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08-0534 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: Applicant: 08-00000534 53461 VIA PISA 772-530-043- - WALL/FENCE LOW DENSITY RESIDENTIAL 6525 Td`�14.XPQ" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Architect or Engineer: 1)14 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 Professionals Code, and my License is in full force and effect. License Class: B -C27-053 License No.: 93470 te. «actor: J / ! /F/j C"�F�li � Ao GF OWNER-BUILDE 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, atter, 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 Codel or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by anysapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$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.). (_ 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 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. , BAP.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: LQPERn1iT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: TOM & MICHELE SCHMALZRIED' 8 MORGAN LANE ROLLING HILLS ESTATE, CA 90274 Cul I LI at.lui . HILLIARD, RICHARD D�?PR ;1' —+ 76280 VIA CHIANTI INDIAN WELLS, CA. 0 (760)399-0365 /��Lic. No._ 493470 �ti 4 ZQfun' � cino LA Date: 4/01/08 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 EXEMPT Policy Number EXEMPT 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shalse provisions. WARNING: FA URE TOS KERS' 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 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 Ouinta, 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. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this my to enter upon the ove-mentioned propertyfor inspe ion purpose ate: ature (Applicant or Agent l: Application Number . : . . . 08-00000534 Permit . . . BUILDING PERMIT INV FEE Additional desc . . Permit Fee . . . . 180.00 Plan Check Fee . Issue Date . . . . Valuation . . . . Expiration Date . . 9/28/08 .00 6525 Qty Unit Charge Per Extension BASE FEE 90.00 5.00 18.0000 THOU BLDG 2,001-25,000 90.00 ---------------------------------------------------------------------=------ Special Notes and Comments 339 L.F. 6' eAP.DFnT VRPTMP.TPR WATT. F 9n L.F. 3' RETAINING WALL,INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE §304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. Fee summary Charged ----------------- ---------- Permit Fee Total 180.00 Plan Check Total .00 Grand Total 180.00 LQPERMIT Paid Credited Due . ---------- ---------- ---------- .00 .00 180.00 .00 .00 .00 .00 .00 180.00 Hillwood 1 1 1 Custom Wbmes 17 7 - 7112- 76-280 Via Chianti Indian 'Wells, CA 92210 230 Ke'oawa Street Lahaina, 9f�7-61 h,-Jwdi@aol.com T: (760) 399-0365 F: (760) 200-3047 L'd LtOE-OOZ-09L PJBIII!H NON d8Z:£0 80 LO AV 3c 1 2.61 I 1"12.1 TG 1 t IB 60 12.6FG 4 17. 21 4 .............. 7. 2 sov 1 14.1 n.6 2.6FG 4 1 0 IS - 2.> I�101 I l I ' I it' 12.5- 110.75TG 7 '.75 NV R I-1i� 7It �� _ j ,r. r1 4, it4l.50 FS. 3c 1 2.61 I 1"12.1 TG 1 t IB 60 12.6FG 4 17. 21 4 .............. 7. 2 sov 1 14.1 n.6 2.6FG 4 1 0 IS - 2.> I�101 I l I ' I it' 12.5- 110.75TG 7 '.75 NV Bin # City of La Quint3 Building 4 Safety Division P.O. Box 1504, 78-495 Calle Tairpico La Quinta, Permit .# CA 92253 - (760) 777-7012 '✓ ✓ Building Permit Application and Tracking Sheet Project Address:' S-3 _ y6 Owner's Name: ®�' / SC / A: P. Number: 7 ©- Q D - 8 Address:. ' 6,,4 F Legal Description: City, ST, Zip: apS C Contractor: Telephone:. Address: roject Description: City, ST, Zip: Z Telephone: 3,e13_1 7 �f e, State Lic. # City Lic. #:1007V6.1Q Ic 3 / 6 1v Arch., Engr., Designer: b ti 4 ®�6 AV Address: L • - City, ST, Zip: Ci4_ q Z� a Telephone: UE O 3 6 _� Construction Type: occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq.FL: #Stories:. # Units: Telephone # of Contact Person: Estimated Value ofProject: d °- D APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMTT FEES Plan Sets Plan Check submitted Item Structural Calcs. Amount Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plaa Check Balance Energy Calcs. Plans picked up Corstruction Flood plain plan Plans resubmitted Me(hanical Grading. plan 2°" Review, ready for correctionsrissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.MI. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''" Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Permit Fees