12-0714 (D34)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 1'2=0;00007.14 ."
Property Address: 55539—FIRESTONE-
APN: 775 -151 -003 -
Application description: DEMO - COMML/OTHER
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 0
T44t
"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Applicant: Architect or Engineer:
PIP
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section ]]jj000) of Division 3 of the Bu s d Prof si Tal Code, and my License is in full force and effect.
License,Classi B License N 684857
�te(P_. ntractor:
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).:
(_) 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 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.).
(_ 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:
LQPERMIT
Owner:
BILL GORDICA
55539 FIRESTONE
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
:TIONS (760) 777-7153
Contractor:
EDWARDS CONSTRUCTION INC,
51455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
(760)777-8202
Lic. No.: 684857
6/26/12
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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 the work for which this permit is
►/ issued.
RL 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 GRANITE STATE Policy Number WC1914223
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 become subject to the workers' compensation laws of California,
and agree that, if oul a ome ct t he workers' compe anon provisions of Section
3700 of the Labor Cod , 1 II f ith ply with thosepro Bions.
I �
ate: `� Ap 'ant:
WARNING: FAILUR TO'SECURE WORKERS' 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.
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 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 thA[Kuildinv
rmation is correct. I agree t comply with all
city and court y ordinances and state laws relating toc ' , an ereby authorize epesentatives
of this co my to enter upon the above-mentioned prn pur s.
ate: /Sigre (Applicant or Agent):
Application Number . . . . . 12-00000714
Permit . . . DEMO PERMIT.
Additional desc .
Permit Fee . . . . 45.00
Plan Check
Fee
.00
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date 12/23/12
Qty Unit Charge Per
Extension
BASE
FEE
45.00
----------------------------------------------------------------------------
Special Notes and Comments
DEMO EXTERIOR GARDEN WALLS TO PREPARE
FOR FUTURE CASITA ADDITION. 2010
CODES.
Fee summary Charged
-------------------------------------
Paid Credited
--------=-----------
Due
Permit Fee Total 45.00
.00
.00
45.00
Plan Check Total .00
.00
.00
.00
Grand Total 45.00
.00
.00
45.00
LQPERMIT
June 21, 2012
Mr. Bob Edwards
Bob Edwards Construction, Inc.
51-455 Desert Club Drive
La Quinta, CA 92253
RE: 55-539 Firestone —Demolition Phase
Dear Bob,
Your request of June 18, 2012, to start the demolition phase of the casita and kitchen remodel at the above referenced
address Is acceptable based on the following conditions:
1. It is understood that proceeding with a demolition permit and demolition, is based on a three week timetable
for your receipt of a building permit from the City of La Quinta.
2. It is understood that during this three week demolition period, the site will be fenced with screening and the site
kept safe.
3. Any damage or disruption to HOA property is to be replaced/repaired as necessary, without delay, and to the
satisfaction of the HOA.
4. The conditions are noted to maintain the interest of the neighboring homeowners and to assist Mr. Gordica. If
they are acceptable please sign and return a signed copy by yourself and Mr. Gordica.
If you have any questions, please contact me.
Cordially,
Steve Herthel
Architectural Chairman
Enc:1
cc: Architectural Committee
William GorcI --Homeowner-55-539 Firestone
Bob EdwhAff— Bob Edwards Construction, Inc.
Date
A
Date
rA
40
4
isI" iv
City of La Quinta
Building a Safety Division '
P.O. Box 1504, 78-495 Calle Tampico i
La Quinta, CA 92253 - (760) 777-7012 t-
Building Permit Application and Tracking Sheet
Permit #
l I
Project Address: 15-57,5-31 V'f— wrier's Name:
A. P. Number: Address:3 qWp
Legal Desero :
i iCity, ST, Zip:7WFto
Contractor: le hone:
eP
Address: - U Project Description: LLQ cid
City, ST, Zip: GV 22,53 t�–,
Telephone: e h
P R2 lid �� `t ZZ21
State Lic. # : �
�p �.
City Lic.,#:
Arch., Engr., Designer:
t
S
Address:
City, ST, Zip:
......................................................
.......................................................
......................................................
.......................................................
TelePh Construction T)P e:Occupancy:
Telephone: 7DZ2-�3
Project type one): Add'n Alter
Repair Demo Lic.
lit
Name of Contact Person: q. Ft.: # Stories: # Units:
Telephone # of Contact Person: stimated Value of Project:
PC
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
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
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.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'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