08-1107 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: (.J 08-00001107 `--'-1
Property Address: 49595_VISTA LUNA
APN: 602 -180 -999 -6 -294S74 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
A lication valuation' 5250
c&ty/ 4 4 Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
T D DESERT DEV
P O BOX 1716
LA QUINTA, CA 92253
N
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/27/08
1.
JUL
Contractor: 1 v LULL .•
Applicant: Architect or Engineer: BARAJAS 'MASONRY INC e '
42901 LIMA HALL ROAD CFNOFLAQUfA►TA
BERMUDA DUNES, CA 92203 AIlt�`E ADEP
T
(760) 345-3912 ^,...�
Lic. No.. 863760
• 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: F
Section 7000) of Division 3 of the Business and Professionals Code, and my License isin full force and effect. - I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
license Class: C29No.: 863 760 : for by Section 3700 of the Labor Code, for. the performance of the work for which this permit is -
e/ / O..issued.
Date:, �S JO Contractor: !/�. _ 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
OWNER- I ER DECLARATION - insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt the Contractor's State License Law for the Carrier ZENITH INS Policy Number Z069532601
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 bject orkers' compensation provisions of Section
. License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or eOO of the Labor Code, I she o rth'cllm ty w 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 subjectsthe applicant to a civil penalty of not more than five hundred dollars ($500).: Date: Applicant: '
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATIO C ERAGE 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 CI L F ES 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 ,
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 burderi 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 (Seca 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 contractorls).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 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.
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 160 days will subject
CONSTRUCTION LENDING AGENCY 'permit to cancellation. -
I 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 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 truc ' eby authorize representatives
of this co ty t enter upon the above-mentioned property s [ion
..Lender's Name: � -
Date: Signature (Applicant or Agent)'
-Lender's Address: -
LQPERMIT
Application Number 08-00001107.
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 81.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
5250
Expiration Date 12/24/08
Qty Unit Charge Per
Extension
BASE.FEE.
45:00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
Special Notes and Comments
210 L.F..6' GARDEN WALL,,PROTO II SYSTEM
Fee summary Charged Paid
Credited
Due
Permit Fee Total 81.00
.00
.00
81.00
Plan Check Total .00
.00
.00
.00
Grand Total 81.00
.00
.00
81.00
LQPERMIT .
s