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BWFE2017-0160Twit a 78-495 CALLE TAMPICO LA CZUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2017-0160 Property -Address: 81443 JACARANDA CT APN: 764780065 Application Description: FU51CK / 20LF BLOCK WALL AT EAST SIDE PIL Property Zoning: Application Valuation: $1,200.00 Applicant: D DAZ P 0 BOX 5083 LA QUINTA, CA 92253 AUG 2 2 2017 CITY OF LP, QUINTA COMMUNITY DEVELOPMENT DEPARTMENT 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.: 944325 DaF `t!0 1/ A&'Contractor: o 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.). ( ) 1, 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 Na Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/22/2017 Owner: FUSICK INV INC 407 SMOOTH iTONE CRES SASKATOON ! K CANADA S7J, T192253 Contractor: DAZ P 0 BOX 5083 LA QUINTA, CA 92253 (760)285-3793 Llc. No.: 944325 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 he ork for which this permit is issued. i :I have and will maintain workers'compensation insurance, as required by Section 100 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: STATE COMPENSATION INSURANCE FUND Policy Number: 9168769 _ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner :o 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 forthwith comply with hose p ovisions. Daattee: App plic_ant: "" 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 ($100J)00). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKOOWLEDGEMENT IMPORTANT: Application is hereby made twthe 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 perfo med 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 Cit/ of La Quinta, its officers, agents, and employees for any act or omission related tc the work being performed under or following issuance of this permit. 2. Any permit issuedas 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 cancellat©n. 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 oreinances and state la relating to building construction, and hereby authorize representatives of this city a ter pont above- mentioned property for inspection purposes Date: 8/22/2017 Application Number: BWFE2017-0160 Owner: Property Address:. 81443 JACARANDA CT FUSICK INV INC APN: 764780065 407 SMOOTI-STONE CRES Application Description: FUSICK / 20LF BLOCK WALL AT EAST-SI DE PL SASKATOON 3K CANADA S7J, TT 92253 Property Zoning: Application Valuation: $1,200.00 Applicant: Contractor: DAZ DAZ P 0 BOX 5083 P 0 BOX 508= LA QUINTA, CA 92253 LA QUINTA, CA 92253 (760)285-3793 -------------------------------------------------------------------------------------------- LIc. No.: 944325 Detail: 20LF OF 6' GARDEN AT EAST PROPERTY LINE [CITY SPECIFICATIONS) PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. THE AREA BETWEEN THE BACK OF CURB AND ANY FENCING SHALL BE LANDSCAPED, HAVE A SUITABLE PERMANENT IRRIGATION SYSTEM, AND BE CONTINUOUSLY MAINTAINED BY THE PROPERTY OWNER. 2016 CALIFORNIA BUILDING CODES. Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 TOTALS: $120.0 DESCRIPTION FINANCIAL• • 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 BLO�-K 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 TOTALS: $120.0 r Bin# City of La 'Quinta Building & Safety Division Permit# 78-495 Calle Tampico - r ' La Quinta, CA 92253 - (760) 777-7012 - g�jy Building Permit Application and Tracking ghi et Project Address: J Owner's Name: % A.P. Number / 2 Y' . J Address: 4 1W Legal Description: City, ST, Zip: Contractor: Z Telephone: Address: A �p Cd Project Description: City, ST, Zip: L a '' 044- WMf Telephone: ` , 1-41S - +13 7 City Lic #: State Lic. #: ?J 5 iLm STAN= Arch, Engr., Designer: Q Address: City, ST, Zip: % _ Telephone: Construction Type: Occupaacy: State Lic..#: Proj. Type New Add'n Alter Repair Demo Name of Contact: ?� #Stories # Units: Telephone of Contact:Qy Estimated Value of Project: t APPLICANT: DO NOT WRITE BELOW THIS LINE . # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan Check Deposit: Truss Calcs Called Contact Person Plan Check Balance: Title 24 Calcs Plans Picked Up Construction: Flood Plain Plan . s Plans Resubmitted Mechanical: Grading Plan 2nd Rev, Ready for corrections / Electrical: , Subcontractor List Called Contact Person Plumbing: Grant Deed Plans Picked Up S.M.I. HOA Approval Plans Resubmitted Grading IN-HOUSE , 3rd Rev, Ready for corrections / Developer Impact Fee Planning Approval Called Contact Person' A.I.P.P. Pub. Wks. Apps Date of permit issue School Fees l Total Permit Fees �Aj DA ID GA ILQAr. %'rf • �.:;.asszi::::z::,z:.;::.::2t,<ia�s:r�s:.<:r::>:k::>::<z<:•:z::::;<:>:zi>:: <:>i:<:: .. . _ _ _ �v�' r- --� ,..1•. _ ZIMMEN zzl% vp 1 ......... J�■J��LrJL.Ll.rrr... r........■.....■r■■. o.uuu.uuuu r—tv—.�■.o L 44 S