08-1753 (BLCK)-�4bt 4 * 4 "W
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/22/08
Application Number: 08-00001753 Owner:
Property Address: 52445 AVENIDA BERMUDAS JOAN BITTLE
APN: 773-275-020-10 -000000- 52445 AVENIDA BERMUDAS
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 2433
Contractor: D
Applicant: Architect or Engineer: FEDOR MASONRY INC, JAMES
P.O. BOX 1397 Q
LA QUINTA, CA 92247
ic. o.: 823 0�'� 2220�g
Lic . No .: 823181 11
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EPZ-----
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the fallowing declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect._ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License CI 9 License No.: 823181 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
ate:` y�/� Com{actor: 1 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier ENDURANCE AMRCN Policy Number WEN100232501
following reason.(Sec. 7031 .5, Business and Professions *Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should ecome subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Co el orthwith comply with those provisions.
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).: ate: =RE
ant:
1 _ 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 WARNING:ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.).
(_ 1 I 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.I.
Lender's Name: tl a
Lender's Address:
LQPERMIT
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 buil 'ng construction, and hereby authorize representatives
of thi oun toe r Pon the above-mentioned prop fo action purposes.
l
ate: �ature (Applicant or Agent
Application Number . . . . . 08-00001753
Permit . . . WALL/FENCE
PERMIT
Additional desc .
Permit Fee . . . . 54.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 2433 ,
Expiration Date •4/20/09
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00 9.0000 THOU BLDG
2,001-25,000
9.00
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Special Notes and Comments
80 L.F. 6- GARDEN WALL, 10 L.F.
5141-
'4"WALL
WALL& 10 L.F. 418" GARDEN WALL,
ALL
CITY STANDARD Q SIDE P/L.
Fee summary Charged
-------------------------------------
Paid
Credited
Due
Permit Fee Total 54.00
----------
.00
----------
.00
5.4.00
Plan Check Total .00
.00
_
.00
.00
Grand Total 54.00
.00
.00
54.00
LQPERMIT -
I
APPROV BY PLANNING DEPARTME T
SY DATE 10 22.0'
EXHIBIT
CASE NO.
CITY OF LA QUINTA
BUILDING & SAFETY DEPT. -
APPROVED
FOR CONST
7'F�kB
AE1,,f6 DA- &CMtf,'-;�As
Bin #
Permit #
Project Address: 5'2. 4 45
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
I/ -A1 100 &rwl e)Owner's Name:
A. P. Number:
Address: .rZ ,- 444.<
Legal Description:
City, ST, Zip: A
Contractor: J
Telephone:
Address: AV� ,l�7
Project Description:
City, ST, Zip: 4 - //d rA
4.
p L ' _ &,,i ewzz I&A&
Telephone:
State Lic. # :
City Lic.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft_: # Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project:
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2"d Review, ready for correctionsfiissue 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
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated (619) 347-8631
DateE12128
/93 Type of reranit
No.Q I I
Perm
Owner Name WES Development Log
No. street See Below
City La Quinta Zip 92253 Study Area 111
Arlo # Tract # Lot #[_] Square Footage 19244
Type of Development Ibingle Family Residence No. of units
Comments 54785 Avenida Tuarez. 51970 Avenida Rubio, 52445 Avenida Bermudas. 52440
Avenida Mendn7a,54565 F.is nhnwpr., 53660 AvenidaR z�,
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under 500 square feet,
detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.58 X 9 244 or $ 14,605.52 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By Stockman Homes/Cashier's Check Telephone 564-5154
Name on the check
By James E. Uvely
Assistant Superintendent, Business Services
Fee collected /exempted by Vickie J. Durrett
Payment Received
Signature 61 Check No. 053666
Collector. Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
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