04-5570 (BLCK)TAW
. f 44Q"
BUILDING & SAFETY DEPARTMENT
P.O. BOX 1504 (760).777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153
BUILDING PERMIT
Application Number . . . . . 04-0.0005570` Date 7/20/04
Property Address . . . 52500 EISENHOWER DR
APN: 773-301-001- - -
Application description WALL/FENCE
Property Zoning . . . . . . . COVE RESIDENTIAL
Applicatign valuation . . . . 2500
Owner Contractor
------------------------ ------------------------
JOSEPH BIRDSELL BIRDSELL BUILDERS, JOSEPH
78073 JALOUSIE DRIVE 35558 SUMMERLAND AVENUE
PALM DESERT CA 92211 PALM DESERT CA 92211
(760) 360-2301
WCC: DAUGARD INS
WC: 22946491 11/01/04
CSLB: 811293 08/31/05
CCC: B
Permit. . . . . . . WALL/FENCE PERMIT
Additional desc
Permit Fee 54.00 Plan Check Fee .00
Issue Date Valuation . . . . 2500
Qty Unit Charge Per Extension
BASE FEE 45.00
1.00 9.0000 THOU BLDG 2,001-25,000 9.00
------------------------------------=---------------------------------------
Special Notes and Comments
100 L.F. 6' GARDEN WALL, CITY STANDARD
Fee summary Charged Paid Credited Due
---------------------------------------------------------
Permit Fee Total 54.00 .00 .00 54.00
Plan Check Total .00 .00 .00 .00
Grand Total 54.00 .00 .00 54.00
0 004 Ir
CITY OF LA QUINTA
P.O. Box 1504�� VOICE (760) 777-7012
T-Vf
78-495 CALLE TAMPICo FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: ZI - �� 7� Date:
Applicant: I Architect or Engineer:
Applicant's Mailing Address:
Architect or Engineer's Address:
A) //4 .
Lic. No..
BUILDING PERMIT DECLARATIONS
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
SpdiF and my Licenser is in full force and effect.
..-,License Class LS ilcense No. 6
Date 2 C ntractor9
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt 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 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 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 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).):
U 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 or 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.).
U 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 projec"s with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
U I am exempt under Sec. , B.8 P.C. r thi reason
Date !^G�� 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 workers' compensation rice carder policx number ar
Carrier l�.srrG.cn � I VAIV olicy Number � Z �r �f e c? /
_ I certify that, in the performance of the work for which this permit is issued, r shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,end a ree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those-provii ions.
rl �Z
/6ate p?� plicant
WARNING: FAILURE TO SECURE WORKE 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.).
Lender's 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 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 cant
I certify that I have read this application and state that the above in rmatio is rect. I agree o comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this coun t enter on / above m ti ed property for inspection purposes.
Date \ �— Vig�5 nature (Applicant or Agen
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under .
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 2,615 S.F. or $5,857.60 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC -La Jolla Bank -Joseph Birdsell Check No. 800538
Name on the check Telephone 409-7070
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Beth Schieferstine Payment Recd 1$0.00
o $5,857.60 Over/Under
Signature "Qle�
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the DistrictCs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building DepartmenUApplicant Copy - Applicant/Receipt Copy - Accounting
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District�4��N0
47950
Dune Palms Road
U
¢ aERMUDADNES r
Date
7/19/04
La Quinta f CA 92253
RANCHO MIRAGE d
� INDIAN WELLS
No.
26188
(760) 771-8515�.�
PALM DESERT
LA QUINTA �y
.
�INDIO y�
O
Owner
Joseph Birdsell
APN #
773-301-001
Address
52500 Eisenhower
Jurisdiction
La Quinta
City
La Quinta Zip 92253
Permit #
Tract #
Study Area
Type
Single Family Residence
No. of Units
1
Lot # No. Street
S.F. Lot # No.
Street S.F.
Unit 1
52500 Eisenhower
2615 Unit 6
Unit 2
Unit 7
Unit 3
Unit 8
Unit 4
Unit 9
Unit 5
Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under .
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.24 X 2,615 S.F. or $5,857.60 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC -La Jolla Bank -Joseph Birdsell Check No. 800538
Name on the check Telephone 409-7070
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Beth Schieferstine Payment Recd 1$0.00
o $5,857.60 Over/Under
Signature "Qle�
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or
other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which
those amounts are paid to the District(s) or to another public entity authorized to collect them on the DistrictCs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building DepartmenUApplicant Copy - Applicant/Receipt Copy - Accounting