BWFE2017-02804
VOICE (760) 777-7125
78-495 CALLE TAMPICO FAX (760) 777-7
L!� QUINTA, 011
CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT FAX
777-7153
BUILDING PERMIT
Date: 12/29/2017
Permit Type/Subtype: WALL/FENCE/CITY STANDARD/PRE-APPROVED Owner:
Application Number: BWFE2017-0280 - SCOTT BLOUGH
Property Address: 78950 SONESTA WAY
APN: 604151029 92253
Application Description: BLOUGH 40 LF OF WOOD FENCE
Property Zoning:
Application Valuation: D j�
Applicant:QAC r� 9 Contractor:
SCOTT BLOUGH 2017 SCOTT BLOUGH
78950 SON ESTA WAY CITYOF(�Q(jINTA
LA QUINTA, CA 92253 Comm UNITYDEVELOP�ARAIEUT 92253
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.::CONV:140528101254117968
Date: Contractor:
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 *
ection 7031.5, by any applicant for a permit
r
cts 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
4o e did not build or improve for the purpose of sale.).
, as owner of the property, am exclusively contracting with licensed contractors to
c ruct 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
Da4o tractors' State License Law.).
I am exeniptunnder Sec. B.&P.C. for this reason
teJ2 9q -1r7 Owner: s
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
Lender's Address:
Llc. No.::CONV:140528101254117968 .
WORKER'S COMPEMSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certifi:ate of consent to self -insure for workers'
compensation, as provided for by Section 2700 of the Labor Code, for the performance
of the work for which this permit'is.issued-
I have and will maintain worker' 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: _ Policy Number:
_ I certify that in the performanceof 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 become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date:
Applicant:
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDEDFOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
, APPLICANT ACENOWLEDGEMENT
IMPORTANT: Application is hereby made to the.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 performed under or pursuant to any permit issued
as a result of this application, the owner, znd the applicant, each agrees to, and shall
defend, indemnify and hold harmless the Gty of La Quinta, its officers, agents, and
employees for any act or omission related :o 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 ssuance of such permit, or cessation of work
for 180 days will subject permit to cancellation.
I certify that I have read this application ar,J state that the above information is correct.
I agree to comply with all city and county crdina.nces and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above- .
mentioned property for inspection purposes.
Date:) Signature (Applicz nt or Agent):
Date: 12/29/2017
Application Number: BWFE2017-0280
Owner:
Property Address: 78950 SON ESTA WAY
SCOTT BLOUC H
APN: 604151029
Application Description: BLOUGH 40 LF OF WOOD FENCE
92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
SCOTT BLOUGH
SCOTT BLOUGH
78950 SONESTA WAY
LA QUINTA, CA 92253
92253
--------------------------------------------------------------------------------------------
Lic. No.::CON'/:140528101254117968
Detail: REPLACING 401-F OF 6' WOOD FENCE'ON SOUTH SIDE REAR PL. AND NEW PT 4X4 WOOD POST EVERY VON CENTER. AND 6' DOG EAR RED CEDAR
FENCE BOARDS (CITY STANDARD)
FINANCIAL
DESCRIPTION
/ i •
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: $117.03
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000=43611
0
$5.00
i
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS: $132.03