09-0518 (BLCK)fr
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4 Q".
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
09-00000518
Property Address:
51455 DESERT CLUB DR
APN:
770-153-003- - -
Application description:
WALL/FENCE
Property Zoning:
VILLAGE COMMERCIAL
Application valuation:
224
Applicant 1P n Architect or Engineer:
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 License No.: 684857
Date:_ �9 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 (5500).:
1—) 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: _
Lender's Address:
LQPERMIT
Owner:
BOB EDWARDS
51-455 DESERT CLUB
LA QUINTA, CA 92253
(
Contractor:
EDWARDS CONSTRUCTION INC, BOB
51455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
(760)777-8202
Lic. No.: 684857
P,
VOICE' (760) 777-7012
FAX (760) 777-7011
,TIONS (760) 777-7153
5/27/09
AA v \
y� O
P� i �OOJ6,
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 GRANITE STATE Policy Number WC 555-61-55
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: Applicant: E
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 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 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
r 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 county toenterupon the above-mentioned cFy-fe'-inspr+ n purposes.
Date -5 ��l Signature (Applicant or Agent):
Application Number
. . . . . 09-00000518
Permit . .
. WALL/FENCE PERMIT
Additional desc .
Permit Fee . . .
. 15.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation .
. 224
Expiration Date
11/23/09
Qty Unit Charge Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
14 LN FT X 4 FT HT
BLOCK WALL PER CITY
STANDARDS AND APPROVED PLANS FOR TRASH
ENCLOSURE.
------------7----------7----------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged Paid
Credited
Due
Permit Fee'Total
--------------------
15.00
--------------------
.00 .00
15.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
1.00
.00 .00
1.00
Grand Total
16.00
.00 .00
16.00
LQPERAi[T
I
APPROX.
NORTH
ASD D'j T I ON o I
Scope of work: V high Trash Enclosure 8' wide 40 0 N
iwith two 32" returns.
.
.....................................................
' -
.................................................... Option A: Planter bed in
.............................. front of enclosure.
.......................:',EX I ST I N.6 .........................
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5 X —455 DESERT . GLiJB DRIVE
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SITE PLAN t
5CALE: 1/8' = 1' -o" CA L L E CADIZ
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HIBIT
1SE N®•
PLRN
5CALE: 1/8" = P-0"
A',DDITI
Scope of work: 4" high Trash Enclosure 8' wide
with two 32" returns.
:::::....... ...........
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::::::::::::.EXISTING::: :::::::::::
:::::::: 0FF1(E ::::::::::::: :::::::: ::::::.::::::::......:::::. :::::
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AP1V 770 153 003
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B'° #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 #
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Project Address: ,l�CJ&J.1r CiLVB -UZ;
Owner'sName: (3013 Eae.%4�(S
A. P. Number. • 7 7 O - /5- 3— 0o3
Address: .J 7 - VS- bee va- CLr/Q be
Legal Description: Lo %/ z)6-r&
Contractor: 4 L/A- 1 n/S 'fW oT7)N SNC
city. ST, Zip: LA &vt°,✓ 7-A CA ? LLS 3
- w•;; � tr. +:s�•-: •+• max•
Telephone:
Address: f hAe 4S "a V
Project Description:
City, ST, zip:
l y .4 F 1Y g /o GK . tua- /I PCNL 49'
Telephone: / D
i�i3::i)": vrw,iy—'. <`..T • f
ex�t"'�;'i��
nn
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S i /�4r✓pti f GL� D �i !_/"/Lo t/ S
State Lic.#: 6 Y gs
City Lie. #c 3 ZIz
PLA, r►. I •t�tl, F__'Va/oSti/fe,
Arch., Engr., esigne r-:!-D (?A � dA W- V t
S T'v GC o 1f i , rs A T—o /`" + cJ, OFPrce—
Address: SR-n, A-S
BV,�dld6r. Gle. m*I 6�,J +cn,, MS A&m�rr
City., ST, zip:
{7 9' 0 Z6 �ti r`j7an1 uNcetJt- COAISraUCrAd
Telephone:
State Lic. #- yoJ RC�G231t
».r Vz �'i�. iu:i�';s,. +
- 'f
`'Std`',:•:•ii
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: C-P
Sq. FL: it Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Reed
TRACKING
PERAnT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
211 Review, ready for correctionstissue
Electrical
Subcootactor 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
Pub, Wks. Appr
Date or permit issue
School Fees
Total Permit fees
TANDY`S INSPECTION SERVICES, INC.
PO BOX 13766 - PALM DESERT, CA 92255-3766
OFFICE/FAX•• ••• •
SPECIAL INSPECTION DAILY I WEEKLY REPORT
TYPE OF INSPECTION PERFORMED PERMIT NUMBER E OF STRUCTURE DATE(S)
RESIDENTIAL COMMERCIAL f
PHYSICALADDRESS (INCLUDESTREETNAME AND CITY) JC*•NAME(INCLUDE NAME OF COUNTRY CLUB I BUSINESS PARK/ CORPORATE CENTER / LOT NUMBER." ECT.)
ARCHITECT t � ENGINEER r5
Vj
GENERALCONTBACTOR- .-k _ -a- SUBCONTRACTOR
WELDING INFORMATION
WELDERS NAME CERTIFYING AGENCY'S NAME AND ID NUMBER PROCESS AND ELECTRODE
SAMPLE INFORMATION
LOCATION:
LOCATION:
TO THE BEST OF MY KNOWLEDGE, WORK INSPECTED WAS IN ACCORDANCE WITH THE
BUILDING DEPARTMENT APPROVED PLANS, SPECIFICATION AND APPLICABLE
WORKMANSHIP PROVISIONS OF THE IBC EXCEPT NOTED ABOVE
INSPECTORS SIGNATURE
INSPECTORS CERTIFICATION AGENCY AND NUMBER