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BLCK (05-0901)44030 Mariposa Ct 05-0901 o U BUILDING & SAFETY DEPARTMENT ` Sw O. Box 1504 (760).777-7012 -C 78 495 CALLE TAMPICO O OF FAX'(760) 777-701.1 p. L UINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 7,77-7153 BUILDING PERMIT Application Number . . . 0.5-00-0-0.0901 Date 3/16/05 Property Address 44030 MARIPOSA CT APN: 604-091-007-7 .--22982 Application description- WALL/FENCE Property Zoning . . . . LOW DENSITY RESIDENTIAL Application valuation . . . 1875 Owner Contractor --------------------- ---------------------- MORAN JAMES STRZELCZK, EDWARD J. 44-030.MARIPOSA 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 -C2.9 ------------- ------------7----------------- Permit WALL/FENCE PERMIT -Additional desc Permit Fee 43.00 Plan Check Fee .00 Issue Date Valuation 1805 Expiration Date 9/16/05, Qty Unit Charge Per. Extension BASE FEE 15.00 14.00- 2.0000 HND, BLDG 501-2,000 28.00 ------------------------------ Special Notes and Comments 75 L.F 6' HIGH BLOCK WALL (ORCO SYSTEM)-, Fee summary Charged tPaid Credited Due ---------- ---------- Permit Fee Total 43.00 .00 .00 43.00 Plan Check Total .00 .00 .00 ..00 Grand Total 43.00 .00 .00 43.00 I 4 4 P.O. BOX 1504 Tity 78-495 CALLE TAMPICO ��/� , FAX (760) 777-7011 w VOICE (760) 777-7012 La QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153 BUILDING & SAFETY DEPARTMENT Application Number: OJr -Date: '� — /� • 06 Applicant: I Architect or Engineer: Applicant's Mailing Address: ��2zv t, Architect or Engineer's Address: Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I reby affirm under penalty of perjury that I am licensed and visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals ode, and my, Li se ' in II fo and H (� License Class 7 License No. 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. , BA P.C. for this reason Date Owner. WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to If -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 kers' compens on insurance, as required by Section 3700 of the Labor Code. for the performance of the work for which this permit is ue Arc y pensation ' urance carrier a ppliy� yihe artier olicy Number I Iffertify that, in the perfor ance 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with tty Ke provisions. i WARNING: FAILURE TO SECURE WORKERS:ZrOMPENSATION 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 Ouinta, 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 /Date truction, and hereby authorize r presentatives of this county to enter up the above-mentioned property for inspection purposes. /O Kr ,gnature (Applicant or Agent): 4 P.O. BOX 1504 No. Building 78-105 CALLE ESTADO Address 44-030 Haariposa Court LA QUINTA, CALIFORNIA 92253 Owner La Quints Associates Mailing Address City Zip Tel State Lic. City & Classif. 493919 Lic. # 1231 Arch., Engr., Designer Address Tel. City IZip I State Lic. # LICENSED CONTRACTOR'S DECLARATION . I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. _SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby afflrin that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Bushess and Professions Code: Any city or county which requires a permit to construct, after, brprove, dernofth, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contactors 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 civilpenally of not more than five hundred dollars ($500). O 1, 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 inprovements 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 erprove 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 Contractor's License Law does not apply to an owner of property who builds or bnproves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I 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 ,,dCopy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ff the pemut is for one hundred dollars ($100) valuation or less.) 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 Date owner NOTICE TO APPLICANT. tl, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall 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, Chill Code.) Lenders Name Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certity 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 BUILDING: TYPE CONST. OCC: GRP. 05184 A.P. Number F`rar•tn 171 e►Rsc+ Legal Description Project Description r1. 'V _ TQ It'* .a trig 7 REMARKS i3 (t13t it •-!i1-PE3 4f1 .itlJ f i MAL AL X GLfirI r 4V 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: DaterL99 tiFPermit Validated by: Validation: Sq. Ft. 1033 'Size No. `Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation 36.825 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. S 339.25 Const. 394.00 Mech. 36.00 Electrical . 72.53 Plumbing 82.00 S.M.I. 6.06 Grading Driveway Enc. Infrastructure 1053.56 TOTAL S2.883.40 REMARKS i3 (t13t it •-!i1-PE3 4f1 .itlJ f i MAL AL X GLfirI r 4V 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: DaterL99 tiFPermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO. FT. ® $ UNITS UGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2ND FL SO. FT. DUCT WORK ROCK STORAGE FOUND. REINF. ?lid MOBILEHOME SVC. BAR SINK POR. SD. FT. ® REIN F. STEEL GAS (FINAL) TEMP. POLE POWER OUTLET ROOF DRAINS GAR. SO. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRAINAGE PIPING CAR P. SO. FT. ® LUMBER GR. FINAL INSP. y � 9 FRAMING Y-FFINAL INSP. WALL SO. FT. g/' / DRINKING FOUNTAIN. REMARKS: URINAL SO FT ® ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L 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, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SO.FT.GAR ® V4c 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 OUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE UGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SE A oe ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. ?lid GAS (ROUGH) °, METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REIN F. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ —Plus—X$—=$ LUMBER GR. FINAL INSP. y � 9 FRAMING Y-FFINAL INSP. ROOFING ��?� VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL //JJ LATHING A/,O/�- MESH INSULATIONISOUND 6 FINISH GRADING FINAL INSPECTION CERT. OCC. g/' / REMARKS: INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL