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08-0364 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00000364 Property Address: 51125 EISENHOWER DR APN: 773-065-024- - Application description: WALL/FENCE Property Zoning: VILLAGE COMMERCIAL Application valuation:' 1025 Applicant: Architect or Engineer: ----------------- LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT I herebyaffirmunder penalty of perjury that,( 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: C29 License No.: 823181 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 Lice^^r,e Law (Chepter.9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or the. or she is exempttherefromand the basis for theallegedexemption. Any violation of Section 7031.5. by any plicant for permit subjects the.applicartt to a civil penalty of not more than five hundred dollars (9500).: (_ as owner of the property; or my employees with wagesas their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contraciors' 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 arenotintended 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, 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 alcontractor(s) licensed pursuant to the. Contractors' State. License Law.). (_) I am exempt under Sec. , B.&P.C. fortes reason Date: er/114 / Owner: CONSTR CTION LENDING AGENCY I.hereby affirm under pen ahy r'jury that there is aconstruction lending agencyfor the performs a of -the work forwhich this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT ® CcATIACT09 VOICE (760) 777-7012 FAX (760)'777-7011 INSPECTIONS (760) 777-7153 Date: 3/24/08 Owner: MOONEY GEORGER rn TF n 51125 EISENHOWER LA QUINTA, CA 922 ( 1H -MAIL 241000 Contractor: FEDOR MASONRY INC P.O.. BOX 1397 LA QUINTA, CA"9.22:47 (76,0)772-3036 Lic. No.: 823181 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 theworkfor 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 anis policy number are: Carrier :ENDURANCE AMRCN Policy Number WEN100232501. _ 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 a reethat, if I should become subjectte the workers' compensation provisions of Section j 370 the Labor Code, forthwith comp) iththase provisions. Date�I" plicant: - - WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFU ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN LTIESAND CIVIL FINES UPTO 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 behalfthisapplication is.mad Ia, each person at whose request and for whose benefit work is performed under or pursuant to anypermit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend,.indemnifyand 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..I agree to comply with all city and county ordinances and state laws relating to building co ruction, and hereby authorize representatives of'thiiss c ty t nter upon the above-mentioned property _ spection purposes. Oat yt/ Signature (Applicant orAgent)' Application Number 08-00000364. Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 27.00 Plan Check Fee 00 Issue Date . . . . 2/28/08 Valuation 1025 Expiration Date 8/26/08 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 2.0000 HND BLDG 501-2,000 12..0'0 -------------------------- t ---------------- I --------- --------------- Special Notes and Comments < 41 IN FT X 6 FT HT RET WALL TO CITY STANDARDS AND APPROVED PLANS. February 2.8, 2008 10:35:01 AM pjuarez. Other Fees . . . . . . . . . CHANGE OF CONTRACTOR 4.50 Fee summary Charged Paid Credited Due Permit.Fee"Total 27.00 27.00 .00 .00 Plan Check Total. .00 .00 .00 .00 Other Fee Total 4.5;0 .00 .00 4..50 Grand Total 31.50 27.00 .00 4.50 LQPER.MIT P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application NumGer: 08-00000364 Property Address: 51125 EISENHOWER DR APN: 773-065-0.24- - Application description: WALL/FENCE Property Zoning: VILLAGE COMMERCIAL Application valuation: 1025 a 1 #5 ____ # I Applicant: Architect.or Engineer: LICENSED CONTRACTOR'S DECLARATION BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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. LicenseClass: C15 C54 B _ License No.: 756194 ^ n Date: 1 Contractor: 1 A oWTE LL. 4-4(t � G C.W $-T4U(;r 1CeJ 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 construm.aher, 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 apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500):: 1 _ 1 1, as owner of the property, or myemployees.with wages as their sole compensation, will do the work, and the,structureisnot.