08-0720 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA', CALIFORNIA 92253
Application Number: _/08-00000720M
Property Address: 53035 ERIWETHER WY
r; .jar.APN: 767-200-998-80 -330761-
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 12938
Applicant:. Architect or'Engineer. '
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busines Professionals Code, a my License is in full force and effect.
License Class: A UpB C17 ense 207 8.7
oat.: � � �0 Contractors -wr+
' OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the 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 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, 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 1, 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.).
( I Iam 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:
iI LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date
Owner:
EAST OF MADISON LLC
80955 AVENUE 52 _
LA QUINTA, CA 921 D
f, ^pJ��
Contractor:. d �iY � � 200® LU'
LUSARDI CONSTRUC IO CO
1570 LINDA VISTA DRIVICITYOOLAQ yINTp
SAN- MARCOS, CA. 9 078 FINNICEQEPT:
(760)744-3133
Lic. No.: 207287
4/30/.08
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificateof 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 NAT' L UNION FIR Policy Number WC1593670
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 I shout become subject [o the rkers co nsation provisions of Section
J1C 3700 of th or Code, 1 s II for wi omply ith tho pr isions.
DateO -k - ()b APPlican
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 (5100,0001. 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 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 Quina, 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 buil L construc ion, and hereb authoriz epresentatives
—f -this county to enter upon the above -menti property for�sp coon p poses.
- Date: y_I - V Signature (Applicant or Agent):
-Application Number . . ... . 08-00000720
�a.
Permit WALL/FENCE PERMIT
•." ,
Additional desc
Permit Fee-, 144.00 Plan Check Fee
.00
'
Issue Date Valuation
.12938
Expiration Date 10/27/08
,r
Qty ..Unit Charge Per
Extension
BASE FEE
45.00,.
' r
11..001=E 9.0000 THOU -BLDG'•2,001-25,000
_
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Special Notes and Comments
----------------
•
SITE WALLS / TOTAL LN FT & HT (TOTAL OF
RETAINING WALL INCLUDED)
WALL "A" 67.52 LNFT 121HT (8' OF RET)
_
WALL "B" 92.62 LNFT'5'HT (31.8" OF RET)
• -
. WALL "C" 90.40 LNFT 61HT (4' OF RET)
.,WALL "D" 94.02 LNFT 121HT (8' OF RET)
WALL "E" 182.31LNFT 8 -HT (51.3" OF RET)
Fee summary Charged Paid Credited
Due
Permit Fee Total 144.00 .00 00
144..00
Plan Check Total .00 .00 .00
.00
Grand Total 144.00 .00 .00
144.00
LQPERMIT
-
Bin #
City of La Quinta
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 #
��
Project Address: 5-;:—
Owner's Name:
A. P. Number:
Address: SS AVegv� S�
Legal Descriptio n:
City, ST, Zip: Lc,— �j v�R� Cam �22s3
Contractor: L U pr t l
Telephone:
i
Address:
Project Description: Me 4 e>; s CIA, 144 ose.
City, ST, Zip:
tke— We M-% A-)A.tV E
Telephone:
State Lic. # :
City Lic. #:
Arch., Engr., Designer:
Wall Lc, 90.46%4
Address:
�t ` 9Lt. 07,14 � yflp �k
City, ST, Zip:
W crA\ $Z . 3 t I 4018
4
Telephone:
Construction Type: Occupancy: v
State Lic. #:
Project type (circle one) New Add'n Alter Repair Demo
Name of Contact Person: p��
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: 3q 1 - 25g3
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance
Energy Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2e° Review, ready for correction .ssue
Electrical
Subcontactor List
Called Contact Person
Plumbing -
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'" Review, ready for correctionsfissue
Developer impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
M"LK
?e6,t,1
3 �$'