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14-0464 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 14-00000464 Property Address: 53281 ROSS AVE APN: 767-200-998-29 -330761- Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 0 Applic Tuyl 4 4 Q" Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. License Class: B di License No.: 848057 KD.te:&` Contr ctor: tv l NER-BUILDER DECLARATION Ihereby 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).: (_ 1 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.). (_) 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.). 1 _ 1 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 Name: _ Lender's Address: LQPERMIT Owner: LEAMOR RESIDENCE 53281 ROSS AVE LA QUINTA, CA 92253 Contractor: BRADSHAW CONSTRUCTION INC 46248 ROUDEL LN LA QUINTA, CA 92253 (760)347-4246 Lic. No.: 848057 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/12/14 WORKER'S COMPENSATION DECLARATION 1 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 the work for which this permit is issued. ,have and will maintain workers' compensation 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: Carrier STATE FUND Policy Number 904390214 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 as to become subject to the workers' compensation laws of California, and agree that, if I should beco a subject to the workers' compensation provisions of Section 3700 of the Labor Code, I sh I forthwith com911 with tho a pr Bions. pate: -=1- Applicant: WARNING: FAILURE TO SECURE WORKERO COMPEATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A r CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). 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 the Director of Building and Safety 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 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 City 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 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 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, aqq hereby authorize representatives of this -county ,to eenter upon the above-mentioned grope y or inspection pu ses. L)ate:' " V "L "1 Signature (Applicant or Agent): j Application Number Permit Additional desc . Permit Fee . . . . Issue Date Expiration Date . . . . . . 14-00000464 WALL/FENCE PERMIT 2013 165.88 Plan Check Fee . Valuation . . . . 12/09/14 .00 0 Qty Unit Charge Per Extension 1.00 47.1900 LS MISC WALL, FIRST 100 LF 47.19 5.00 .14.3000 EA MISC WALL, ADDL 50 LF 71.50 1.00 47.1900 LS MI RET WALL <=121, 1ST 100' 47.19 ---------------7------------------------------------------------------------- Special Notes and Comments ORCO STANDARDS 271 LF X 5 HT;33 LF X 6 HT & ENG. COMBO 61& 4' RETAING X 28 IN FT PER APPROVED PLANS &JJ.'PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. ---------------------------------------------------------------------------- Other Fees.. . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 HOURLY PLAN CHECK 140.00 PLAN CHECK, WALLS 60.06 Fee summary Charged ----------------- ---------- Permit Fee Total 165.88 Plan Check Total .00 Other Fee Total 201.06 Grand Total 366.94 LQPERMIT Paid Credited Due ---------- ---------- ---------- .00 .00 165.88 .00 .00 .00 .00 .00 201.06 .00 .00 366.94 I Bin # City Of La Qudnta Building &r Safety Division �. P.O. Box 1504,78-495 Calle Tampico - La Quinta, CA 92253 - (760) 777-7012 qp� Building Permit Application and Tracking% 1 S� Permit # . Project Address: S328t �bS3 tAV(� Owner'sNamc: U_c> A. P. Number: Address:0ATq Legal Description: City, ST, Zip: Contractor: L7F+T�$ NAr1J CA�i�d.ti+►C..�1 t7+� Telephone: r.:;.:.s :::: •. Address: Ll(/L Project Description:'�Wv,� City, ST, Zip: iwteY• �' 2'l.S�6A P.O" � r—i��r kSl t (..- Tcic hone State Lic. # : IMCA$7 City Lic. #; X 2 L� Arch., Engr., Designer.. Address: City, ST, Zip: . Telephone: Construction Type: Occupancy: YP P cY= Project type (circle one): New Add'n Alter Repair Demo State Lic. #: :<>>-;<:>:s»:<::> r:::.>•<:>.<:>:».<:::_ ........................... Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: '76 a . V7S_ (o ( Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE ti Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted / Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person S Plan Check Balance, Title 24 Calcs. / Plans picked up 4S Construction Flood plain plan Plans resubmitted �` Mechanical Grading plan god Review, ready for corrcclionsfissue Electrical Subcontac(or List Called Contact Person Plumbing Grant Deed Plans picked up S.M.L. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready for correction Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Perm'(Fecs 1—� "s7;6 Y Sl3o�G , ^ may.