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BWFE2017-009678-495 CALLE TAMPICO T� U VOICE (760) 777-7125 a LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/30/2017 Application Number: BWFE2017-0096 �f/J 1 Owner: .531 Property Address: -4 AVE NIDA V LL'A' ( LISA MOLLER & WALTER URBAN APN: 773102006 2609 N SEPULVEDA BLVD Application Description: MOLLER RESIDENCE /BLOCK WA ® � ® MANHATTAN BEACH, CA 90266 Property Zoning: Application Valuation: $10,000.00 Applicant: MAY 3 0 2017 Contractor: LISA MOLLER & WALTER URBAN OWNER / BUILDER 2609 N SEPULVEDA BLVD CITY 01QUJMA MANHATTAN BEACH, CA 90266 DESIGNAND DEVELOpMENl'DEPgRTMENT Llc. No.: 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: License No.: Date Contractor: 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 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 Date361- Owner:CONSTRUCTIO ENDING 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: WORKER'S COMPENSAMON DECLARATION I hereby affirm under penalty of perjury one or 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 th 9t, if I should become subject to the workers' compensation provisions of Section 7 of the or Code, I shall forthwith comply withh tjh�o a provisions. Date: �" (� applicant: WARNING: FAILURE TO SECURE WORKERS' CCIvIPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRImirml_ PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FO i IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to tl•e Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this appl cation 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 tie 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 ofissuance of such permit, or cessation of work for 180 days will subject permit to tante lation. 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 -menti n d roperty for inspection purposes. Date: Signature (Applicant or Agent) Application Number: BWFE2017-0096 Property Address: 51401 AVENIDA VIILLA APN: 773102006 Application Description: MOLLER. RESIDENCE / BLOCK WALL Property Zoning: Application Valuation: $10,000.00 Applicant: LISA MOLLER & WALTER URBAN 2609 N SEPULVEDA BLVD MANHATTAN BEACH, CA 90266 Owner: LISA MOLLER & WALTER URBAN 2609 N SEPULVEDA BLVD MANHATTAN BEACH, CA 90266 Contractor: OWNER/BUILDER Llc. No.: Date: 5/30/2017 Detail: 1S8 LF X 6 FT HIGH BLOCK WALL [ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH'STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. THE AREA BETWEEN THE BACK OF CURB AND ANY FENCING SHALL BE LANDSCAPED, HAVE A SUITABLE PERMANENT IRRIGATION SYSTEM, AND BE CONTINUOUSLY MAINTAINED BY THE PROPERTY OWNER. 2016 CALIFORNIA BUILDING CODES FINANCIAL DESCRIPTION .• !. ACCOUNT QTY AMOUNT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $30.40 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $50.67 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $63.33 Total Paid for BLOCK WALL: $144.40 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00. Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 &A*(247lb 009 I q 11 4vE Ul U410^ _ey t Bin # CI tOf La Quint 'a &r Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ' Project Address: 5 i 1 "f 1 U�1Jl (J A7 u A Owner's Name: U SP, M WA L'Mp, V � A� A. P. Number: 3 I O Z' 6 0 -7 " Address:9bol ti1.1;F_P Vuf5W P?W) . Legal Description: City, ST, Zip: NDN � (,�-} cx qo Contractor: Tele nn�� Telephone: o �'NI C!/ -1 too 3 P S Address: Project Description: City, ST, Zip: WALL, , ��i Y�/ALL, Telephone: State Lie. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone:Construction T e: Occupancy: State Lie. # Project type (circle one).New Addn' Alter air Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 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 21" Review, ready for correctionsfissue Electrical Subcontactor, List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A.-Approval Plans resubmitted Grading IN HOUSE:- 3d 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 �� M