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05-4764 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: ,, _05-00004764 r Property Address: 49025 VISTA-ESTRELLA APN: 649-580-024- - - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: _ 250 Applicant: Architect or Engineer: hereby a rm and penalty of jury that I licensed u der pro isions of Section 70 01 of Di i�eft -3 of th Business a Professions s Cpp�dde, and my I License Cla : B I I is ftse o.: 7 ontractor: J A 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-,7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: rPnrKRTT DAVID P ZS BEND CT CON, IL 60010 .ONSTR DON DBA CHEROKEE :GHWAY 111 3ERT, CA 92260 --0920 :.70b794 , Date 10/24/05 ----------------------------------------- -------------- - - - - -— WORKER'S COMPENSATION DECLARATION r 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: - is in full force and effect. - _ 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' compe tion insurance, as required by ection 3700 of the. Labor ~ Code for the performance of the rk r which this permit is issu My workers' compensation OWNER -B �LDER DECLLRATION Y insurance carrier and policy num r are 1 ' I hereby affirm under penalty of perjury that I m exempt i om the Contractor's State License Law for the Carrier STATE FUND Polic umb r 3j1276 following reason (Sec. 7031 5, Business and rofessions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repairany structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or s e 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 sale 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: tA LQPERMIT pers n in any manner so and gre at, if I should 37 0 the Labor Code, 0 , I shall not employ any ition laws of California, provisions of Section WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000). 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 employees for any act or omission rept to the work being performed under or following issuance of this per ' . / 2. Any permit issued as a result of this application become null and void if wor is not commenced within 180 days from date of issuance of su h permit, r tion of work or 180d ys will subject permit to cancellation. - Icertify that I hay read this application and state that - e above n rmation ' correct. I agree comply with all city and ounty di=c!s state laws relating to b ilding c n uction, a d hereby authori representatives of this � my t � en on the ve-mentioned prop y for i ection pu poses. at . Sig ure he, or Agent): r Application Number . . . . . 05-00004764 Permit . . . WALL/FENCE PERMIT + Additional desc . Permit Fee . . . . 15.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 250 Expiration Date 4/22/06 Qty Unit Charge Per Extension BASE FEE 15.00 ---------------------------------------------------------------------------- Special Notes and Comments 10 LF 6' GARDEN BLOCK WALL -AT -SIDE YARD RETURNS, CITY OF LA QUINTA STANDARD Fee summary Charged Paid Credited Due Permit Fee Total 15.00 .00 .00 .15.00 Plan Check Total 00 .00 .00 .00 Grand Total 15.00. .00` .00 15.00 Bin # City of LaQ uinta 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 # 0<1b Project Address: _ S 14S7fq t9`7/99U_.Pt Owner's Name: C j�ke r 7 . A. P. Number: Address: si /4S�rrZ7 Legal Description: City, ST, Zip: Contractor.I 4,11U Address: �- [ �� C [ . ' - Telephone: 01 Project Description: City, ST, Zip: k- G.s Telephone: Z -c> City Lic. kvt 4 — l4•✓�%1i1�� to �1(t State Lic. # : (, Arch., Engr., Designer: KN Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo . Name of Contact Person: Sq. Ft.:# Stories: #Units: Telephone # of Contact Person: p� - �Uq�. 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 Calcs. Called Contact Person Plan Check Balance Energy Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading, plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. H.O.A. Approval Plans resubmitted i Grading IN HOUSE:- ''d 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