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BWFE2019-016278-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: C&tr0F aiwQ" DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT WALL/FENCE/CITY STANDARD/PRE-APPROVED BWFE2019-0162 52818 CLARET COVE 770290028 HASTINGS / 130LF OF GARDEN WAL Applicant: CLARK DEVELOPMENT CORPORATION 84-573 ANCHORA WAY INDIO, CA 92203 P Q U AUG 22 2019 D VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/22/2019 Owner: DUANE HASTINGS 1818 PORT TIFFIN NEWPORT BEACH, CA 0 Contractor: CLARK DEVELOPMENT CORPORATION 84-573 ANCHORA WAY INDIO, CA 92203 (760)989-0099 Llc. No.: 893790 CITY OF LAQUINTA ------------------------------OEM%&DEVELOPMENTDEpARTMEN!-------------------------------------- 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: B License No.:8937 S 22 [ ►� C 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 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 APPLICANT ACKNOWLEDGEMENT within one year of completion, the owner -builder will have the burden of proving that IMPORTANT: Application is hereby made to the Building Official for a permit subject to he or she did not build or Improve for the purpose of sale.). the conditions and restrictions set forth on this application. (_) I, as owner of the property, am exclusively contracting with licensed contractors 1. Each person upon whose behalf this application is made, each person at whose to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' request and for whose benefit work is performed under or pursuant to any permit State License Law does not apply to an owner of property who builds or improves issued as a result of this application , the owner, and the applicant, each agrees to, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and the Contractors' State License Law.). employees for any act or omission related to the work being performed under or (_) I am exempt under Sec. B.&P.C. for this reason 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. Date: Owner: 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' comps on, as provided for by Section 3700 of the Labor Code, for the performance of t;o;T7AhG e for which this permit is issued, ave and will maintain workers' compensation insurance, as required by Senof 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 OMPENSATI N INSURANCE FUND Policy Number: 9106372 I certify that in the performance of the work for which this permit is issued, 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 1noof the Labor Code, I shall forthwith comply with those provisions. ? Z/ 0 ojytplTcant: t!// 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. CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct. I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state laws relating to building the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of thiscity er upon the above - Lender's Ed pr petty for inspection purposes. Lender's Name: ��� Z�� (ApplicantorAgentj Lender's Address: FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $16.01 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $53.37 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $66.71 Total Paid for BLOCK WALL: $136.09 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 W (.'A[ IFOR IA PERMIT # QL,,,i�CrCreL PLAN LOCATION: Project Address: Project Description: APN #: n J�� J' (�1'cVl W4u— Applicant Name: yt�(( Address: - g et-Atr7- COr! City, ST, Zip: to QVi, TK C4 21 Telephone: 76 Up Email: C LA f I�_ �G� &jyp� Project Valuation 0•0c,4 Contractor Name: r/L��i l � V eVeLV&,e,(?' New SFD Construction: Address: © Ll / 4 V4 `y Conditioned Space SF City, St, Zip ��� 't) 4vze) Garage SF Telephone: �� .� g v Patio/Porch SF Email: �Li'� �`�� ��p Fire Sprinklers SF State Lic: 8T3720 City Bus Lic: 76 3 d'Ze Architect/Engineer Name: Construction Occupancy: Address: Grading: City, St, Zip Telephone: Bedrooms: Stories: # Units: Email: State Lic: City Bus Lic: Property Owner's Name: ,/A N-Q 4A ST,% CNew Commercial / Tenant Improvements: Address: q#31 1-f Av (s s f'TCe-1- Total Building SF City, ST, Zip -r -75-1� Construction Type: Occupancy: Telephone: _ 3 - q 1 Email: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 OFFICE USE ONLY # Submittal Required Received Plan Sets Structural Calcs Truss Calcs Title 24 Calcs CVWD Fire Flow Letter Soils Report Grading Plan (PM10) Landscape Plan Subcontractor List Grant Deed HOA Approval School Fees Burrtec Debris Plan Planning approval Public Works approval Fire approval City Business License l 1