BWFE2016-010378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
COMMUNITY DEV E 411MAV10tPARTMENT
BUILD RMITQ
• ice._
Application Number:. BWFE2016-0103
Property Address: 78280 VIA SEVILLA,
APN: 604201010
Application Description: WALLUM RESIDENCE / 59 LF WROUGHT IRON
Property Zoning:
Application Valuation: $5,000.00
Applicant:
ARDEN WALLUM
78280 VIA SEVILLA
LA QUINTA, CA 92253
It'Iri i
i VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
nn .Date: 5/2/2016
r{Pb4 M
S ILLA
NTA, A 92253
CITYOFLAQUINTA
CQMA#T.NITy DEVELQPMENT DEPARTMENT
Contractor:
Llc. No.:
-
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LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I herffirm under penalty of perjury one of the following declarations:
9 {commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: _ License No.:
of th ork for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Date: Contractor:
Sectio 700 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:
OWNER -BUILDER DECLARATION
Carrier: _ Polity Number: —
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performanceof the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair.
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with tha provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
f.�
V I
3 of the Business and Professions Code) or that he or she is exempt therefrom and.the –
Date:— - Applicant:
. basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora
ri ✓�
permit subjects the applicant to a civil penalty of not more than five hundred dollars
��
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO.THE COST OF,
compensation, will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official fora permit subject to
within.one year of completion, the owner -builder will have the burden of proving that
the'conditions and restrictions set forth on this application.
she did not build or improve for the.purpose of. sale.).
1. Each person.upon whose behalf this application is made, each person at whose
1, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project.' (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant;: each agrees -to, and
'State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify.and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for.the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
t(tQtyontractors'
State License Law.).
following issuance of this permit. .
I am exempt under Sec. , B.&P.C. for this reason
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
6-, ___
Date: ✓ Owner:
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.
CONSTRUCTION LENDING AGENCY
I agree to comply with all city and county ordinances and state laws relating to building
I.hereby affirm under penalty of perjury that there is a construction lending agency for
construction, and hereby authorize representatives of this ci o enter upon the
the performance of the work for which this permit is issued (Sec. 3097, Civ..C.).
Lender's'Name:
above-mentis�eproperty for inspection purposes.,.
(D e_ ~. � Signature(Applicant or Agent):
Lender's Address:
4
FINANCIAL • • • •
x-
bESCRIPTION h ',MN4 ' ACCOUNTSz� yQTY " PAID PAID DATE.
F AMOUNT`s�
x
BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/2/16
€€,,^ `'.;'"ii *,': ,, �'• ;a. _..;: ,zs axx a:;.:.. ,&y
PAID BYa a {METHODs< CHECK BY
x- ,: , , ;.: fi . o � ,
ARDEN WALLUM DEBIT R15179 BWFE2016-0103 MFA
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1:00 $1.00
g DESCRIPTION •`` 'rvA �§ e 4
#ACCOUNT&:r ',
QTY`
AMOUNT'S
`? j 'PAIDsA
PAID`DATE
r
s
WALL/FENCE -FIRST 100 LF
101-0000-42404
0
$47.86
.$47.86
5/2/16
l;.sg z 7 •< n -:- x �( .,; > x` 4x
P PAID BY s"+:: `
S, a:: € Y -...
METHOD'
,�.
RECEIPT #
_.iz x*^ a .�a
r,...s
BY,
� •,..
,
<��;,. a
3 r •CHECK*#-V;'CLTD
ARDEN WALLUM
DEBIT
R15179
BWFE2016-0103
MFA
� $'4 iK
ACCOUNTt,,
QTY
AMOUNT
PAIDJI
PAID DATE`
t r tlDESCRIPTION
;
¢
r� r
WALL/FENCE - FIRST 100 LF PC
- 101-0000-42600
0.
$60.91
$60.91
5/2/16
ti aPAID'$Yz'x
��' METHOD p�RECEIPT
#��
a,y��E
CH ECK#CLTDBYad
�.
ARDEN WALLUM
DEBIT
R15179,
BWFE2016-0103
MFA
Total Paid for FENCE OR FREESTANDING WALL: $108.77 $108.77
• •LS: $109.77 $109.77
Description: WALLUM RESIDENCE / 59 LF WROUGHT.IRON. FENCE
Type: WALL/FENCE
Subtype: CITY STANDARD)/PRE- Status: ISSUED
Applied: 5/2/2016 MFA .
APPROVED
Approved: 5/2/2016 MFA
Parcel No: 604201010 Site Address: 78280 VIA SEVILLA LA QUINTA,CA 92253
Subdivision: TR 23971-1
Block: Lot: 10
Issued: 5/2/2016 MFA
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,000.00
Occupancy Type: Construction Type:
Expired: 10/29/2016 MFA
No. Buildings: 0
No. Stories: 0 No. Unites: 0
[Details: 59 LF OF WROUGHT.IRON FENCING PER 2013 CALIFORNIA BUILDING CODE
Printed: Monday, May 02, 2016 8:05:36 AM 1 of 2
CIPWIYSTEMS
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DESCRIPTION' -"'
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3' ACCOUNT`' a
CITY
.a�ANIOUNT_
PAID*
PAIDDATE'RECEIPT#,
'CHECK#k+<
:`METHOD`
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WALL/FENCE - FIRSTBWFE2016-
101-0000-42404
0
$47.86
$47.86
5/2/16
R15179
DEBIT
ARDEN WALLUM
MFA
100 LF
0103
WALL/FENCE - FIRST
BWFE2016-
101-0000-42600
0
$60.91
$60.91
5/2/16
R15179
DEBIT
ARDEN. WALLUM'
MFA .
100 LF PC
0103
Total Paid for FENCE OR,FREESTANDING WALL: $108.77 $108.77
_.. INSPECTIONS
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Bin #
City. of La Quinta .
Building 81- Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit. Application and Tracking Sheet
Permit #
Project Address:
Owner's Name: �e A. l AA AA
A. P. Number: C 20 1 - l
Address
Legal Description:
City, ST, Zip:
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Contractor: -�
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Address:
Project Descripti
City, ST, Zip:.
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Telephone: h
one•
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State Lic..# :
City Lic. #.:
[ma? 1 ��
Arch., Engr., Designer:
Address:
City., ST, Zip:
h
Telephone:
one:
s
Construction type: KA ecu ane
P Y•
State Lica
ew
'Demo Alter RepairProJect tYPa circle one
Name of Contact Person:
Sq. Ft.:#
-Stories:
# Units:
Telephone # of Contact Person: J
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Ree'd
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.I.
H.O.A. Approval
Plans resubmitted
,
Grading
`
IN ROUSE:-
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
1
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BUI,•LDING..&SAFETY DEPT
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Review & Submit Your Application Coachella Valley Water District
Page 4 of 5
https://cvwd-rebates.droplet.us/submit-appiication/906
11/29/2015
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https://cvwd-rebates.droplet.us/submit-appiication/906
11/29/2015