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BWFE2015-030178-495 CALIE•TAMPICO •. LA QUINTA, CALIFORNIA 92253 `&tr4la4" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2015-0301 Property Address: 53551 ROSS AVE APN: 767680039 Application Description: SURES RESIDENCE / BLOCK WALL Property Zoning: Application Valuation: $36,000.00 Applicant: BRADSHAW CONSTRUCTION INC 46-248 ROUDEL LANE LA QUINTA, CA 92253 10 A U � 1� CCT 09 2015 - 3 Ci�Ya; !10C3(i��`fi� COV.IL'?:ITY D ti rL0?..,MMT DErPA-iii 'IW LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: B License No.: 848057 Date: < -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 C 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, 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.). ( ) 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.). (_) 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: 11111111111111111111 22 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date:. 10/9/2015 Owner: SURES, JONATHAN & MOLLY 53551 ROSS AVE LA QUINTA, CA 92253 Contractor: BRADSHAW CONSTRUCTION INC 46-248 ROUDEL LANE LA QUINTA, CA 92253 (760)347-4246 Llc. No.: 848057 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: _ 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 mannerso 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 fo ith comply with those provisions. 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 ($100,000). AN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and ,void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon h above-mentioned property for inspection purposes. , or el it ivi I o � �h Y�DyESCRI ON. ACCOUNT QTY _ ' AMOUNT ` PAID �PAIUDi4TE r}Y"�s.s3."vfi:'f7. �3t.,+$�.'-d.4C.: ." ...w -. .• -.." =. .'.'4`r. ,��v�ri,,r'.'`v"r&,:,.. dtsG r �.Y�`LS$i`�n. x. `4�,..Yi:i'.#,LN534.N' k.� :h,. i� , 3.,..c�:ev3�uGt S'Yliii%ink:.6A BSAS SB1473 FEE 101:0000720306 0 • $2.00 $0.00 `u r PA IDBY MOD r :RECEIPT # CIEC1C# CLT:UBY� Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:. ' $2.00 $0.00 5a DESCRIPTION`, �i"�Lk:7.' "._ A�CCOUNT� ... .+�..-,kSS�. yxX(k cei', MO NT��l AN, C140 ,"s'�,3W, PAID .; ' PAIUDAT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0-- $87.06 $0.00 METHOD�R � % RECEI- � 4C'� K # A �T�B WALL/FENCE -FIRST 100 LF: 101-0000-42404 0. $47:86 .; $0.00 YA£ :t METcHO>D m . •u. s � ^� *�`: ` '� il RECEIPT # y -vXS,utb..E�iR3 .� ...�..V;uA, , CFI ff # $iKR'421y ,*�s:,�z�-.��x� �CLTD BY .dri7x•StC`^�. k��YDESCRIPTO" ` -'%ra>s...y+r sj R;, �l,•,�m1;M-:�`€.. s: a:.9.�>"+?ank�,z.:�.�,+.� ..+, a `" g.A000UNT > `.,�•`?zb AC .;.� S:'.-:��iC, k°,$.C:: .�..,..:,�� QTY �Z4rx�� AMOUNT` a'k;•. ��� PAIDSi� C�.1•*t��dr�4-����.53s�x. P ID`DA E �t.4 �n?'r:Y%FF.>ek?s;, WALL/FENCE- FIRST 100 LF PC 101=0000-42600 0 $60.91 $0.00 ` �r PAID B � 1111 OD hREC Tk #, W �3 a;,gsis,��.'�.s�s CH K # 0111 U`U) Y Total Paid foi FENCE OR FREESTANDING WALL:,. $195.77 WNW CRIP IT�ON �i4 t . Yx.. CO N QTY zAMOUTT k =PAD PAID DAT RET WALL <=12 - EA ADD 50 LF 101=0000-42404 0 $43.50 $0.00 r K' PAID BY � MINIM, _ ETg sz" �C`� _. y fey. DESCRIPTIONy�� ACC UNTO; ..• . _4101 FIX, 'PAID 'PAID DATE RET WALL <=12 = FI RST 100 LF 101-0000-42404 0 - $47.86 so.6 � � : �, ��.�� a ,,;, .. 'N' PAID BY ,,,�: �� M ODS � R k, -"E IPTG# � CH CK #: ,CL BY jjj sACCOU�N, T n . „s . WQTY•AMO0U' NTS.01D N N�A RET WALL <=12 - FIRST 100 LF PC 101-0000-42600 _ 0. $60.91 $0.00 ""y -,`C D - �REG K # �G ,CLT6P#0BYA Total Paid for RETAINING WALL: $152.27 $0.00 • Description: SURES RESIDENCE / BLOCK WALL Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: UNDER REVIEW Applied: 10/9/2015 MFA APPROVED Approved: 10/9/2015 MFA Parcel No: 767680039 Site Address: 53551 ROSS AVE LA QUINTA,CA 92253 Subdivision: TR 33076-1 Block: Lot: 34 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $36,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 362 LF OF 6' GARDEN AND 206 LF W/2' RETAINING [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. Applied to Approved Printed: Friday, October 09, 2015 12:31:02 PM 1 of 2 ��� SYS TEti15 Permit Details PERMIT NUMBER --� - City of La Quinta BWFE2015=034 R DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY WALL/FENCE - EA 101-0000-42404 0 $87.00 $0.00 ADDITIONAL 50 LF 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: $195.77 $0.00 RET WALL <=12 - EA 101-0000-42404 0 $43.50 $0.00 ADD 50 LF RET WALL <=12 - FIRST 101-0000-42404 0 $47.86 $0.00 100 LF RET WALL <=12 - FIRST 101-0000-42600 0. $60.91 $0.00 100 LF PC Total Paid for RETAINING WALL: $152.27 $0.00 TOTALS:$350.04 $0.00 ATTACHMENTS Printed: Friday, October 09, 2015 12:31:02 PM 2 of 2 SYSTEMS —A ........ .... . . .... ..... ..... ... . .. .... . .... ;'. . .... .. ... ... .. .... .. . .... .... .... . ... ... . .... .... .... ... .... .... .... .. .. . ... .. .... ... .... ... -r-N .. .... .... .. . .... ... ki ... ... . ... ..... ...... ... 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F. .... .... .... I .......... ... ....... ... .... .............. .... .......... ..... .... ........ . .... . ...... . .. ..... . ..... ..... . .... . s ...... . ................ .. . . .... . .... . ..... .... ....... . .. . . . . ...................... ................. . ...... ....... .............. ..... . ....... I . ........ .................... . RM.; EWUA8,-: ... ..... ..... .... ..... ..... . AV ............. .............. ............. s-'..........._....... ... ........ .... . ...... ....... .... .... ....... ......... ... y'..............._............. .. .. ............. ............. .. ..... ....... ....... .... ..... . . ... . ..... DO ��Hai i. n) CJj 91 w m c I Mi 9 If .. R oll, III z_ HI ' G. . ml ........... Bin # City of La Quinta Buifding 8L Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 to k Building Permit Application and Tracking Sheet Permit # 2015," Projec Address: S �S SSS /FUE' -wner's�2Name� V- A. P. Number: Address: Legal Description: City, ST, Zip: Contract r o � .i, 3 � s .ti.rs T ne• Telephone: P Address: �ojectDescription:., a W City, ST, Zip: Tele P hone: Elm 1` N. State Lie. # : City Lie. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: aneY Constructionn Type: Occupancy: : State Lie. #• Repairair DemoProJecttyP �circle ne • New Add'n Altor Na e f:Contact�Person: Sq. Ft.: # Stories: #Units: Telephone" ofCo'ntact Person: -7G0 - yl S -. T5`5` _ _ �EstimatedxValuelof;Project.p10,000 APPLICANT: DO NOT WRITE BELOW THIS LINE 9 Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. 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 correclionsfissue 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 correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Pcrmit Fees