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BWFE2015-0291LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions ospaig- 9 (commencing with Section 7000) of Division 3 of the Business and Pro ons Code, and my License is in full force and effect. jLicense Class: B License No.: 410408 at e. 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 ) 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.). (1 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 agencyfor the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's Address: .WORKER'S COMPENSAT®N DECLARATION tite`by affirm under penalty of perjury one of the following declarations: I have and w7forby asertificateof consent to self -insure for workers' compensation, viection 3700 of the Labor Code, for the performance of w r which thissued. I ave and wworkers' compensation insurance, as required by S do 3700 f the Labr the performance of the work for which this permit is issu d. workers' on 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 a6 to become subject to the workers' compensation laws of California, and agree that. if I should become subject to the workers' co pensati n provisions of Section 3770 of the Labor Code, I shall forthwith co/m.�pl/y wit those p visi Date' Applicant: WARNIN : FAILU E TO SECURE WORKERS' COMPENSATION OVERA IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND IL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITIO 0 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOW EDGEMENT IMPORTANT: Application is hereby made to the 3uilding Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applicacion 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 Cay of La Quinta, its officers, agents, and employees for any act or omission related to thework being performed under or following issuance of this permit. 2. Any permit issued as a result of this applicaton 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 t above -mention d prope y for inspection purposzs. Da S`gnature (Applicant or en F a� 4 64P VOICt(760) 777-7125 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 9/28/2015 Application Number: BWFE2015-0291 Owner: Property Address: 53605 FREMONT WY JACK DUDUM APN: 767710008 P 0 BOX 979 Application Description: DUDUM / 25OLF OF ORCO BLOCK WALL ALAMO, CA 0 Property Zoning: z Application Valuation: $16,000.00 Cr Applicant: Contractor: N ? Q MICHAEL JEHA CONSTRUCTION MICHAEL JEHA CONSTRUCTION QO a w 53408 VIA PISA 53408 VIA PISA N a LA QUINTA, CA 92253 LA QUINTA, CA 92253 4J LUvL.Li c5 C/D v (925)250-4038 Llc. No.: 410408�� O - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - U - - - - - - - - - - - - - - - - - - - - - LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions ospaig- 9 (commencing with Section 7000) of Division 3 of the Business and Pro ons Code, and my License is in full force and effect. jLicense Class: B License No.: 410408 at e. 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 ) 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.). (1 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 agencyfor the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's Address: .WORKER'S COMPENSAT®N DECLARATION tite`by affirm under penalty of perjury one of the following declarations: I have and w7forby asertificateof consent to self -insure for workers' compensation, viection 3700 of the Labor Code, for the performance of w r which thissued. I ave and wworkers' compensation insurance, as required by S do 3700 f the Labr the performance of the work for which this permit is issu d. workers' on 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 a6 to become subject to the workers' compensation laws of California, and agree that. if I should become subject to the workers' co pensati n provisions of Section 3770 of the Labor Code, I shall forthwith co/m.