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05-4562 (BLCK)P.O. BOX, 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 05-00004562 Property Address: 54365 EISENHOWER DR APN: 774-252-018-6 -000000- Application description: WALL/FENCE Property Zoning: COVE RESIDENTIAL Application valuation: 2050 Applicant: T4'!t44Q"'- Architect or Engineer: P 11 na 12 2005V Owner:. SPRINGER VELMA 1AQUIWA 54365 EISENHOWER DRIVE FIFIiANCED�6s'T LA QUINTA, CA 92253 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 Profes 'onals C , and my License is in full force and effect. License Class: 13 C99 C53 Li No.: 435033 Date: U G 6 ntractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of per))'I jj,, I am exempt from the Contractor's State License Law for the following reason (Sec. 7031 .5, 8trkinesSrand Professions Code: Any city or county that requires a permit to construct, alter, improve, demol' h, 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).: 1 _ 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.l. (_ 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 who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 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: P IR LQPERMTI' Contractor: STOKER CONSTRUCTION, INC. 56471 TWENTYNINE PALMS HWY YUCCA VALLEY, CA 92284 (760)365-8691 Lic. No.: 435033 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/11/05 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ 1 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'STATE FUND Policy Number 1542853-2005 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. he workers' compensation provisions of Section 3700 of the Labor Cod , shall f rt ith ply with those provisions. :a.,a. pp11icantRNING: FAILURE TO SECUR ORK RS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C INAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN AD ION 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 Quints, 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 1 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 bu' ing constryejion, and hereby authorize representatives of this cou to ter upon the above-mentioned pro y f 'ns �c ( n urposes. Pate: �Q'J Si lure (Applicant or Age Application Number . . . . . 05-00004562 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 54.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2050 Expiration Date 4/09/06 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 40 L.F. COMBO WALL, 2' RETAINING, 5' GARDEN, 42 L.F. 6' GARDEN WALL BOTH ORCO SYSTEM 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 LQPERMIT Bin # City of La Quinta Building & 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: ^) c{-'�cS /56W tMtz)Lve Owner's Name: P V2 A. P. Number: Address: Legal Description: City, ST, Zip: 1 � q 22S'-2, Contractor: Telephone: I Address: ' D Project Description: f City, ST, Zip: CJe�,L X22 `i —4o ILF, Cew,%, toau 2' v ar I Telephone: State Lic. # :-c{ City Lic. #: — Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type:Nj�0� Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING. PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Energy Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd 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:- 7'd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees A 1 EX BLOCKWALL U V �Lr�.S�LI—LJ SCALE IN FEET 10 0 10 20 �_ I r � v 1 SII i II EX SWR LAT LL �� E CUf� I GUTTER LL LEGAL DESCRIPTION LOT 6 BLOCK 299 ( II SANTA CARMELITA AT VALE \ LA QUINTA UNIT #27 OWNER: MB 19/82 VELMA SPRINGER 54365 EISENHOWER DRIVE © 2005 JHA ENGINEERING, INC. LA QUINTA, CA 92253 (760) 771-5175 SITE PLAN FOR NEW BLOCKWALL M---A FOR VELMA SPRINGER 54-365 EISENHOWER DRIVE LA QUINTA ENGINEERING, INC. Consu7tingCi 'n"neersBS-- 30 SEPT 2F0532752-20 ORGES J HACKER 41921 Beacon Hilt Prom: 7a6779OG57 PLOTTING S ML WO# ParoaSuite, Co. 92211 e-Maepw&sdm�og 1 "=10' 105-3252 i Building Address Owner Mailing Address Contractor Address rZip� �"�_ ty izip I Tel. State Lic.I City & Classif. Lic. q Arcn., tngr., Designer Address Tel. P.O. BOX 1504 78-105 CALLE ESTADO OUINTA, CALIFORNIA 92253 CityI Zip I State I Lic. q LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm 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. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5.Business and Professions Code: Any city or county which requires a permit to construct, alter, improve• demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemp:Ion. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o! not more than five hundred dollars ($500). 1-2 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon pnd who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. d, however, the building or improvement is soldlwithin one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I i I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I"' I am exempt under Sec. B. 6 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company n Copy is filed with the city. C Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORK E RS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thF work for which this permrt Is issued, 1 shall not employ any person in any manner so as to become subject to tt)e Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shell be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and vatidated, and is subject to expiration it work thereunder is suspended for 180 days. 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 the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip FINANCE pa CV APPLICATION ONLY WING: TYPE CONST. OCC. GRP P. Number Legal Description �f / Project Description�— Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation , PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S. M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: W411-1 90 ev, 10