08-0505 (BLCK)Architect or Engineer:
PC
105
I hereby affirm under penalty of perjury that I ar
Section 7000) of Division 3 of the Business and
License Class: B _
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SPALETTO
53556 ROSS AVENUE
E`E LA QUINTA, CA 92253
R's DECLARATION
r provisions of Chapter 9 (commencing with
ils Code, and my License is in full force and effect.
License No.fi8-1
I hereby affirm under penalty of perjury that I am exempt m a 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 thafthe
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.).
(_) 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 (lie Cuntractors' State License Law.).
(_) I am exempt under Sec. , BAP.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:
LQPE&NtIT
Contractor:
JEHA CONSTRUCTION, MICHAEL
3089 SANDSTONE ROAD
ALAMO, CA 94507
(925)250-4038
Lic. No.: 410408
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/26/08
. 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 238-0002300-06
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject -to the workers' compensation laws of California,
and agree that, if by ome subject to the workers' compensation provisions of Section
/ 37 of the or Cl6de, I sh mply wit atose provisions.
Da e- plicant: /)
WARNING: FAILURE TO SECURE WORKERS' OMPENS ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL SA CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 upnn whose behalf this application is made, each person at whose request and foe
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 related to the work being
performed under or following issuance of this permit.
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
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city andunty ordinances and s to la 'ng to bu' 'w construction, and hereby authorize representatives
oft ' county to enter upon abo-mentione rty for pecYerposeC.
Date: nature (Applicant or Agent): J
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
' :Application Number:
08-00000505
Property Address:
53556 ROSS AVE
APN:
767-200-998-46 -330761-
Application description:
WALL/FENCE
Property Zoning:
LOW RESIDENTIAL
Application valuation:.
i�TY
/� •' 9
Architect or Engineer:
PC
105
I hereby affirm under penalty of perjury that I ar
Section 7000) of Division 3 of the Business and
License Class: B _
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SPALETTO
53556 ROSS AVENUE
E`E LA QUINTA, CA 92253
R's DECLARATION
r provisions of Chapter 9 (commencing with
ils Code, and my License is in full force and effect.
License No.fi8-1
I hereby affirm under penalty of perjury that I am exempt m a 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 thafthe
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.).
(_) 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 (lie Cuntractors' State License Law.).
(_) I am exempt under Sec. , BAP.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:
LQPE&NtIT
Contractor:
JEHA CONSTRUCTION, MICHAEL
3089 SANDSTONE ROAD
ALAMO, CA 94507
(925)250-4038
Lic. No.: 410408
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/26/08
. 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 238-0002300-06
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject -to the workers' compensation laws of California,
and agree that, if by ome subject to the workers' compensation provisions of Section
/ 37 of the or Cl6de, I sh mply wit atose provisions.
Da e- plicant: /)
WARNING: FAILURE TO SECURE WORKERS' OMPENS ION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL SA CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,0001. 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 upnn whose behalf this application is made, each person at whose request and foe
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 related to the work being
performed under or following issuance of this permit.
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
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city andunty ordinances and s to la 'ng to bu' 'w construction, and hereby authorize representatives
oft ' county to enter upon abo-mentione rty for pecYerposeC.
Date: nature (Applicant or Agent): J
;r.
LQPERMIT
Application Number
. . . . . 08-00000505
Permit .. .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee
81.00
Plan Check
-Fee
.00
Issue Date
Valuation
. . .
. . 5629
Expiration Date
9/22/08
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
260 L.F. 5' GARDEN
WALL, CITY STANDARD.
SEE APPROVED PLANS
FOR DETAILS.
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
Bin #
City of La Quinta
Building g Safety Division
Permit #O
5G
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:,.._
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: � G �0
Telephone:.
Address: C>
Project Description:
� S
City, ST, Zip:
9 K�.7--
c
o1 r
Telephone: Q 2� -1(63,
0`1100 lam.
State Lie. # : p B>
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Q�DGI� Occupancy:
State Lic. #:
Project type (circle one): ew Add'n Alter Repair Demo
Name of Contact Person: ,7
Sq. Ft.:
#Stories: #Units:
Telephone # of Contact Persona 9L,S =Z S70-, p Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Recd
TRACHING
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
SALL
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'" Review, ready for corrections/issue
Developer Impact Fee
A.LP.P.
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
0