11-0617 (BLCK)4 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: 6/09/11
Application Number: 11-00000617 Owner: `
Property Address: 80429 VIA PESSARO BRUCE KANTER Q
APN: 772-520-056- - - 53-664 VIA BELLAGIO
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL tt
Application valuation: 9000
Contractor:
r f
Applicant: Architect or Engineer: FEDDERLY & ASSOCIATES C)•7y ()f '-A
38747 NOPALES ROAD rt.t-i-,y :
+ PALM DESERT,CA 92211 ��-
(,prcgOQ�
(760)773-52015
Lic. No.: 762889
LICENSED CONTRACTOR'S DECLARATION 4 "
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• Licen o.: 76 889
Date: Contractor:Jllof�o
OWNER -BUILD ECLARATION
I hereby affirm'under penalty of perjury that I' am exempt fr a Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions de: 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 thealleged 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.).
(_ 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. , 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:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
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: 4,
Carrier EVER INS Policy Number 760000440081
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 agreethat, if Ishould b ome subje to the cers' o nsation provisions of Section
• 3 0 of the Labor Code s II fo ith' om C�w' h t ovisions. -
CDate: Applicant: -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATI OVERAGE 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 r
_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 w
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 corre I agree.to comply with all
city and county ordinances and state laws relating to building structi nd he y u ori representatives
of this court t enter upon the above-mentioned property r i pe n rp
Date: Signature (Applicant or Agent(: -
Application Number 11-00000617
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Fee 108.00 Plan Check Fee
.00
Issue Date- Valuation . . .
. 9000..
Expiration Date 12/06/11
Qty Unit Charge Per
Extension
BASE FEE
45.00
7.00 9.0000 THOU BLDG 2,001=25,000
63.00'
---------------------------------------------------
Special Notes and Comments
360LF Q 6' HIGH PROPERTY LINE WALLS
[CITY STD)
- June 9, 2011 9:06:54 AM AORTEGA
Other Fees . . . . BLDG STDS ADMIN (SB1473)
1.00'
- Fee summary Charged Paid Credited\
Due _
r Permit Fee Total ---.108.00 -------.00 -------.00 -
--108.00
Plan Check Total . 00 00 ' 00
:00-:
_ Other Fee Total'" 1.00 .001.00
1.00
Grand Total `-109.00 .00,E .00•
109.00,: f.
Y r
-
LQPE[NUT
PROJECT DATA
-----------
3*9
LOT 1.
Z
Lo -r ?71
: LA QUINTA
& ]SAFETY DEPT.
ROVED
Al.
4�
SITE FLOOR PLAN
SCALE: 1/8* - 1'-0'
SITE SECTION X
Bin
City of la Quinta
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Obit
Project Address: $O„ 2-q V FSSS CW -0
Owner's Name:
A. P. Number: `7 7'7 —
Address: 53 L/ v l "1 l 1 C(
Legal Description: 1 SZ A-C/ZL__5 AOT
City, ST, Zip: La I rj-�e 672253
Contractoer d , /�iV.
Address: -38 --714 on C4, e
Project Description:
City, ST, Zip: 144"t YYx C
Tele P hone:
S
.:
/ w
1�(J I /S
StateLic. # : -7(p Z ge7
City'Lic.:# q q
Arch., Engr., Designer: P h UZ( 1V
Address:, go CQ fle- Q
City, ST, Zip: ,� i 2 ZJ� 3
Tele h /
one: lA
P 7 0 / 7 � q� 3
:.
..........................
Construction Type: Occupancy: � r At,v
Lie.
moState
Project type (circle one): e Add'n Alter Repair De
Name of Contact Person: R6 (7
Sq. Ft.:
#Stories:
#Units:
, y
Telephone # of Contact Person: O 5-7V ! 0060
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
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
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2n' Review, ready for corrections/issue
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
1
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