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08-1503 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 08-00001503 Property Address: 52245 VIA SAVONA APN: 772-480-024- - - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1623 Applicant: Architect orr Engineer: Il/../ BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 nd Professi nal? Code, and my License is in full force and effect. License Class: BLicense No.: 671203 Date' 3'08 Contractor: 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).: (_ 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.). 1 _ 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.). ( ) 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: O'BRIEN, MICHEAL & P.O. BOX 726-98009 BELLEVUE, WA 98009 ( BILLIE Uritractor: PIERCE CORPORATION, P.O. BOX 3420 PALM DESERT, CA 9226 (760)346-3228 Lic. No.: 671203 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/02/08 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. 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 DELOS INS CO Policy Number 01DKRM12003819 _ 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 agreethat, if I should be me su 'ect to the workers' compensation provisions of Section AA3700 of the Labor C de, I I h comply with those provisions. Date: 9* 3 ' V 8 Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 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 buildinconstruction, a d hereby authorize representatives of this county to enter upon the above-mentioned property r ins oses. Date: 9, 3 *GS Signature (Applicant or Agent): Application Number . . . . . 08-00001503 Permit . . I. . . WALL/FENCE PERMIT Additional desc . . Permit Fee 39.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1623 Expiration Date . . 3/01/09 Qty Unit Charge Per Extension BASE FEE 15.00 12.00 2.0000 HND BLDG 501-2,000 24.00 ---------------------------------------------------------------------------- Special Notes and Comments 58 LN FT X 6 FT HT GARDEN WALL / 8 IN FT X 5 FT HT GARDEN WALL TO CITY STANDARDS (1) PILASTER @ 24" X 24" Fee summary Charged ------------------------------------- Paid Credited ---------- ---------- Due Permit Fee Total 39.00 .00 .00 39.00 Plan Check Total .00 .00 .00 .00 Grand Total 39.00 .00 .00 39.00 LQPERMIT SL IASSOCIATION EASEMENT Bin # City of La Quinta Building u Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 7 -7-1 ®� Building Permit Application and Tracking Sheet Project Address:' 51,g,4r, gjjj 54,16a FAddreqv ner's Name: �� ,� w� 0,50;;71 l ;. I A. P. Number: 1'[�. dqp� p2�,� yt bA (a..,.. . A f n�...a 1�► - - + Legal Description: -TVA0 . Zg 44.4 .I3'.. aiZ% �b. I ' I n - r/"- t City; ST, Zip: Contractor: JWCPOW� Telephone: Project Description: Address: 44.; g** air LowYOd 04b Ci,tyST, Zip: Mm WI -W t I ,oOP P4& PYLASeV Telephone: -019; .�, City Lic. #: 4144 Lf 1 WAQ. aeLic.#: L{i �2 Arch., Engr., Designer: 01*14 AWA(46i5 Address: %0$11 `liar Al*. 40114.%a City, City, ST, Zip:1jA4T A" kI4*j Telephone:114.44 - Zyob State Lic. #-:609 f1m Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Telephone # of Contact-Person:16 . ;4 -mg, x • 34 Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE . N Submittal Req'd Recd TRACKING PERMIT FEES Platt Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check 3alance Energy . Calcs. Plans picked up Construction. Floodplain 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:- Review, ready for corrections/issue Developer In: pact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees