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BWFE2016-008175 O�i 78-495 CALLE TAMPICO D VOICE (760) 777-7125 LA QUINTA, CgFAX (760) 777-7011LIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lic d under provisions of Chapter 9 (commencing with Section 7000) of Division 3o he B sinew and Professions Code, and my License is in full force and effect. /p// License Class: B License No.: 594043 Date: — 1 t(1 Contractor: 0 &,151. I hereby affirm under penalty of perjury thathm 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: I ) 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.). I ) 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 performanceof the work for which this permit is issued (Sec. 3097,, Civ. C.). Lender's Name: Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following rations: I have and will maintain a certificate of consent to self -insure for workers' co— en ation, as provided for by Section 3700 of the Labor Code, for the performance of te /ork forwhich this permitisissued.Ihave and wilmaintain workers'compensation insurance, as required by ed 370 a Labor Code,forthe performance of the work for which this permit isied. 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 manner, so as ome subject to the workers' compensation laws of California, and agree that if I sh uld ecome subject to the workers' compensation provisions of Section 3 0O of a bor Code, I shall forthwith comply with those provisions. Date: �� ` 16 Applicant WARNING: FAILURE TO SECURE WORKERS' COM PONSATION 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 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 " orm tion is correct. I agree to comply with all city and county ordinances and stat law rel i to building construction, and hereby authorize representatives of this ci to enter �j6n the above-mentioned property for inspection purposes. Dater -L� Signature (Applicant or Agent): Date: 3/29/2016. Application Number: BWFE2016-0081 Owner: Property Address: 54135 SOUTHERN HILLS JIM HIETBRINK APN: 775101043 541352 SOUTHERN HILLS Application Description: HIETBRINK / EQUIPMENT WALL LA QUINTA, CA 92253 Q p Property Zoning: cn t= w Z Application Valuation: $2,500.00 ( c� 1 go Applicant: LARRY COIA JR DBA 7 C'S CONSTRUCTION & M y � Contractor: IrN_ LARRY COIA 1R DBA 7 C'S CON- I N &MQ �y J O 48-236 VISTA DE NOPAL 48-236 VISTA DE NOPAL . :;�i CD LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)564-5811 ' I ® � C:) Llc. No.: 594043 ------------------------------------------------------------------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am lic d under provisions of Chapter 9 (commencing with Section 7000) of Division 3o he B sinew and Professions Code, and my License is in full force and effect. /p// License Class: B License No.: 594043 Date: — 1 t(1 Contractor: 0 &,151. I hereby affirm under penalty of perjury thathm 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: I ) 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.). I ) 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 performanceof the work for which this permit is issued (Sec. 3097,, Civ. C.). Lender's Name: Lender's Address: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following rations: I have and will maintain a certificate of consent to self -insure for workers' co— en ation, as provided for by Section 3700 of the Labor Code, for the performance of te /ork forwhich this permitisissued.Ihave and wilmaintain workers'compensation insurance, as required by ed 370 a Labor Code,forthe performance of the work for which this permit isied. 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 manner, so as ome subject to the workers' compensation laws of California, and agree that if I sh uld ecome subject to the workers' compensation provisions of Section 3 0O of a bor Code, I shall forthwith comply with those provisions. Date: �� ` 16 Applicant WARNING: FAILURE TO SECURE WORKERS' COM PONSATION 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 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 " orm tion is correct. I agree to comply with all city and county ordinances and stat law rel i to building construction, and hereby authorize representatives of this ci to enter �j6n the above-mentioned property for inspection purposes. Dater -L� Signature (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION :ACCOUNT QTY AMOUNT 'PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT #' CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 .$0.00. DESCRIPTION ACCOUNT QTY ' AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $0.00 PAID BY. METHOD RECEIPT# CHECK # CLTD BY Total Paid for FENCE OR FREESTANDING WALL: TOTALS:0• $108.77 $0.00 00 Permit Details PERMIT NUMBER City of La Quinta BWFE2016-0081 Description: HIETBRINK / EQUIPMENT WALL Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: APPROVED Applied: 3/29/2016 TSA APPROVED Approved: 3/29/2016 TSA Parcel No: 775101043 Site Address: 54135 SOUTHERN HILLS LA QUINTA,CA 92253 Subdivision: TR 22432-2 SEE ASSESSORS MB 769/43 Block: Lot: 1,2-P Issued: FOR CMS Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $2,500.00 Occupancy Type: Construction Type: Expired'. No. Buildings: 0 No. Stories: 0 No. Unites: 0 STATE Details: 14LF OF 6' EQUIPMENT WALL AT SIDE YARD [CITY SPECIFICATIONS) PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESS1- CITY STATE ZIP PHONE- FAX EMAIL APPLICANT LARRY COIA JR DBA 7 C'S 48-236 VISTA DE LA QUINTA CA 92253 (949)640-1754 CONSTRUCTION & M NOPAL CONTRACTOR LARRY COIA JR DBA 7 C'S 48-236 VISTA DE LA QUINTA CA 92253 (949)640-1754 CONSTRUCTION & M NOPAL OWNER JIM HIETBRINK 541352 SOUTHERN LA QUINTA CA 92253 (949)640-1754 HILLS FINANCIAL INFORMATION Printed: Tuesday, March 29, 2016 2:30:25 PM 1 of 2 SYSTEMS INSPECTIONS PARENT PROJECTS BOND INFORMATION Printed: Tuesday, March 29, 2016 2:30:25 PM 2 of 2 SYS TERAS CLTD DESCRIPTION _ ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY - BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: 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: $108.77 $0.00 TOTALS: $109.77 00 INSPECTIONS PARENT PROJECTS BOND INFORMATION Printed: Tuesday, March 29, 2016 2:30:25 PM 2 of 2 SYS TERAS 6 "'(f .y. I -�o)sv- CITY OF LA QUI NTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DATE BY '11 � {A - 1 A i . SITE REQUIREMENT'S IHT'ERIOR LOT SIDEYARD: 5 FEET RBAR-YARD: 10 FEET NU NR" EACH SME . • ' i . + MON YARD;' AREA TO 20I LT LAf{DSCOED q''MimmUNr } ��..••- PROPERTY LINES . ti lBin City of.La QCdln'ta Building ST Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Trackilig Sheet Permit # Project Address: 3 �� �� P 1�� Owner's Name: l Vv-, A. P. Number:o Address: S4• (3 .5 r Legal Description: City, ST, Zip:LA ntra Co ct r: o C� �4 telephone: Address: LV v �P��, Project Description: City, ST, Zip: ,,(A f�_�� � 4 SJ l ,( 1 ICY— +tiiA `% r�►'��l e�✓ C -47 Telephone: ne• L s Cl J �i . State Lic. #: 514043 City Lie. #; Arch., Engr., Designer: Z6` Movedy. Address: ` q I N DZ City, ST, Zip: -0, TI�J - CQ q� Te le h ne:� I r�� l Zd-7 Constructiontruction Type: Occupancy: State Lic. #: Project circle one): New n r Repair Demo Name of Contact Person: Sq t.: L L,IN F # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: ,-5Co APPLICANT: DO NOT WRITE BELOW THIS LINE tl Submittal Req'd Rcc'd 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 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 I40USE:- '"' 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 Ky