�pl/y wit those p visi Date' Applicant: WARNIN : FAILU E TO SECURE WORKERS' COMPENSATION OVERA IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ND IL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITIO 0 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOW EDGEMENT IMPORTANT: Application is hereby made to the 3uilding Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applicacion 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 Cay of La Quinta, its officers, agents, and employees for any act or omission related to thework being performed under or following issuance of this permit. 2. Any permit issued as a result of this applicaton 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 t above -mention d prope y for inspection purposzs. Da S`gnature (Applicant or en "DESCRIPTION '.- 1 i FINANCIAL •' ,,; ACCOUNT r': 1 QTY , :t_ AMOUNT;` . PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 9/28/15 PAID BY y '. - •y'METHOD. RECEIPT# CHECK #: CLTD BY MICHAEL JEHA CONSTRUCTION CHECK R9541 5773 SKH Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 DESCRIPTION _ ACCOUNT = .:, QTY AMOUNT .. PAID -PAID WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $43.50 $43.50 9/28/15 . BY' METHOD RECEIPT# CHECK#PAID CLTD BY. MICHAEL JEHA CONSTRUCTION CHECK R9541 5773 SKH DESCRIPTION : ACCOUNT ``; ' QTY ' ;, , AMOUNT _ -; PAID °° PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $47.86 9/28/15 .'PAID BY = _' ' , METHOD '' RECEIPT # CHECK #: CLT D BY MICHAEL JEHA CONSTRUCTION CHECK R9541 5773 SKH DESCRIPTION `�a , . ' _ _ ` - ACCOUNT, _ , .. CITY, 1 AMOUNT r• - PAID F,. .... _ .ti PAID AID DATE' WALL/FENCE -.FIRST 100 LF PC 101-0000-42600 0 $60.91 $60.91 9/28/15 PAID BY' r METHOD: ' .RECEIPT# CHECK # -CLTD BY MICHAEL JEHA CONSTRUCTION CHECK R9541 5773 SKH Total Paid for FENCE OR FREESTANDING WALL: $152.27 $152.27 TOTALS: $1S3.27 $153.27 v 1 i ~ Description: DUDUM / 250LF OF ANGELUS BLOCK WALL Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: ISSUED Applied: 9/28/2015 SKH APPROVED Approved: 9/28/2015 SKH Parcel No: 767710008 Site Address: 53605 FREMONT WY LA QUINTA,CA 92253 Subdivision: TR 33076-2 Block: Lot: 95 Issued: 9/28/2015 SKH Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: / Valuation: $16,000.00 Occupancy Type: Construction Type: Expired: 3/26/2016 SKH No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 25OLF OF 6' GARDEN WALL WITH (5) PILASTERS AT NORTH AND SOUTH PL [ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA .BUILDING CODES. CONDITIONS . n Applied to Approved IM Approved to IssuEd Printed: Monday, September 28, 2015 5:20:35 PM 1 of 2 CR SYSTEMS CONTACTS NAME.TYPE. _ .: .'NAME, • ,.; ADDRESST CITY STATE 'ZIP .PHONE � e A ,�C U { �r.._-. 1 :1. � .nR.•t.. 4 .ti3+.�i�..= �.'^��'M �+it.ps�..r'.....A ..I_•�.T �-rr Yu,;.,,�. ..Tt.;.. rift •._s. - t,^ T T t Y 5 N ..'; 'vaa V cA 4¢ .. .4 ..'S.. ,r.::. "-'.y'+'�"'� ."'t _. rs a :.."•± _Y. ....-.:::, nY.:. -.. .. x �'. i✓: 7 "'Fr .h'9 4 , is'"f. 7 -'°?mss- ?f : _'?r,,,#P . 