BLCK (04-7779)78695 Maracas Ct
04-7779
z 4 2004
`107:AQUINT'Ca BUILDING & SAFETY DEPARTMENT
111A 9 ®f" 'T.
.Os`Ba 1504 (760).777-7012
78-495 CALLE TAMPICO. FAX (7.60) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . 04-00007779 Date 12/13/04
Property Address . . . . . . 78695 MARACAS CT
APN: 646-050-013- - -
Application description . . . WALL/FENCE
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . . 2125
Owner Contractor
------------------------ ------------------------
KENARD RIDING STRZELCZK, EDWARD J.
78695 MARACAS CT 82231 EAST HELIO COURT
LA QUINTA CA 92253 INDIO CA 92201
(760) 578-0201
WCC: STATE FUND
WC: 1641435 05/16/05.
CSLB: 439904 05/31/05.
CCC: B -C10 -C29
----------------------------------------------------------------------------
Permit . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee . . . . 54.00 Plan Check Fee .00
Issue Date Valuation 2125
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001-25,000 9.00
----------------------------------------------------------------------------
Special Notes and Comments
85 LF 6' BLOCK WALL PER ORCO DETAIL.
Fee summary ` Charged Paid Credited Due
----------
.Permit Fee Total,""'54.00 .00 .00 .54.00
Plan Check Total .00 .00 .00 .00
Grand Total 54.00 .00 .00 54.00
P.O. BOX 1504 •
VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: X77 % I Date:./-,?
Applicant.
Applicant's MailingAd resd s:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILUINU PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
Code, and my License is in full force and effect.
License Class License No.
Date,ZContractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
U 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.).
U I am exempt under Sec. , B.& P.C. for this reason
Date
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Ihave 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
_-4Vuej, My erVompensation insurance caner apdp li y prpr�re:
Carrier T" ��--z Policy Number
_ I certify that, in the pe ormance of the work for which this peffinit 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date/7/ O Applicant
WARNING: AILURE TO SECURE WORKE ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnify and hold harmless the City of La Quinta, its
officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or
cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to a ter upon the above-mentioned property for inspection purposes.
Date Signature (Applicant or Agent):
T4-tyl 4 4 Q"
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 7$-60% NwrkAm rhitrt LA QUINTA, CALIFORNIA 92253
Owner
James Labcaw
mailing
Address SBtgB
City Zip Tel.
La Quints 92253 340-4561
Contractor
74-818 #1 Valle
Falai Desert x9226 - 346-5335
State Lic. City
& Classif. 5204321366 Lic. # _ 1366
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTORS DECLARATION
I hereby affirm that I am licensed under Drovisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is 1 fyu11 force and
effect. C! -!/ .i`[ r
_SIGNATURE P DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,8us ness and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to lie a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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).
❑ 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor fs) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. w_ & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city- ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemnN is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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.
Date Owner
NOTICE TO APPLICANT: h after making this Certificate of Exemption you should become
subject to the Workers' Corrpensatim provisions of the Labor Code, you must forthwith
comply with such provisions Or this permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
No. 07121
JILDING: TYPE CONST. OCC: GRP.
P. Number hoe La 0uinta
egal Description
roject Description Faze list Otti,tlta
8 d
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 81.90
Const.
126.00
Mech.
30.00
Electrical
27.00
Plumbing
24.00
S.M.I.
.77
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
t.!(t 5 i 11" ..0 .2 AP t '
r
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date 2/20/90 Permit
Validated by:
Validation:
It 3/
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. gp, FT. ®
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. Q. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET`
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID (cp 1+/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
l
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION ( /
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
1
• 4 4 "
P.O. BOX 1504 N Q .
Building 78-695 MairaCbs Ct.
7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner &Wcovk XiC4•
]BUILDING: -TYPE CONST. OCC: GRP.
Address
a58-713 Perez Rd.. # 1
City Zip Tel.
Cat City 92234 773-9024
Contractor
sem
Address
ty
State Lic. City
8 Cjassip37$77 Lic. # 1219
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
Lic. #
LICENSED CONT'RACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division of 7Business and essions Code, and my license is in,full force and
effect- 1J
SIGNATURE
DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,s and Professions Code: Any city or county which requires a
Permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires •the applicant for such Penn# to file a signed statement that hes licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (commencing with section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption- Any viobtion of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a chd pemagy of not more than foe hundred dollars ($500).
❑ 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, BuIsness and
Professions Code: The Conwadors License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. H, however, the building
or improvement is sold within one year of completion, the owner -builder wig have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or inproves thereon, and who contracts for
such projects with a confractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P -C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is tar one hundred dollars (E100) valuation
or less.)
I certify that in the performance of thF work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT. 0, after maksug this Certificate of Exemption you should become
subject to the workers' Corrpersation provisions of the Labor Code, you must forthwith
comply with such provishi s or this permit sLalf be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives .of this city to enter the above.
mentioned property for inspection purposes
Signature of applicant Date
Mailing Address
City, State, Zip
®5948
A.P. Number,
Legal Description Ptt"e Ill Lot 13
Project Description PIzii 2222 Fare €,a Quimta
Sq. Ft. 2222 No. No. Dw.
Size Stories Units
New M Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation 112,161.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
7 1. 10
Const.
M5.00i
Mech.
#7UI.D
Electrical
•
Plumbing
s_
S.M.I.
Grading
Driveway Enc.
Infrastructure
L
TOTAL
t• //.,f/
REMARKS _
1' hYik.`^ ter._.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date 6-16—$9 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE 49(2—fF6Q- 9%0
GH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ROUGH) — D,
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING
VENTILATION /
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING a .-
MESH n
INSULATIONISOUND ( p %
II
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
ccurc cuiw
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 49(2—fF6Q- 9%0
GH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
o
FOUND. REINF./ii,
I / f
ROUGH) — D,
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR. FINAL INSP.::—,?NCi
FRAMING / F AL INSP.
ROOFING
VENTILATION /
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING a .-
MESH n
INSULATIONISOUND ( p %
II
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
ccurc cuiw
' / — — n,
aL (
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL