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BWFE2018-005078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype:. Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: ERIC MUSSER 53755 AVENIDA DIAZ LA QUINTA, CA 92253 ivy °r'40" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT WALL/FENCE/CITY STANDARD/PRE-APPROVED BW FE2018-0050 53755 AVENIDA DIAZ 774151013 . ERIC MUSSER / 60LF BLOCK WALL $1,500.00 WYORAOUINTA 100MMU%nYDBWNW!! 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: License No.::CONV:140528101254089034 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 basis for the aIle ed exemption. Any violation of Section 70315 by any applicant fora permit s ethe applicant to a civil penalty of not more than five hundred dollars ($500).: 1111: ,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 she did not build or improve for the purpose of sale.). as owner of the property, am exclusively contracting with licensed contractors to onstruct the project. (Sec. 7044, Business and Professions Code: The ContractorsState 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 Co tractors' State License Law.). am exempt under Sec. . B.&P.C. for this reason Date: O Owner: CONST 'ON' ENDING AGENCY I hereby affirm under penalty of perjury thatthere 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (7 60) 777-7153 Date: 3/5/2018 Owner: ERIC MUSSER 53755 AVENIDA DIAZ LA QUINTA, CA 92253 Contractor: ERIC MUSSER 53755 AVENICA DIAZ LA QUINTA, CA 92253 (310)489-5348 Llc. No.::CONV:140528101254089034 WORKER'S COMPEN!ATION DECLARATION I hereby affirm under penalty of perjury oneof 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' -ompensation 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: I certify that in the performance or 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 agree fiat, if I should become subject to the ' workers' compensation provisions of Sectior 3700 o the Labor Code, I shall forthwith comply�wiit thos provisions. Date: ✓ v Applicant: WARNING: FAILURE TO SECURE WO RS' ©MPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,900). 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 :he Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this app,ication is made, each person at whose request and for whose.benefit work is perfor red under or pursuant to any permit issued as a result of this application, the owner, anc the applicant, each agrees to, and shall defend, indemnify and hold harmless the Ci% 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 app] cation becomes null and void if work is not commenced within 180 days from date of iss jance of such permit; or cessation of work for 180 days will subject permit to cancellaticn. 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 ord nances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentioned rope ty for inspection purposes. Date: Signature (ApplicanCo/Age. 1 U Date: 3/5/2018 Application Number: BWFE2018-0050 Owner: Property Address: 53755 AVENIDA DIAZ ERIC MUSSER APN: 774151013 53755 AVENIDA DIAZ Application Description: ERIC MUSSER / 601-F BLOCK WALL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $1,500.00 Applicant: Contractor: - ERIC MUSSER ERIC MUSSER 53.755 AVENIDA DIAZ 53755 AVENIDA DIAZ LA QUINTA, CA 92253 LA QUINTA, CA 92253 (310)489-534£ ------------------------------------- ------------------------------------------- Llc. No.: :CON J:140528101254089034 60LF OF 6' RETAINING WALL SOUTH SIDE OF YARD [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2016 CALIFORNIA BUILDING CODES. 1 U DESCRIPTION FINANCIAL INFORMATION ACCOUNT QTY AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $52.01 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $65.02 Total Paid for BLOCK WALL: $117.03 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 . $1.00 Total Paid for BUILDING STANDARDS ADMINISTRAT®N BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-000043611 0 $5.00 N Total Paid for TECHNOLOGY ENHANCEM =NT FEE: $5.00 TOTALS: $133.1 0 Contractor Name: New SFD Construction: Address: PERMIT # PLAN LOCATION': Project Address: �3 '�Z Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech. APN #: Telephone: Patio/Porch SF Email: Fire Sprinklers SF State Lic: City Bus Lic: Applicant Name: S Address: Q �� City, ST, Zip: Telephone: Email: Valuation of Project $ /Soo Contractor Name: New SFD Construction: Address: Address: Conditioned Space SF City, St, Zip Garage SF Telephone: Patio/Porch SF Email: Fire Sprinklers SF State Lic: City Bus Lic: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Construction Type: Occupancy: Telephone: Bedrooms: Stories: #Units: Email: State Lic: City Bus Lic: Property Owner's Name: New Commercial / Tenant Improvement's: Address: Total Building SF City, ST, Zip Construction Type: Occupancy: Telephone: Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY Submittal ` Req'd Rec'd Plan Sets Structural Calcs k- Truss Calcs Title 24 Calcs ' Soils Report Grading Plan (PM 10) Landscape Plan . Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris•Plan Planning approval Public Works approval Fire approval City Business License