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BWFE2020-010878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: witit 4 m(P Qa14 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT WALL/FENCE/SPECIAL/ENGINEERED DESIGN B W FE2020-0108 81735 DE SOTO AVE 767700046 ANN WALKER TRUST/ 10OLF PLANTER WALL $3,000.00 Applicant: BRADSHAW CONSTRUCTION INC D 81335 THUNDER GULCH WAY LA QUINTA, CA 92253 MAR 1 1 7n9n CITY OF LA QUINTA DESIGN & DEVELOPMENT DEPARTMENT 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.: 848057 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 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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/11/2020 Owner: ROTNER GLENN /ANN WALKER TRUST Contractor: BRADSHAW CONSTRUCTION INC 81335 THUNDER GULCH WAY LA QUINTA, CA 92253 (760)347-4246 Llc. No.: 848057 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 th for which this permit is issued. have and will maintain workers' compensation insurance, as required by Se 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: MTE COMPENSATfQNINSURANCE FUNQ Policy Number:9245081 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 with those provisions. 1 Ai PIMM: 190,511011 WARNING: FAILURE TO SECURE WORKS �' OMPENSATION 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. I� (AppUcant or Agent): Date: 3/11/2020 Application Number: BWFE2020-0108 Property Address: 81735 DE SOTO AVE APN: 767700046 Application Description: ANN WALKER TRUST/ 100LF PLANTER WALL Property Zoning: Application Valuation: $3,000.00 Applicant: BRADSHAW CONSTRUCTION INC 81335 THUNDER GULCH WAY LA QUINTA, CA 92253 Owner: ROTNER GLENN / ANN WALKER TRUST Contractor: BRADSHAW CONSTRUCTION INC 81335 THUNDER GULCH WAY LA QUINTA, CA 92253 (760)347-4246 LIc. No:: 848057 Detail: 200LF SPECIAL ENGINEERED PLANTER WALL RETAINING WALL ON NORTH SIDE OF ENTRY ROAD.CONTRUCTED ON EASEMENT. [ESSI ENGINEERING] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2019 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT RETAINING/COMBINATION WALL EA 50LF 101-0000-42400 0 $64.40 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - EA ADDITIONAL 501-F 101-0000-42404 0 $32.20 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100LF 101-0000-42404 0 $53.67 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100LF PC 101-0000-42600 0 $67.08 Total Paid for BLOCK WALL 2019: $217.35 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 e' �-SeFETY R OVI D •- ; f o FUEL L TANG 1QN7 DATE BY ,, s m g'`if i[ 114 $. 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