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BWFE2017-0136I® 78-495 CALLE TAMPICO T4t1/ D 4v VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT 7/20/2017 Application Number: BWFE2017-0136 Owner: W © Property Address: 53149 VIA DONA NICK BOZICK L APN: 777380016 53149 VIA DONA O_ Application Description: BOZICK RESIDENCE /BLOCK GARDEN WALL LA QUINTA, CA 92253 LU Property Zoning: o CZ Application Valuation: $23,000.00 N 2�i z �U Applicant: Contractor: a L JO MICHAEL JEHA CONSTRUCTION MICHAEL JEHA CONSTRUCTI Q 53408 VIA PISA 53408 VIA PISA j LA QUINTA, CA 92253 LA QUINTA, CA 92253 Z Q . Z ® ' (925)250-4038 � Llc. No.: 410408 0 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. LicenseClCllas BB License No.: 4 8 Date: 1 a�T /�� Contractor: Pr/ OWNER -BUILDER DECLAFEAT 7IV 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 by.any applicant for a permit subjects 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 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.). (_) 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 WORKER'S COMPENSATION DECLARATION I 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. I 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: EXEMPT Policy Number: _ 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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wi those drov' ions. Dater / Applica WARNI G: FAILURE TO SECURE WORKERS' COMPENkATION GOV AGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA 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 isperformed 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 or '7s d state laws relating to building construction, and hereby authorize repre tatives of th . city t e er upon the above --me tione property for inspedi purposes. Date: / � Signature (Applicant or Agen Date: 7/20/2017 Application Number: BWFE2017-0136 Owner: Property Address: 53149 VIA DONA NICK BOZICK APN: 777380016 53149 VIA DONA Application Description: BOZICK RESIDENCE / BLOCK GARDEN WALL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $23,000.00 Applicant: Contractor: MICHAEL JEHA CONSTRUCTION MICHAEL JEHA CONSTRUCTION 53408 VIA PISA 53408 VIA PISA LA QUINTA„CA 92253 LA QUINTA, CA 92253 (925)250-4038 Llc. No.: 410408 ------------------------- --------------------------------------------------------------------- Detail: 340 LF OF 6' GARDEN WALL [ANGELUS SPECIFICATIONS 5-1.2LQ] 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. PER 2016 CALIFORNIA BUILDING CODES., r. FINANCIAL •1. DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $76.00 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 1 $50.67 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $63.33 Total Paid for BLOCK WALL: $190.00 DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT CITY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 a Bin # Permit;' Project Address: City of La Qucnta Buifding 8& Safety Division 78-495 6Ife Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet n A, Ownct s Name: ,00, A. P. Number: ,,, p b Address: Legal Description: City, ST, Zip: Contractor: . Telephone: P o c.• Address:Project Description: / --)A City, ST, Zip: 7-7 _ / til Telephone: .I ...•. _ State Lic. # 'Rj46 o 4Qq: City Lie. #; ' Arch., Engr., Designer: Address: City, ST, Zip: Telephone: NMI ane on tru t' Occupancy: C s c ton T Y: Type: YP State le Ltc. 4: Project type (circle one • New Add'n Alter Repair. Demo 0 Naive of Contact Person: � �� Sq. Ft.: # Stories: tl Units: Telephone # of Contact Person: Estimated Value of Project: (j -d / APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit ' Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN ROUSE: -1 '" Reyiew, ready for corrcctionstissuc Developer Impact Fee Planning Approval Called Contact Person. A.I.P.P. Pub: Wks. Appr Dale of permit issue School Fees, 1 Total Permit Fees Dads aLilpF ' ' +� •/'/ _J, 1 A. ��Ir.l jj� - �' �� �,y� r. ..� � 'r- (;�(a�•�� t L �'rilt� 41 3�-Sk.S•,�' j + `ta�/1/ �IL��I�f/- / •'� 1 �" � �Il ,l���SX%,, y�.i��.tJ §� __ ;;;�../aa /// ,. � {,t; � k,1` •. may' ��-�t� e ,1°+ ` \' ' _ � � ;� a `� ° �•,� 'irk - , I � ' j 7 .. Irk, mw\` \n �.-;� � ,ex,�fx 't o •,7o�.N� 1 fel• C� r" ,t' P'y ', � `+'+ ;.• ' -1 ``�\` /\rte \� b' 1�\ x�" `��r ii { � �, r�—• ,��.. Fn YJ d + €, y J (\\ III 1 z. i� iu o[�Q -tel C►�►I� lIJ � ul 0 0 9 Y I L eJ ( „� r �'� LLk F -yy § 5 6 4 ! g 2'. S§ �' y � S �•� ke is ��q � pRI CP S a c 4d Ga, 531 q,1 u r P- Pont BOZICK RESIDENCE LOT 48 VIA DONA CONSTRUCTION TION� At�X LA QUIVTA, CALIFORNIA 92253 LandscapeDesign Services sCO\SPR Po 11 ILII III IIII I"EE[aa aa aromaro rea5 I i I HIDEAWAY M"°"""'°".,.u° •'" 'rLLM31✓7473<wa.CVruWe��rOn..eom'n;L T8Da1411/] 531 q,1 u r P- Pont "t,���,� CITY OF LA QUINTA SUB-CONTRACTOR LIST JOB ADDRESS5�(� _ PERMIT NUMBER'PwW�n-01" �WNER,- -tC-le -' . _BUILDER l�tfi�4 This form shall bp�ostect on the ob with the Buildinct Inspection Card at aEf times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable trade, all information requested below must be. completed by j)pplicant . "On File" is not an acceptable response :.. :.. • : ura�cc City Business License ., , :...... : s .: tion lrtis. Tide J Cla-ssificaiioit Contractor StatC.CbntiacEor_s-Licctise::;: Workers Coii�perisa.. . Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date (e.g. A, B, C 8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx) EARThiW0AK.:(C; 1:z).'.:. ' .C.'0NCRETE (C=8);:; F AIMING-(C-5)' "STRUC7 STECL (C`5... MA9:O RY (C-29) (k CA-rit".1c.`S cokJCx,*-te-L25N Q81(ol l 8131118 Mtpt% ( Je ?At 'PLUMBING IC-36}:., . LATH,. PLASTER (C=35)'. DRYWALL (C-69) HVACaC 20):; _ ELECTRICAL. "(C 10) ROOE_ING (CI-3W 'SHEET N1ETl1L (•C.g3) � _ .._.-_ FLOORING (C-15} GLAZING{C1,7) .. SEWAGE D169P.-(C-42) Pl11NTING (C-33)`:'..`;.;.. — — -CE11AMIC`TkE:(C-ri4i CABINETS ("C-G.) .:• — FENCING (C-13) -- Ll1NIJ5CAPING (C-27) .: ,: — — — i�ooL