BWFE2017-022578-495-CAUE.:TAM P.1 CO
LA"QUINTA, CALIFORNIA -92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
WALL/FENCE/SPECIAL/ENGINEERED DESIGN
B W FE2617-0225
78612 PEERLESS PL
770310017
JOHNSON / GARDEN AND RETAINING WALLS
$10,000.00
Applicant:
SOUTHWEST CONCEPTS
78115 CALLE ESTADO STE 105
LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
DEC 19 2017
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: _ 7r
Date: Contractor:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/19/2017
Owner:
PAUL AND BRENDA JOHNSON
9429 148TH ST
EDMONTON A3, CN T51R1A-7
Contractor:
OWNER / BUILDER
LIc. No.:
WORKER'S COMPENS.aT10N DECLARATION
I hereby affirm under penally of perjury one & the following declarations:
_ I have and will maintain a certificace 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.
_L,1' I have and will maintain workers' compensation insurance, as required by
Section 3700 ofthe Labor Code, for the perforrmance ofthe work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier:— Polity Number. _
I hereby affirm under penalty of perjury that l am exempt from the Contractor's State
_ I certify that in the performance ofthe work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair any
compensation laws of California, and agree tiat, if 1 should become subject to the
structure, prior to its issuance, also requires the applicant for the permit to file a signed
workers"compensation provisions of Section 3700 of the Labor Code I shall forthwith
statement that he or she is licensed pursuant to the provisions of the Contractor's State
comply with those provisions.
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
n
)2 _-1,01 — (1
and Professions Code) or that he or she is exempt therefrom and the basis for the
Date: Applicant:
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).:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
(_) 1, as owner of the Property, or my employees with wages as their sole
AND SHALL SUBJECT AN EMPLOYER TO CRimml. PENALTIES AND CIVIL FINES UP TO
compensation, will do the work, and the structure is not intended or offered for sale.
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
COMPENSATION, DAMAGES AS PROVIDED FC IR IN SECTION 3706 OF THE LABOR CODE,
apply to an owner of property who builds or improves thereon, and who does the work
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
within one year of completion, the owner -builder will have the burden of proving that he
IMPORTANT: Application is hereby made to tie Building Official for a permit subject to
or she did not build or improve for the purpose of sale.).
the conditions and restrictions set forth on the application. '
( ) I, as owner of the property, am exclusively contracting with licensed contractors to
1. Each person upon whose behalf this application is made, each person at whose
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
request and for whose benefit work is performed under or.pursuant to any permit issued
License Law does not apply to an owner of property who builds or improves thereon,
as a result of this application , the owner, and the applicant, each agrees to, and shall
and who contracts for the projects with a contractor(s) licensed pursuant to the
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
Contractors' State License Law.).
employees for any act or omission related to the work being performed under or
(� I am exempt under Sec. B.&P.C. for this reason
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 instance of such permit, or cessation of work .
Date: Owner:
for 180 days will subject permit to cancellatiow.
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 Address:
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 represent.tives of this city to enter upon the above-
mentioned property for inspection purposes.
Date: ) — ! Signature (Applicant or Agent
t Date: 12/19/2017
Application,Numbet: , BWFE2017-0225, Owner:
Propeiry Adiiress "' ` '" `�'78612.PEERLESS PL PAUL AND BRENDA JOHNSON
APN: 770310017 9.429 148TH ST
Application Description: JOHNSON/ GARDEN AND RETAINING WALLS EDMONTON AB, CN T5R1A-7
Property Zoning:
Application Valuation: $10,000.00
Applicant: Contractor:
SOUTHWEST CONCEPTS OWNER / BUILDER
78115 CALLE ESTADO STE 105
LA QUINTA, CA 92253
Llc. No.:
---------------------------------------------------------------------------------------------
Detail: 180.51-F OF GARDEN VARYING FROM 66" TO 9' AND 141LF RETAINING WALL VARYING 2'6" TO 5' THROUGHOUT PROPERTY [CITY AND ESSI
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.
:.DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - ESGIL STRUCTURAL ENGINEER
101-0000-42600
1
$120.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES ADMINISTRATIVE STAFF
101-0000-42600
0.25
$10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE - YES ADMINISTRATIVE STAFF
101-0000-42600
0.25
$10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
HOURLY CHARGE -YES STRUCTURAL PLAN REVIEW ENGINEER
101-0000-42600
1
$95.00
Total Paid for BLDG CITY STAFF - PER HOUR: $235.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RETAINING/COMBINATION WALL EA 50LF
101-0000-42400
0
$46.80
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$31.20
DESCRIPTION
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: $195.03
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
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEM=NT FEE: $10.00
DESCRIPTION ACCOUNT QTY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $S.00
I