BWFE2017-001378-495 CALLE TAMPICO
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LA QUINTA; CALLFORNIA.92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:. . BWFE2017-0013
Property Address: '
44065 CALICO CIR CIR
APN:
.604091035
Application Description:
PATTERSON / BLOCK WALL AT SIDE YARD AND EQUIPMENT WALL
Property Zoning:
Application Valuation:.
$8,000.00
Owner:
MICHEL PATTERSCN
44065 CALICO r'D
LA QUINTA, CA
VOICE (760) 777-7125.
FAX (760) 777-7011
INSPECTIONS (760) 777-7153,
Date: 1/27/2017
Applicant Contractor: z
MAURICE PHILIP'PEGORELLI MAURICE PHILIP �OREt;I vs
P0BOX 541 P0BOX 541 1
�j �
TWENTY NINE PALMS, CA 92277 TWENTY NINE PA _(SSCA192277w'
(714)404-5514
Llc. No.: 823063► +
�i
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 and Professions Code,
and my License is in full force. and effect. . .
License Class: B License No.: 823063 -n
Dte-!9' Contracto
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.).
(_) 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:
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'
compens t n, as provided for by Section 3700 of the Labor Code, for the performance
of the w rk or 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:. EXEMPT . Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shA.not employ any person in any manner so as to become subject to.the workers'
compensation laws of California, and agree tha-,, if I should become subject to the
workers' compensation provisions of Section 3:00 of the Labor Code, I shall forthwith
comply with those provisions.
Datp-1 / 1 Applicant M -14L- e-6 1 �t�s^li GtKG Lr
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). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FORBN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT:'A'pplication 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 owne4 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 applic: tion 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 cancel tion.
I certify that I have read this application and state that the above information is orrect.
I agree to comply'with all city and county ordirances'and state laws relating to uilding .
construction, and hereby authorize representa>rives of this city to enter upon e
above-mentioned property for inspectionpurp>)ses.
Da� Signature (Applicant )..r Agent)
Date: 1/27/2017
. Application;Number: BWFE2017-0013:
Owner:
Property Address: 44065 CALICO CIR CIR
MICHEL PATTERSON.
' APN: 604091035
44065 CALICO CIR .
Application Description: PATTERSON / BLOCK.WALL AT SIDE YARD AND EQUIPMENT WALL
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $8,000.00
Applicant
Contractor.
MAURICE PHILIP PEGORELLI
MAURICE PHILIP P=GORELLI
PO BOX 541'.
P O BOX 541
TWENTY NINE.PALMS, CA 92277
TWENTY NINE PALMS, CA 92277
(714)404-5514 .
LIc. No.: 823063
Detail: 90LF,OF 6' GARDEN WALL AT SIDE.YARD AND EQUIPMENT WALL. [CITY SPECIFICATIONS] PRECISION CONCRETE BLACK SHALL BE COVERED WITH
STUCCO, PAINT, OR TEXTURED.COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODE S.
1 • 1
FINANCIAL
DESCRIPTION ACCOUNT
QTY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$50.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600.
.0
$63.33
Total Paid for BLOCK WALL: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT.
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
• 1 00
Bin It ..
Permit #I
„��b %
Tip (%�
Project Address:
L/�J
Qty of Quinta
Buifding & Safety Divisiod
78-495 Caffe Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking She
A. P. Number:
Address: GS L _ () Cl
Legal Description:
City, ST, Zip:
Contractor:r-
O �2
Telephone:
e:
Address: `A
ProjectDescription:
City` ST, Zip: PALrn
TelePh0ne: t,
State Lie.# : Z ('�j
City Lie. #.:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: hone•
arcy
Occupancy:
Constructiontraction T YP e: .
State Lie- •
Repairair
ProJect �P (circle ne • New Add'n Al-Demo.
0
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
al
Estimated Value of Project: j 2�
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 Deposst
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 corrcctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3" Revicw, ready for correctionstissue
Developer ImpackFee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks_ APpr
Date of permit issue
School Fees,
Total Permit Fees