPROVED SFD PLANS.
TYPE OF INSPECTION DATE INSP.
TEMPORARY POWER
SETBACKS
U/G PLUMBING/ WASTE
U/G ELECTRICAL / GROUNDING
FOOTINGS /STEEL
CONCRETE SLAB
DO NOT POUR CONCRETE UNTIL ABOVE SIGNED
HUUt- 114AIL / rh
nV AV Tn %A/RAP
FHAMINU (UUMbINAI IUN) .
or,i ir_u M Cr`TDIr
ROUGH PLUMBING I I
Qnl Ir -'W hAFr'-4AK11r Al
COVER NO WORK UNTIL ABOVE SIGNED
INTERIOR GYP. BD. DRYWALL
EXTERIOR LATH
GAS TEST
SEPTIC ABANDONMENT
SEWER CONNECTION
SEPTIC / GREASE INTERCEPTOR
MASONRYINS5 IONS
FOOTINGS / STEEL (o 45- 0(p Yj 1 -2/ • 0& S.t
BOND BEAM 1' .3 •0 (o 1 S. LD. >' IGb
POOL / SPA / WATER FEATURE INSPECTIONS
PRE-GUNITE / SETBACKS
i U/G PLUMBING
U/G GAS
U/G ELECTRICAL
PRE -PLASTER (ALARMS/ BARRIERS
•• FINAL INSPECTIONS
TEMP. USE OF PERMANENT POWER
ELECTRICAL
PLUMBING
MECHANICAL
PUBLIC WORKS DEPARTMENT
COMMUNITY DEVELOPMENT DEPT
(FIh1AL/JOB COMPLETED
`;ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
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