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 orimproves.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 improvemen0s sold within oneyear 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. whocontracts for the projects with a contractor(s) licensed pursuant tothe Contractors' State License LawJ. ( 1 Iam exempt under Sec. , B,&P.C: for thisireason 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: MOONEY GEORGE R 51125 EISENHOWER LA QUINTA, CA 92 ( Contractor: MONTELLANOS CONS 79733 DANDELION LA QUINTA, CA 92 (760')360-0899 Lic. No.: 75.6194 VOICE (760) 777-70.12 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/28/0.8 WORKER'S COMPENSATION DECLARATION 'I hereby affirm under penalty of perjury one"of.the following declarations: _ I haverand will.maintain acertificate -of consent to self -insure for workers' compensation, as provided for by Section -3700 of the Labor Code, for the performance, of thewwork for which this permit_is issued. _ Ihave 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 islissued. My workers' compensation insurance carrjerand 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 soas to become "subjeartothe workers' compensation laws. of California, and agree that,;if I should become subject to the workers' compensation provisions of Section �t Q 3700 of the Labnode,shall forth- h comply with those provisions. Date:<Zp� .Applicant: WI WARNING> FAILURE TO SECURE -WORKERS' COMPENSATION COVERAGEI'IS'UNLAWFUL, AND SHALL SUBJECT AN EMPLOYERTO'CRIMINAL PENALTIES AND CIVIL FINES UPTO 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 fora permit subject to the conditions and restrictions set forth onthis application. 1. Each person upon whose behalf this application is made, each person atwhose 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 cessatiomof work for 180 days wilbsubject 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 lawsrelating to ilding construction,.and:hereby authorize representatives of"this county to enter upon the above-mentioned pro y Io jn 'o oses. Date:` n ��� Signature (Applicant or Agent): Application Number . . . . . 08-00600364 Permit . . . WALL/FENCE PERMIT Additional desc . . Permit Fee . . . . 27.00 Plan Check. Fee .00 Issue Date . . . . Valuation . . . . 1025 Expiration Date . . 8/26/08 Qty Unit Charge Per Extension BASE.FEE 15.00 6.00 2.0000 HND BLDG 501-2,000 12.00 ----------------------------------------------------------------------------------- Special Notes and Comments 41 LN FT X 6 FT HT RET WALL TO CITY STANDARDS' AND APPROVED PLANS. February 28, 2008 10:35:01 AM pjuarez. Fee summary Charged Paid Credited Due Permit Fee Total 27.00 .00 .00 27.00 Plan Check Total .00 .00 .00 ..00 Grand Total 27.00 .00 .00 27.00 LQPEMrr Bim # City of La Quinta Building ex Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta; CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # J Project Address:' SI'`a S ^ w�- Owner's Name: Utz (tion, A. P. Number: Address: Legal Description: Contractor: S M1 u o Address: R "1 ` ti City, ST, Zip: Telephone: ( Project Description: city, ST,.Zip: �. �c.. izSjv:, ` o r -e yr .: 1 Telephone: -1 lo. 03loc� f L/ 1=14 1 o ; „ ��' ' State Lic. # City Lic: #: Arch., Engr., Designer: Address: City, ST,.Zip: Telephone: State Lic. #: IlR Name. of Contact Person: Construction Type: Occupancy: Project type (circle one):, New Add'n Alter Repair Demo Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: � Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACIONG • 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 Energy Calcs. Pian&oicked up Construction Flood plain plan Plans resubmitted. Mechanical Grading plan tad Review, ready for correctionslissue Electrical Subcontactor:List. Called Contact Person Plumbing Grant Deed Plan&picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 30 Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person, A.Lpx. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees I James Fedor Masonry, P.O. Bet 1397, La Qaima, Ca. 92247 Td (760) 772.1036 Fax (740).112-3313 Lloemoc-29.829181 "Propm8l" . Ref # 675 March 6, 2000 George Mooney 51125 Eisenhower La Quints. Ca 92M Phone: (760) 586-0012. 'Fax: (760) 341-1632 Re: 61125 Eisenhower — La Quirda Inc 41 LF of Tan Precision BlockII $3,067.00 Demo side of rear wood tenoe (�oR� �''� �'I�.W JIVId N) TOTAL COST 0 $3.657.00 ,/QLD/�<N-i �r � �✓�Gr�,2�,. � 6i� a��r �L Res fly Submitted, Bob Gartner O O Customer Approved: Signature Tide Date Z/1 A 89WON EZ£E-ZLL-09L A O 80033 S3AVf WdZO:Z 80OZ A 1eW