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BWFE2017-016878-495 CALLE TAMPICO T 4 Quie 4ht 1v LA QUINTA, CALIFORNIA 92253 DESIGN & DE' BU Permit Type/Subtype: WALL/FENCE/SPECIAL/ENGINEERED DES Application Number: BWFE2017-0168 Property Address: 78612 PEERLESS PL. APN: 770310017 Application Description: JOHNSON / COMBO WALL Property Zoning: comply wit those provisions. Application Valuation: $11,775.00 Applicant: SOUTH WEST CONCEPTS, INC. 78115 CALLE ESTADO, SUITE 105 LA QUINTA, CA 92253 NOV 0 7 2011 CITY QF LA QUINTA COMMUNITY DEkIELOPMENT DO 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.: Date: Contractor: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/7/2017 PAV JOHNSON 712 PEERLESS PL LA QUINTA, CA 92253 Contractor: OWNER / BUILDER Uc. No.: WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one Y the following declarations: I have and will maintain a certific.te of consent to self -insure for workers' compensation, as provided for by Section 3730 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 oft work for which this permit is issued. My workers' compensation insurau,ce carrier a policy number are: OWNER -BUILDER DECLARATION Carrier: _ Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance cfi ch 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 Sa bject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree teaome subject to the JoLa any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply wit those provisions. 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 them :Date:— 1 17 n: tom` 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ( AND SHALL SUBJECT AN EMPLOYER TO CRIMNAL PENALTIES AND CIVIL FINES UP TO Q ,las owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000): IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKN 3WLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to :he Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on trais application. Ate did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this apF lication is made, each person at whose IT., as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is perforned under or pursuant to any permit to -construct the project. (Sec. 7044, Business and Professio ode: The Contractors' issued as a result of this application , the ow ier, and the applicant, each agrees to, and State License Law does not apply to an owner of property w builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and there and who contracts for the projects with a contra or ) licensed pursuant to employees for any act or omission related tc the work being performed under or ontractors' State License Law.). following issuance of this permit. I am exempt under Sec. B.&P.C. for t ' r n 2. Any permit issued as a result of this app ication becomes null and voil if work is not commenced within 180 days from date of issuance of such permit, Of essation of work for 180 days will subject permit to canoellation. CONSTRUCTION LENDINJIVENCY I hereby affirm under penalty of perjury that they s a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Lender's I certify that I have read this application and state that the abo I agree to comply with all city and county ordinances and st laws construction,.and hereby authorize representatives of this to e above-fmgpti* ed erty for inspection pLrposes. Da�` //•/ 'Signature-(Applicait-or-Agent): i is correct. to building the e; Date: 11/7/2017 Application Number: BWFE2017-0168 Owner: Property Address: 78612 PEERLESS PL PAM JOHNSON APN: 770310017 78612 PEERLESS PL Application Description: JOHNSON / COMBO WALL LA QUINTA, CA 92253 Property Zoning: ' Application Valuation: $11,775.00 Applicant: Contractor: SOUTH WEST CONCEPTS, INC. OWNER / BUILDER 78115 CALLE ESTADO, SUITE 105 LA QUINTA, CA 92253 --------------------------------------------------------------------------------------------- Llc. No.: Detail: ENGINEERED WALLS 6'-6" HIGH WALL, 2'-6" RETAINING AND 5'-0" HIGH WALL,4'-6" RETAINING, PER 2016 CBC CODES } l . FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - ESGIL STRUCTURAL ENGINEER 101-0000-42600 1.S $180.00 Total Paid for BLDG CITY STAFF - PER HOUR: $180.00 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $124.80 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 BLOCS WALL: $241.83 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 S02-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $S.00 TOTALS: $427.83 0 0 G