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BWFE2015-013078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&,y 44Qalgro COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2015-0130 Property Address: 52700 EISENHOWER DR APN: 773301012 Application Description: HUDSON / 45' OF 6' GARDEN WALL AT SOUTH SIDE YARD Property Zoning: Application Valuation: $4,000.00 Applicant: EDWARD J STRZELCZYK 7.al P O BOX 7114 aEDWARD LA QUINTA, CA 92248-7114 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: B CSO C29 License No.: 439904 (� Date: " Contractor: ✓ �M G7_y 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).: (_J 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.). (_) 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 a contractor(s) licensed pursuant to the Contractors' State License Law.). (_) I am exempt under Sec. 9. 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/26/2015 Owner: RONNIE HUDSON LU iz Contractor: 7.al aEDWARD J STRZELCZYKaPO BOX 7114o 0 LA QUINTA, CA 92248-7114 d Q �:o cG U Z (760)578-0201 Llc. No.: 439904 r_, �v 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 thigVfor which this permit is issued. SrI have and will maintain workers' compensation insurance, as required by on 00 of the Labor Code, for the performance of the work for which this permit 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 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: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I 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 Building Official 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 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 city to enter.upon the above- mentioned pr perty for inspection purposes. DSignature (Applicant or Agent FINANCIAL •• • DESCRIPTION ACCOUNT QTY AMOUNT. PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forFENCE OR FREESTANDING WALL- TOTALS:09 $108.77 $0.00 00 Description: HUDSON / 45' OF 6' GARDEN WALL AT SOUTH SIDE YARD Type: WALL/FENCE Subtype: Status: UNDER REVIEW Applied: 5/26/2015 SKH Approved: Parcel No: 773301012 Site Address: 52700 EISENHOWER DR LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 144 Lot: 12 Issued: UNIT 15 Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $4,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 45 LF OF 6' GARDEN AT SOUTH PROPERTY LINE SIDE YARD [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES Printed: Tuesday, May 26, 2015 4:28:38 PM 1 of 2 CR SYSTEMS CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT EDWARD J STRZELCZYK P O BOX 7114 LA QUINTA CA 92248- 7114 CONTRACTOR EDWARD J STRZELCZYK P O BOX 7114 LA QUINTA CA 92248- 7114 OWNER RONNIE HUDSON 42481 CORTE MURRIETA CA 92253 CANTANTE Printed: Tuesday, May 26, 2015 4:28:38 PM 1 of 2 CR SYSTEMS _DESCRIPTION ACCOUNT A QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD FINAL" BLD BY BSAS S81473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $0.00 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $0.00 100 LF PC Total Paid for FENCE OR FREESTANDING WALL- $108.77 $0.00 TOTALS:•• 0• SEQID INSPECTION TYPE INSPECTOR SCHEDULED DATE INSPECTIONS COMPLETED DATE RESULT REMARKS NOTES BOND BEAM BLD FINAL" BLD FOOTINGS BLD PARENT PROJECTS BOND INFORMATION Printed: Tuesday, May 26, 2015 4:28:38 PM 2 of 2 NAff C1? SYSTEMS Bin # 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 # Project Address: �% - �� 4 w D -a, Owner's Name: A. P. Number: Address: J "A . , " L"Jkaki-eA- &A c Legal Description: City, ST, Zip: . er- ell 1 Contractor: Z telephone: hone• Address: [/ Project Description: City, ST, Zip: Telephone: - -O vs State Lic. # : j 0 City Lic. #.- Arch., Engr., Designer: Address: City., ST, Zip: Telephone: e. aneY Constructi n Occupancy: i State Lc. #:ProJect type le one): Add'n Alter Repair. ir. Demo Name of Contact Person: Sq. Ft.:# Stories: # Units: Telephone # of Contact Person:Estimated Value of Project: i APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, 'ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3' Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr bate of permit issue School Fees Total Permit Fees SITE PLAN SITE ADDRESS-�'D 6iS 6NkDW tAl OAS 6�dU�Lw 9i ASSESSORS PARCEL NUMBER W Provide North Arrow REAR PROPERTY LINE S I D E P R O P E R T Y L I N E FRONT PROrERTYLINE 284-199 (Rev. 06/2009)