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BWFE2014-115078-495 CALLE TAMPICO . LA QUINTA, CALIFORNIA 92253 Application Number: BWFE2014-1150 Property Address: 55765 CHERRY HILLS APN: 775170016 Application Description, Property Zoning: Application Valuation: Applicant: FEDDERLY & ASSOCIATES 38-747 NOPALES ROAD PALM DESERT, CA 92211 145 LF BLOCK WALL $14,000.00 Twit 4 4 49wo COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9'(commencing with Section70DOI of Division3 of the Business and Professions Code, and my License is'Infull force and effect. License Class: B License No.:. 9 Date: 2 �Z contractor: OWNER-BUI R, RATION 1' hereby affirm under penalty of perjury that I am exemptfrom-the Contractor's State Licenselaw for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit toconstruct,'alter, improve, demolish, or repair any structure, priortoits 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 is exempt therefrom and the basis for the alleged,exemption. Any violation of Section 70315byany applicant -for a permit subjects the;applicant to a civil penalty of not more thanfive:hundred dollars ($500):: L ),I, as owner of the property, or my employees with wages astheir 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 ownemployees, provided that the improvements are„not intended or'offered'for sale. If, however, the building or improvementlis sold within.oneyear of completion, the owner -builder will.have the burden of proving that he or she did notbuil&or improve:for the purpose of sale.). (-1 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 notapply to an owner of property who builds or improves thereon; and.who contracts for the projects with a contractor(s),licensedpursuant to the;Contractors' State License Law.). (_J1I am 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 Lender's Address: DEC 22 Owner: WILLIAIV BRITT CITY OF LA 6,460 Tkq&qkgTP61WP1 EXCELSIOR, MN 92253 Contractor: FEDDERLY & ASSOCIATES 38-747 NOPALES ROAD PALM DESERT, CA 92211 (760)773-5205 Llc. No.: 762889, VOICE (760)'777-7125 777-7153 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1'have and wliimalntaina 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 permitis issued. ['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:_ Policy Number: _ I certify that in the:performance of the work for which this permit is issued, l shall not employ any' person In anymannerso 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 Section3700 of the Labor Code, l shall forthwith comply with'those provisions. Date:'/ Z Z Applicant: WARNING:TAILURE TO. SECURE WORKE MPENSATION'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 ATTORNEYS FEES. APPLICANT ACKNOWLEDGEMENT' IMPORTANT: Application Is hereby. made to the Building Officlal'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 requestand for whose:benefit work is:performed under or pursuant to any permit issued as a result of this application , the owner, andthe applicant, each agrees to, and shall defend, Indemnify and hold harmless .the Cityof La Qulnta, its officers, agents, and employees for any act or omission related to thework being performed underor 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 workfor 180 days will subject permit to cancellation. I cer4ifV4hat 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 Ing construction, and hereby authorize representatives of this.ci upo the ove• mentioned prope for Inspection -purposes. Date: 2 Z� Signature (Applicant or Agent): Description: 14S1F BLOCK WALL Type: WALL/FENCE Subtype: Status:,UNDER REVIEW Applied:12/22/2014 MFA Approved: Parcel No: 775170016 Site Address: 55765 CHERRY HILLS LA QUINTA CA 92253 Subdivision: TR 25397 Block: Lot: 16 Issued: Lot Sq Ft:,O Building Sq Ft: 0 Zoning: Finaled: Valuation: $14,000.00 Occupancy Type:. Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: Printed: Monday, December22, 20141:49:40 PM 1°of 2 CnW.".. PROJECTS a Printe&Monday, December 22, 20141:49:40 PM 2 of 2 C . s.I. Bin.#' City of La Quints Building a[ Safety Dh4slon P.O. Box 1504,78-495 Calle. Tampico la Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project.Address: 55,1(05 CAAV"iL Owner's Name: %J111 jWjv% 4PJ l JJ-% A. P. Number: 6 - },D ' Q (p Address.(000 'laxotgeys Pow+ Legal Description: Lot lo of TY-gLc+ 20 b i l City, ST, Zip: t Y.Ce (siov', Mw V953,311 Contractor. Fe d Q1 W 4 A-sepG{ Aft s * Telephone: Address: ?J�'j 1.(�VJORWS Project Description: 5F Res i tevie City,;ST, Zip: P _"vn Des(,� CA- 47,2-11 8( oc*k Telephone: N00 -173 - 62W State Lie. # City Lic. `w"(S l S' Arch., Engr., Designer: Ftddel/( SC -S Address: City, , ST, Zip: PMvna� Om -i( Telephone: 1(00 113 - 5 Z0s5 Construction Type: V ep : Occupancy: Project type (circle one): ew , Add'n Alter Repair Demo State Lic. #: 1(p 2 01 Name of Contact Person: J OSCi Car( GS C q. Ft:: #"Stories-. ` # Units: Telephone # of Contact Person: &dmated Value of Project: (U OoD APPLICANT: D&NOT WRITE BELOW THIS LINE N Submittal Req'd Reed TRACKING PERMIT FEES' Plau,Sets Plan Check submitted Item Amount Structural Cales. Reviewed,.ready: for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Tide 24.Cslcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 20° Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S M.I. H.O.A..Approval Pians resubmitted Grading IN HOUSE:-, kd Review, ready for correctionadissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees