05-1180 (BLCK)T4hf °f 4 Q"
P.O. BOX 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760) .777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number . . .
. . 0 -0M•0 80 Date 3/30/05
Property Address . . . .
. .. 52300 EISENHOWER DR
.APN:
773-271-003-20 -000000-
Application description .
. . WALL/FENCE
Property Zoning . . . . .
. .. COVE RESIDENTIAL
Application valuation . .
. . 1624
Owner
Contractor
JOSEPH BIRDSELL
BIRDSELL BUILDERS,
JOSEPH
78073 JALOUSIE DRIVE
P.O. BOX 680
PALM DESERT CA 92211
LA QUINTA
CA 92247
(760) 360-2301
WCC: ROSTEN INS
WC: 2292649105
11/22/05
CSLB: 811293
08/31/05
CCC: B
-----------------------------------------------------
Permit WALL/FENCE
----------------------
PERMIT
Additional desc
Permit Fee . . . .
39.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 1624
Qty Unit Charge Per
Extension
BASE FEE
15.00
12.00 2.0000 HND
BLDG 501-2,000.
•24.00
---------------------------------------------=------------------------------
Special Notes and Comments
75 LF 5' BLOCK WALL IN FRONT YARD PER
CITY STANDARD.
Fee summary Charged
----------------- ----------
Permit Fee Total 39.00
Plan Check Total .00
Grand Total 39.00
Paid Credited Due
---------- ---------- ----------
.00 .00 39.00
..00 .00 .00
.00 .00 39.00
MAR � 11005
Clr1'OFl.q Q— N
NrAA
,FINA
P.O. BOX 1504 Tit�1444"
VOICE (760) 777-7012
78-495 CALLS O FAX (760) 777-7011
LA QUINTA, CALIFORNIAFORN92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: ") ——
11 O I Dater
Applicant:
Applicant's Mailing Address:
I hereby affirm under penalty of perjury that I am licensed
Code, and my Licerse<i�sin full force and effect-
L�nse Class
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals
rise No.
OWNER -BUILDER DECLARATION
I heretly affirm under penalty of perjury that e1ript from the Contractors' 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 repel 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 Contractors' 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 703 1, 5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars
U 1, as owner of the property, or my employees with wages as their sole compensation. will do the work, and the structure Is naI intended a 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 a herself or through his or her own emptoyees, 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.),
U 1, as owner of the property, am exclusively contracting with licensed con Ira clans to constructthe 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 conlractor(s) licensed pursuant to
the Con tractprs' State License Law-)-
V I am exempt under Sea . B - & p-C- for this reason
Date Owner
WORKERS' 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 rkers' compensation insurance carrier and policy number are: _
Carrier _.'"j7�»�W r r4 Palicyi��f S
I certify that, in the performance of the worts 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 provisic s
WARNING: FAILURE TO SECURE WORK \H 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.
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.).
Lenders Name
Lender's Address
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 parmil 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 car, Ilation.
I certify that I have read this application and state that the above in for a,aan 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 cc Illy to nter n the above-ment ned property for inspection purposes.
Signature (Applicant or A enl
g
4
Concorde Consulting Group
Construction Management . Project Management . Engineering v Development
December 9, 2004
Mr. Joe Birsell
Bid, LLC
La Quinta, CA
RE: 52-300 Eisenhower Road, La Quinta, CA — Structural Observation Letter
Dear Joe
Per my structural observation on December 9, 2004, we find the work to have been completed per
general construction practices and in compliance with the plans and code.
If you may have any further questions, please call us at our office,
ire] ,
Raj . N an
Vice President
cc. K.M.Kripa
W
4511 E. Sunnydunes Road Ste # E Palm Springs, CA 92264 Ph: (760) 322-8626 Fax: (760) 416-1893