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BWFE2015-015978-495'CALLE TAMPICO LA QUINTA, '4ALIFORNIA 92253 i Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: BWFE2015-0159 80408 PLATINUM WY 775220021 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT SIGNATURE HACIENDAS TM36537-1 PH 1 LOT 39 $2,025.00 Applicant: CALIFORNIA WEST CONSTRUCTION I` 5927 PRIESTLY DRIVE STE 110 CARLSBAD, CA 92008 pQ°D JUN I 1 2015 CITY OF LA OUINTA Y DEVELOPMENT DE 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: B License No.: 927267 r- Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt om the Co actor'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).: ( ) 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 he or 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 the Contractors' State License Law.). (_) 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.). Lender's Name Lender's Address: VOICE (760) 777-7125 'FAX (760) 777-7011 INSPECTIC►NS (760) 777-7153 Date: 6/8/2015 Owner: CALIFORNIA WEST CONSTRUCTION I 5927 PRIESTLY DRIVE STE 110 CARLSBAD, CA 92008 Contractor: CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE STE 110 CARLSBAD, CA 92008 (760)918-6768 LIc. No.: 927267 WORKER'S COMPENSATION DECLARATION 1 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: _ Policy 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 beco a subject to the workers' compensation provisions of Section 3100 of the r ode, I shall forthwith comply with those provisions. C Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSA ON COVERI GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENH IES AND IVIL 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 on a above mentioned property for inspection purposes. //,,ff�� Date: Signature (Applicant or Agent) DESCRIPTION FINANCIAL INFORMATION ACCOUNT CITY AMOUNT PAID PAID DATE BSAS SB1473 FEE _' 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT CITY_ AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD RECEIPT 4 CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 1001F PC 101-0000-42600 0 $60.91 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for FENCE OR FREESTANDING WALL TOTALS:0• $108.77 $0.00 00 Description: SIGNATURE HACIENDAS TM36537-1 PH 1 LOT 39 Type: WALL/FENCE Subtype: Status: APPROVED Applied: 6/5/2015 MFA Approved: 6/5/2015 JJO Parcel No: 775220021 Site Address: 80408 PLATINUM WY LA QUINTA,CA 92253 Subdivision: PM 20426 Block: Lot: 39 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,025.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 75 LF GARDEN WALL [ORCO SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. __j Applied to Approved ADDITIONAL CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE' FAX EMAIL APPLICANT CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE CARLSBAD CA 92008 (760)918-6768 LBELLOSO@CALWESTC STE 110 OMMUNITIES.COM CONTRACTOR CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE CARLSBAD CA 92008 (760)918-6768 LBELLOSO@CALWESTC STE 110 OMMUNITIES.COM OWNER CALIFORNIA WEST CONSTRUCTION 1 5927 PRIESTLY DRIVE CARLSBAD CA 92008 (760)918-6768 LBELLOSO@CALWESTC STE 110 OMMUNITIES.COM FINANCIAL•' • Printed: Monday, June 08, 2015 11:46:52 AM 1 of 2 SYSTEMS Printed: Monday, June 08, 2015 11:46:52 AM 2 of 2 SY57:M5 CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY . BY BSAS SB1473 FEE 1 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $0.00 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $0.00 100 LF PC Total Paid for FENCE OR FREESTANDING WALL $108.77 $0.00 TOTALS:0• • 00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE 0 BOND BEAM BLD 0 FINAL"* BLD 0 FOOTINGS BLD PARENT PROJECTS REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE NON-STRUCTURAL - JIM JOHNSON 6/5/2015 6/12/2015 6/5/2015 APPROVED PER ORCO SPECS 1 WK Printed: Monday, June 08, 2015 11:46:52 AM 2 of 2 SY57:M5