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BWFE2015-021744620 MILAGO DR. LA QUINTA, CA 92253 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 Business and Professions Code, and my,License is in full force and effect. License Class: License No.: Date: Contractor: I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that l 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).: Cy� 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 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 Mhe 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 01%Contractors' State License Law.). I am exempt under Sec. B.&P.C. for this reason Date L Owner: ci 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 Llc. No.: 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:- Polity. Number: _ 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: 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 ($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. 'APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 city to enter upon the above- mentioned property for inspection purposes. � Date:W/Zhls Signature (Applicant or Agent): 78-495 CALLE TAMPICO D� VOICE (760).777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 . COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/12/2015 Application Number: BWFE20IS-0217 Owner: Property Address: 44620 MILAGO DR JEFF LEPPEN APN: Application Description: 604262001 LEPPEN RESIDENCE D /thy 44620 MILAGO DR. LA QUINTA, CA 92253 Property Zoning: Application Valuation: $4,000.00 JUN 1 2 2015 Applicant: Contractor: JEFF LEPPEN CITYOFLA(G)Ul A OWNER/BUILDER 44620 MILAGO DR. LA QUINTA, CA 92253 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 Business and Professions Code, and my,License is in full force and effect. License Class: License No.: Date: Contractor: I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that l 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).: Cy� 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 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 Mhe 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 01%Contractors' State License Law.). I am exempt under Sec. B.&P.C. for this reason Date L Owner: ci 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 Llc. No.: 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:- Polity. Number: _ 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 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: 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 ($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. 'APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 city to enter upon the above- mentioned property for inspection purposes. � Date:W/Zhls Signature (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION• ' ACCOUNT `':�� r ',QTY PAID PAID DATE �f, R^;,g g g, £AMOUNT m'p, ,Y BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/12/15 Ny PAID BY } a, ,a METHOD • CHECK #<CLTD BY Y. JEFF LEPPEN DEBIT R7001 AZA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION A {`ACCOUNT • `,n F'QTY AMOUNTr'` `PAID DATE: s.: <�v' F xy.: zPAID WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $47.86 6/12/15 PAID BY., *~ x METHOD • " �'_ +� ,;RECEIPT #, s; CHECK # �,CLTD BY JEFF LEPPEN DEBIT R7001 AZA F �� saDESCRIPTION 13 v z� a ACCOUNT ' ' F AMOUNT PAID +PAID DATE c< p3QTYg WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $60.91 6/12/15 PAID BY ' 4; ,f METHODS E� ' RECEIPT # g , CHECK # • CL -TD BY g & JEFF LEPPEN DEBIT R7001 AZA Total Paid forFENCE OR FREESTANDING WALL- $108.77 $108.77 • •LS: $109.77 $109.77 • r ' s 4 Description: LEPPEN RESIDENCE Type: WALL/FENCE Subtype: Status: ISSUED Applied: 6/12/2015 AZA Approved: 6/12/2015 AZA Parcel No: 604262001 Site Address: 44620 MILAGO DR LA QUINTA,CA 92253 Subdivision: TR 23913 Block: Lot: 45 Issued: 6/12/2015 AZA Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Fineled: Valuation: $4,000.00 Occupancy Type: Construction Type: Expired: 12/9/2015 AZA No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 85LF OF V HIGH GARDEN FRONT YARD (COURTRAYD) WITH 6 PILASTERS AND ENTRY WITHIN PROPERTY LINE[ PER ATTACHED CITY APPROVED STANDARDS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. Printed: Friday, June 12, 2015 11:00:55 AM 1 of 2 SYSTEMS n .f 40 ,.1,a DESCRIPTION��, >€ ACCOUNT QTYn =A'MOUNT.� PAID, PAID DATE 'RECEIPT :# -CHECK # METHOD PAID BY "' CLT ABY.:. _ �`. 6• WALL/FENCE -FIRST 101-0000-42404 0 $47.86 $47.86. 6/12/15 R7001 DEBIT JEFF LEPPEN AZA 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $60.91 6/12/15 R7001 DEBIT JEFF LEPPEN AZA 100 LF PC Total Paid for FENCE OR FREESTANDING WALL $108.77 $108.77 TOTALS:0• 0• .77 PARENT PROJECTS BOND INFORMATION Printed: Friday, June 12, 2015 11:00:55 AM 2 of 2 H ' sysrrms m Bin. # city 'f.La Qilinta Building &r Safety Mision P.O. Box 1504,•78-495 Calle Tampico Lil.Quinta, CA 92253 - (760) 777-7012 Budding Permit Application and Tracking Sheet Permit # Project Address: `>'`iGZU /1TIILeb 2r: Owner's Name:. A. P. Number: Address: . yyG ZO Legal Description: City, ST, Zip: Le.011in1Aa CA qzz S3 Contractor:Telephone: 3/� Sb� 38`fG �. ��x • ;��• Address: Project Description: City, ST, Zip: Telephone: r:'� ✓i' r aGw. 4 c S State Lie. # : City Lie'. #; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: State Lic. #:ix; :.r " � ,�� ...... F% ?HCG Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Unita: Name of Coataat Person: L. RPeAll Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE 0.# Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit. . Truss Cafes. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted.. Mecharilcal Grading plan 2•a Review, ready for correctionslissue 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 corrections/issue Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees oil w P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT- (760)777-7012 EPARTMENT PROPERTY OWNER'S PACKAGE (760)777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit -has been subrnitted in your name listing yourself • as the builder of the property improvements -specified at We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in yourname as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. �TDD 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "`Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 4922. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 19) 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. ® 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value ooi my construction is at least five hundred dollars ($500), including labor and materials I may be " under state and federal law. Y red an employer /',V)6. I understand if'I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability. insuratice, and contribute to unemployment compensation for'each "employee." I also understand my failure to abide by these laws may subject me to.serious financial risk. I understand under California Contractors' State License Law,' an Owner -Builder who builds single-family residential s ctures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. �8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any. subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9..I understand I may obtain more information regarding my'obligations as an."employer" from the Internal Revenue ervice, the United States Small.Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. (!2�_10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally: and financially responsible for proposed construction activity at the following address: yV40 Af,. -Q zza M11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as mell as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract. with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and, wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner / Date: lKlall Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(§) to act as my agent(s) to apply for, sign; and file. the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owners signature. Property Owner's Signature: Date: FOC DESIGN PARAMETERS: ACTIVE SOIL PRESSURE (PSF) =30 PASSIVE SOIL BEARING (PSF) = 150 COEFFICIENT OF FRICTION = 0.25 ALLOWABLE SOIL BEARING (PSF) =1500. WIND = 80 MPH. EXPOSURE C SEISMIC: NA= 1.3. Nv= I.G. Z=0.4, SOIL PROFILE=So d. 1 y TOP. VIEW a N�x' >''...i'� a FOOTING � _1_ BLOCK 276' 55 £% GROUT r STEEL REBAR, y REBAR _._... _EMENT_- ,[U= TRkTTI.O_N SECTION VIEW ,+ ' BLOCK '� I I ' 12" OR 16" X 16") 0 SOLID GROUT MIN. 24" REBAR 6' (4) - # 4 REBAR , OVERLAP • MAX (ONE AT EACH CORNER) I' v ALL FOOTINGS ADJACENT TO i SLOPES TO BE AT LEAST 5' TO I _ DAYLIGHT AS SHOWN BELOW. • -- MIN 24 REBAR OVERLAP. GRADE BoTTo _ of 5 MIN. { 1 4 'FOOTING s s. jj rl� r sI ,ah P FOOTING REBAR SHALL �Y f"�� h at HAVE MIN.6' I • PILASTER SPACINGSHALL NOT EXCFED 20 FT. WHEN OTHER INFILL FENCING i4t(w�xJ x orto`' IS ATTACHED. a 201. O "' 73„}'°' .}3.)f, L'. HOOK AND A MIN. - ..� . . CONCRETECOVEROF3". 16 i' � 4w 5 • 2, ONLY OPEN TYPE FENCING (SUCH AS WROUGHT IRON) MAY BE ATTACHED TO - PILASTERS. SOLID TYPE FENCING MAY NOT BEATTACHED TO PILASTER. 3. GATES AND DOORS ATTACHED TO PILASTER ARE LIMITED TO 200# MAX. WEIGHT AND 4 FT.'MAX.. WIDTH PER PILASTER. N Q ' 4:THIS PILASTER DESIGN IS INTENDED TO BE USED ONLY.AS A FENCING FEATURE AND IS NOT INTENDED TO SUPPORT ANY OTHER LOADS 5. FENCE HEIGHTS ARE REGULATED - CONSULT ZONING REGULATIONS BEFORE CHECK WITH THE_BU(LDING.DEPARTMENT BEGINNING CONSTRUCTION. " ' TO VERIFY I -F A BUILDING PERMIT 13E 6. INSTALLATION OF ELECTRIC CIRCUITS, CONDUITS. OR LIGHTING, FIXTURES WHEN A BUILDING PERMIT IS REQUIRED, REQUIRE ELECTRICAL PERMITS AND INSPECTION,',' THE FOLLOWING INSPECTIONS ARE ALSO REQUIRED: 7•. FOOTINGS TO BE PLACED IN UNDISTURBED SOIL OR PROPERLY COMPACTED AND ENGINEERED FILL. 1) FOOTING,; EXCAVATION TRENCH CLEAN WITH STEEL S. FOR DESIGN PARAMETERS. SEE FREESTANDING BLOCK WALL STANDARD. IN-PLACE AND SUPPORTED 3" ABOVE AND AWAY FROM -THE SURROUNDING THE EARTH/GIRT. WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM 2) NSPE CTION PRIOR OTOTPLAC NIG GROUT.BAR IN PLACE -` - o� �wI � x '', •« VERTCAL a 3) :FINAL; AFTER GROUT IS PLACED - PRIOR TO ANY, y DECORATIVE CAP PLACEMENT. .� MASONRY .PILASTER DISCLAIMER: . 10, ,,,:o� ALTERNATE DESIGNS MAYBE POSSIBLE WHEN PROVIDED WITH I AN ENGINEERED ANALYSIS. USE OF THIS, STANDARD DESIGN IS PHONE . 760) 777-7125 r .78-495-.CALLE TAMPICO - ( A7 THE USER'S RISK AND CARRIES NO IMPLIED OR INFERRED LA QUINTA, CALIFORNIA 92253 GUARANTEE AGAINST FAILURE OR DEFECTS` ` `,fir FAX (760)'.777-701.1! ]0/9/2014.. COMMUNITY DEVELOPMENT DEPT. yPAGE I OF I