BWFE2018-027778-495 CALLE TAMPICO Tw�/ D 4 Q&rcu VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 12/14/2018
Permit Type/Subtype: WALL/FENCE/CITY STAN DARD/PRE-AP PROVE D Owner:
Application Number: BWFE2018-0277 SCOTT AND SHANNON MCLENDON
Property Address: 79195 TOM FAZIO LANE NORTH 60 SOUTH LAKESHORE RD 1D
APN: 766032027 CHELAN, WA 98816
Application Description: MCLENDON / 205 LF BLOCK WALLS
Property Zoning:
Application Valuation: $15,000.00
Applicant: w LJ Contractor:
EDGAR BENJAMIN BERNAL D '1 1� LLLU111 EDGAR BENJAMIN BERNAL
70
73-673 PACHETA SQUARE , 73-673 PACHETA SQUARE
THOUSAND PALMS, CA 92276 ; DEC 19 "018 ! THOUSAND PALMS, CA 92276
1 CPO�A (760)404-9648
FL1�1QWn+ Llc. No.: 1015356
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: C-8. C29 License No.: 1015356
Date: 12 l9 16 ContraGtfl7.:
OWNER -BUILDER D£CLARA ION
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
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 Andress:
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.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Cade, for the per€ormance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: FALLS LAKE FIRE AND CASUALTY COMPANY Policy Number: FLAO09706
r 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' campensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
I l �i 19 I *Now.
WARNING: FAILURE TO SECURE WORKERS' COmPiNsATION COVERAGE IS UNLAWFUL,
AND 5HALL SUBJECTAN 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,
INTERE5T, 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 ui7on the J
above -mentioned property for inspection purposes. � /i
Up& 1 '7 ! 1 `6f 1 t& Signature (Applicant or Agent):
Date: 12/14/2018
Application Number:
BWFE2018-0277
Property Address:
79195 TOM FAZIO LANE NORTH
APN:
766032027
Application Description:
MCLENDON / 205 LF BLOCK WALLS
Property Zoning:
Application Valuation:
$15,000.00
Applicant:
EDGAR BENJAMIN BERNAL
73-673 PACHETA SQUARE
THOUSAND PALMS, CA 92276
Owner:
SCOTT AND SHANNON MCLENDON
60 SOUTH LAKESHORE RD 1D
CHELAN, WA 98816
Contractor:
EDGAR BENJAMIN BERNAL
73-673 PACHETA SQUARE
THOUSAND PALMS, CA 92276
(760)404-9648
Llc. No.: 1015356
Detail: 205LF OF 5' AND 6' GARDEN WALLS THROUGHOUT PROPERTY FOR EQUIPMENT WALLS AND PRIVACYWALLS [CITY SPECIFICATIONS] 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. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
CITY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$48.03
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$53.37
DESCRIPTION
ACCOUNT
CITY
AMOUNT l
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$66.71
Total Paid for BLOCK WALL: $168.11
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
RECORDS MANAGEMENT FEE
101-0000-42416 0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
I'ro•lett Add e": 79-195 TOM FAZIO LN. NORTH Proje=t Description; Pool, Remodel, Adcl't, Elect, Plumb, i4ech
APN #- P5�'H�IGHWIDE MASONRY WALL BY DETAIL. OF CITY OF
LA QUINTA: FREESTANDING BLOCK WALL. 110 LFT.
Applieant `acme: ANDRERW PIERCE CORP. 6' HIGH 6" WIDE MASONRY WALL BY DETAIL. OF CITY OF
Address: P.O. BOX 3420 LA QUINTA, FREESTANDING BLOCK WALL. 95 LFT.
City, S `� 7T, PALM DESERT. CA. 92261
Te leplivae.
Email: --
l C�rrl ntra`tor- game: B B CONCRETE
,`i dr-
" 73-673 N. PACHETA SQ.
City. St_ Zih THOUSAND PALMS, CA. 92276
Telephone: 760 578 9506
En—tai l-
Valuation of Project
- New SFT) Construction:
(A)f1diuoned Space
Ciarage
Patio Porch
P Fire Sprinkfc
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Property Owner's !Name: SCOTT AND SHANNON McLENDON New Commercial % Tenant Improvements: T
l'ldr":> LAKESH ORE RD. 1 D Total Building SI[.... .
(-ity, S'T. ZipCHELAN WA 98816 Construction Type: Occupancy
Email: - -
78495 CALLE TAMNCO
LA QUINTA, CA 92253
760-777-7000
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DEC I; 2013
CITY OF [.A QUINTA
COMMUNITY DEVELOPMENT
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BUILDING DIVISION
REVIEWED FOR
CODE
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