3 CLTD, .. ',.:-.-. K.. 5•.. _ .. - ;: .., ., ::.:_.. -.. .. :u... r 3'� K . _��• ra h' ACCOUNT -QTY AMOUNT PAID ? PAID DATE RECEIPT #* CHECK# ' METHOD PAID BY. • .DESCRIPTION. BY WALL/FENCE - EA MICHAEL JEHA 101-0000-42404 0 $43.50 $43.50 9/28/15 R9541 5773 CHECK SKH ADDITIONAL 50 LF CONSTRUCTION WALL/FENCE - FIRST MICHAEL JEHA 101-0000-42404 0 $47.86 $47.86 9/28/15 R9541 5773 CHECK SKH 100 LF CONSTRUCTION WALL/FENCE - FIRST MICHAEL JEHA 101-0000-42600 0 $60.91 $60.91 I 9/28/15 I R9541 5773 I CHECK SKH 100 LF PC CONSTRUCTION Total Paid for FENCE OR FREESTANDING WALL: $152.27 $152.27 �... �2yy.4h N b. aa+..: -z- .:� �.-.:'_.: - : L � f:� ;,.; �. ,r. .r:�y, C t F-.3 '�. '. .r'' .'�•`�•, .,.-S}F.'o- p°.'t_ "K. igy.3✓2 Y i .;k r(. 02 y� -.I.. 12- .y^ ty,4 .,F,sSa. �;� ..,�.:4 ,��.�.:. _ ��',���..:.. .� urn �;~��:�;�..�q,< �C3N17`INFUFtNIAIIUI!J�•�;:��.r�a `; •.; �~ .� - .. .. p._. .:�: ,: __ .. _: �r:.:yt:1'..7VL •:� :{"' ..t v'+ .., ,si..' ` �. >. - �.'t� _.:a+H5r-9J'KiF': Y.�F t9i`J�e.� -. � F, s- �f�ti�F �. ^�i..y 'v''4y'c^`:`y" _• 1. 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DRAG _ 4 2 ALLLOK IOM555ALKMA TOMTAMAMtDMM > Ren rPOpiOCF MMARAigQ NPAm rDd[e) l YOR ALL GUp L00 ATAMD04NQ Nf C svo,fL PweraPG DaM,B - ] RUM Int LC1YAtl Alm 4WtlBQ GRfL1WeTO [l wAR MM O U u P�r, e. raor rw4ornr ro uvtxDAYeaQDaa as av ae.Gci a=J�y e g mm.l`d�:.,u..'; _ w. cnrart Swl w.•aAw4ww rn,ea9elw smm�MQDam PV Ai moAn , ... l3 M.um am w.®• � ` ._• - . _ _ r 1.�e<.,D�wI�M,aww.ILa.raavDL•L,. • _ NES• L-1 °•'= r�^^^ r:.•.."+ "• p�r„'�:'..'-: a. .vaL ramM»roaco.iMm uaR DArz orawnD PA.—re..�a..w LAWN— d r unlL. rzs-I� "" """° :r'm:.� ">`. w. •.ww` SEE SHEET L-5 FOR CONSTRUCTION DETAILS ate♦•ra nr.l - N 56A E. Vb• = I'-0' CONSfNUC'rION PLAN SIRFNSM Q ISOO PN AT 2D DAri .A ,A-,R,,.y 0,,,,y BD N6YlT wRPNdo.v000D<Dai r#D w M MM ♦5' ai =P@ r'!PC D315 - - A ALL GOMSTNGTtlN TO Rl!® Alm iqE IR1.55 ODQD4Y o� N v�ftitn. �iPMr Mtt.(.-hl PNDS a.W w•O - 5. 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COY/ll[ wKPR> AYGtAin, SiroMtna U u P�r, e. raor rw4ornr ro uvtxDAYeaQDaa as av ae.Gci a=J�y e g mm.l`d�:.,u..'; _ w. cnrart Swl w.•aAw4ww rn,ea9elw smm�MQDam PV Ai moAn , ... l3 M.um am w.®• � ` ._• - . _ _ r 1.�e<.,D�wI�M,aww.ILa.raavDL•L,. • _ NES• L-1 °•'= r�^^^ r:.•.."+ "• p�r„'�:'..'-: a. .vaL ramM»roaco.iMm uaR DArz orawnD PA.—re..�a..w LAWN— d r unlL. rzs-I� "" """° :r'm:.� ">`. w. •.ww` SEE SHEET L-5 FOR CONSTRUCTION DETAILS ate♦•ra nr.l - N 56A E. Vb• = I'-0' CONSfNUC'rION PLAN Bin .City of La' Q rein to Building 81: Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #1 Project Address: J Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: c Contractor: Telephone: hone: Address: Project Description: City, ST, Zip: 0 , h Tele ne P o o— i�V V State Lie. # .9,41,0Q City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Con Construction Type: Occupancy: cY: State L ic. #• Project type (circle ne • New Add'n Alter Repairair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project:, APPLICANT: DO NOT WRITE BELOW THIS LINE # 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 Balasce Title 24 Catcs. Plans picked up Construction Flood plain plan . Plans resubmitted Mechanical Grading plan 2"" Revic\v, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval 'Plans resubmitted Grading IN ROUSE:- '"' Review, ready for correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees