BWFE2014-103078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
r
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
JEHA MICHEAL
53408 VIA PISA
\LA QUINTA, CA 92253
ceiti,, 4 4 Qumto
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BWFE2014-1030
53408 VIA PISA
777190024
ORCO WALL 66 LF X 6 FT HT
$6,768.00
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/11/2014
Owner:
JEHA, M CHAEL E & CARRIE A
53408 V A PISA
LA QUINTA, CA 92211
Contractor:
MICHAEL JEHA CONSTRUCTION
41479 RESORTER BLVD UIT 27-12
PALM DESERT, CA 92211
(925)25x4038
Llc. No.: 410408
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter.9 I hereby affirm under penalty of perjury one of the following declarations:
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers'
my Li is in full force and effect. compensation, as provided for by Sectson 3700 of the Labor Code, for the performance of
Li nse ClassEFER-BUILDER
.:410408 the work for which this permit is issued.
_ I have and will maintain workers' compensation insurance, as required by
Da tractor: �% 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:
DECLARATION Carrier: _ Policy Number: _
I hereby affirenalty of perjury that I am exempt from the Contractor's State _ I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and agree that, if I should become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions ofth bor Code, I shall forthwith
statement that he or she is licensed pursuant to the provisions of the Contractor's State comply wit Vhoprovi ons.
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 Date: � Applicant 0 of
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).: WARNING: FAILURE TO SECURE WORICRS' COMPE (ATI COVERAGE IS UNLAWFUL,
(_) I, as owner of the property, or my employees with wages as their sole AND SHALL SUBJECT AN EMPLOYER TC CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
compensation, will do the work, and the structure is not intended or offered for sale. HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work INTEREST, AND ATTORNEY'S FEES.
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 APPLICANTACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he IMPORTANT: Application is hereby made to the Building Official for a permit subject to
or she did not build or improve for the purpose of sale.). the conditions and restrictions set fortl, on this application.
(_) I, as owner of the property, am exclusively contracting with licensed contractors to 1. Each person upon whose behalf th.s application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State request and for whose benefit work is performed under or pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon, and as a result of this application , the owner, and the applicant, each agrees to, and shall
who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
State License Law.). employees for any act or omission related to the work being performed under or
(_) I am exempt under Sec. B.&P.C. for this reason following issuance of this permit.
2. Any permit issued as a result of thi: application becomes null and void if work is not
commenced within 180 days from date�of issuance of such permit, or cessation of work
Date: Owner: for 180 days will subject permit to cancellation.
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:
I certify that I have read this applicatior and state that the above information is correct.
I agree to comply with all city and coun-y ordinances and state laws relating to building
construction, and hereby authorize repeesenta ' s of t " city to enter upon the above-
mentioned rope`rty for inspection purposes
Date: (' Signature (Applicant or Agent):
FINANCIAL •• /.
1
DESCRIPTION
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 forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.19
$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
$60.06
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL $107.25 $0.00
TOTALS:00
i ��
Bin # City. of La Quinta
{ Building &r Safety Division
Permit # P.O. Box 1504, 78-495 Calfe Tampico . .
La Quinta,CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Project Address:v�%�' �s�-�: Owner's Name:
A. P. Number:
I
Address: V
Legal Description:
Contractor:
Address: VOP LIA
City, ST, Zip: 7j7i�3
Telephone: - U
P
( Project Description: ~(�
City, ST, Zip: •
- 7j�� '44� I
Telephone 2 CD
O
,1 "15,111111
State Lic. # : g Q 7 ��
Arch., Engr., Designer:
City Lic.
Address:
City., ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
r:<> :.s•> s:,.,:::; > .;;:::: Construction Type:
_ type one): : New . Add'n Alter Repair Demo
J circle one
Sq. Ft.: # Stories: 41 Units:
Telephone # of Contact Person:
ZJi2S_4D VolKstimated Value of Projcct:
# Submittal Req'd
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rcc'd TRACKING PERMIT FEES
Plan Sets
PIan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Cluck Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrcctionsfissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IIOUSE:-
3" Review, ready for correctionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fces
----------------
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