BWFE2018-004578-495 CALLE TAMPICO
LA'QUINTA,'CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
JASON SETTERLUND
52022 AVENIDA NAVARRO
LA QUINTA, CA 92253
. TA'yl 4 4 Quia&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
WALL/FENCE/SPECIAL/ENGINEERED DESIGN
B W FE2018-0045
52396 AVENIDA VALLEJO
773263007
SETTERLUN D /DECORATIVE BLOCK WALL
$5,000.00
FEB 2 2 2018
CITYOFLAQUINTA I
COMMU NIiY DEVELOPMENT DEPARTMEM
LICENSED CONTRACTOR'S DECLARATION
1 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:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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
su ,os the applicant to a civil penalty of not more than five hundred dollars ($500).:
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
id not build or improve for the purpose of sale.).
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
ntractors' State License Law.).
m exempt under Sec.' . B.&P.C. for this reason
Date: 22 8 -'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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/22/2018
Owner:
JASON SETTERLUND
LA QUINTA, 92253
Contractor:
OWNER BUILDER
Llc. No.:
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
Fhave and will maintain a certificate of consent to self -insure for workers'
ompensation, as provided for by Section 3700 of the Labor Code, for the performance
f the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by.
ection 3700 of the Labor Code, for the performance of the work for which this permit is
!sued. `workers' compensation insurance carrier and policy number are:
ar r Policy Number:
certify that in the performance of the work for which this permit is issued, I
hall not employ any person in any manner so as to become subject to the workers'
ompensation laws of California, and agree that, if I should become subject to the
corkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
omply with those provisions.
,ate M I r? 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 PROVIDED FOR IN.SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
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, 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, and hereby authorize representatives of this city to enter upon the above-
mentioned property for inspection purposes.
Date: v -Signature (Applicant or Agent):
Date: 2/22/2018
Application Number: BWFE2018-0045 Owner:
PropertycAddress! _- 52396 AVENIDA VALLEJO JASON SETTERLUND
APN: 773263007
Application Description: SETTERLUND /DECORATIVE BLOCK WALL LA QUINTA, 92253
Property Zoning:
Application Valuation: $5,000.00
Applicant: Contractor:
JASON SETTERLUND OWNER BUILDER
52022 AVENIDA NAVARRO ,
LA QUINTA, CA 92253'
LIc. No.: .
--------------------------------------------------------------------------------------------
Detail: 36LF OF DECORATIVE WALL WITH PRECISION BLOCK AND BREEZE BLOCK[STANDARD APPROVED BY INSPECTOR].[6] PILASTER [CITY STANDARD]
PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY.
POSSIBLE PLANNING APPROVAL AFTER CONSTRUCTION. 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
FINANCIAL INFORMATION
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
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 MANAGEMENT FEE:
$10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
1 V 1 HL3: ?133.V.5
a