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BWFE2014-112478-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2014-1124 Property Address: 81150 ELSWORTH PL APN: 767670007 Application Description: 4 FT 8" X HT 126 LN FT ANGELUS WALL Property Zoning: Application Valuation: $6,900.00 Applicant: M CASTILLO'S CONCRETE CO D P0BOX5 t COACHELLA, CA 92236 14 2014 L -- CITY OF to QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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:` CC -8, C29 License No.: 88166111 P Date: !� z �/ Contractor: /"' �iGSf/617,yC {r /,4 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 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: 7. Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/14/2014 Owner: FILLER RESIDENCE 81150 ELSWORTH PLACE LA QUINTA, CA 92253 Contractor: M CASTILLO'S CONCRETE CO P 0 BOX 5 COACHELLA, CA 92236 (760)398-9227 Llc. No.: 881611 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: _ 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: / & d Applicant: '><Yas 4 5 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: /� ( Signature (Applicant or Agent): O FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY c Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION -ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $62.36 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for FENCE OR FREESTANDING WALL- TOTALS:•• $171.13 $0.00 Description: 4 FT 8" X HT 126 LN FT ANGELUS WALL Type: WALL/FENCE Subtype: Status: SUBMITTED Applied: 11/14/2014 PJU Approved: Parcel No: 767670007 Site Address: 81150 ELSWORTH PL LA QUINTA,CA 92253 Subdivision: TR 33076-1 Block: Lot: 11 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $6,900.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 4'8" HIGH WALL X 126 LN FT ANGELUS STANDARDS APPROVED JJ.] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING ADDITIONAL CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT M CASTILLO'S CONCRETE CO P 0 BOX 5 COACHELLA CA 92236 CONTRACTOR M CASTILLO'S CONCRETE CO P 0 BOX 5 COACHELLA CA 92236 OWNER FILLER RESIDENCE 81150 ELSWORTH PLACE LA QUINTA CA 92253 FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Friday, November 14, 2014 9:49:14 AM 1 of 2 ' CA?wSYS TEMS Printed: Friday, November 14, 2014 9:49:14 AM 2 of 2 cj?1"SYSTEMS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BOND BEAM FINAL" BY WALL/FENCE - EA FOOTINGS L 101-0000-42404 0 $62.36 $0.00 ADDITIONAL 50 LF 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- $171.13 $0.00 TOTALS:•• Printed: Friday, November 14, 2014 9:49:14 AM 2 of 2 cj?1"SYSTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED DATE COMPLETED DATE RESULT REMARKS NOTES BOND BEAM FINAL" FOOTINGS L Printed: Friday, November 14, 2014 9:49:14 AM 2 of 2 cj?1"SYSTEMS Bin.# Ci 0Quinta Building gr Safety Divisiotl P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet i Project Address: fL Bin.# Ci 0Quinta Building gr Safety Divisiotl P.O. Box 1504,78-495 Calle Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Perinit # Project Address: fL Owner's Name:. A. P. Number. Address: / — / rj p� `✓c/ %'+� /" Legal Description: City, ST, Zip: C Contractor.yod2fi Telephone: Address: P f7 7d )T Project Description: City,ST,Tap: CBS ��at !r �� "tj / 1 �� . �1 -Vol /lf'. w, '0 "/./W Telephone: iii O" 311c-- J,/ /%, e'1,1( State Lic. #: 6 j`% i City Lir Arch, Engr., Designer: 2. Address: City., ST, Zip: Telephone: Construction Type. , Occupancy: State Lie. #: ' Project type (circle one): New Ad ' Alter Repair Demo Name of Contact Person: /�� ¢ f� �,i y �' 1 Sq: Ft-: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Plan Sets Req'd Reed TRAC NG Plan Cheek submitted PFRMiT FEES Ibzm Amount Structural CaIcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. CaAed ContaetPersoa Plan Check Balance. Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted.. Mecharikal . Grading plan tad Review, ready for correctionslissue Electrical Subcontactor List Called ContactPerson Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review; ready for correctionsftuc Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr - Date of permit issue School Fees Total Permit Fees 'r-o-w- - --- (005. aW loll., f .-f /'��r / t,D� Opt Vo 75- 1006-M N GV 6A F-DF,4 VAIN..- FFOfEZTy C11-y OF APPI FOR CONaf uu