BLCK (09-0337)54490 Avenida Madero
09-0337
P.O. BOX 1504
78-495 CALLE TAMPICO
LA_ QUINTA, CALIFORNIA 92253
Tdy44QubA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
09-00000337
Property Address:
54490 AVENIDA MADERO
APN:
774-232-026-14 -000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2425
Applicant: Architect or Engineer:
LICENSED CONTRAjApe
OR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed undrovisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Bu iness d Pr esionals e, and my License is in full force and effect.
License C/lass: B C29 LicNo.: 820821
Date: Contractor:
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 ($5001.:
1 _ 1 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.).
(_ 1 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.).
(_ 1 1 am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/15/09
Owner:
COIA LARRY
54490 AVENIDA MADERO D
LA QUINTA, CA 92253
(760)777-9571
` ' 15 2009
Contractor:
CIT^y ,7F. g-
MCD CONSTRUCTION r Aff„xIA
PO BOX 548+:j Y
MORONGO VALLEY, CA 92256
(760)363-7740
Lic. No.: 820821
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 STATE FUND Policy Number 0442271205
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 become subject to the workers' compensation laws of California,
and agree that, if I hould c me I t to the orkers' compensation provisions of Section
3700 of the Labor e, I h II comp with those provisions.
Date: i Applicant: _
WARNING: FAILURE TO SEC E 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 Director of Building and Safety 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 th above in rmation is orrect. I agree to comply with all
city and county ordinances and state laws relating to buil ing con uctio an "h reby authorize representatives
of thisUc uunty to enter upon the above-mentioned prope for ins cti.
se .
Date: J Oq Signature (Applicant or Agent):
Application Number . . . . . 09-00000337
Permit . .
. WALL/FENCE-PERMIT
Additional desc .
Permit Fee . . .
. 54.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 2425
Expiration Date
10/12/09
Qty Unit Charge Per
Extension
BASE
FEE
45.00
1.00 9.0000
THOU BLDG
2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and
Comments
97 IN FT X 6 FT HT
ORCO STANDARD
GARDEN
WALL PER APPROVED
PLANS.
----------------------------------------------------------------------------
Other Fees . . .
. . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary
-----------------
Charged
Paid Credited
Due
Permit Fee Total
--------------------
54.00
--------------------
.00 .00
54.00
Plan Check Total
.00
.00 .00
.00'
Other Fee Total
1.00
.00 .00
1.00
Grand Total
55.00
.00 .00
55.00
LQPERAIIT
a
IV"
PA
llDCo 'STANDARD 6' TO 8' CMU SITE WALLS.
OPTIONAL FLAT CAP
DESIGN CRITERIA: PER THE 2007 CUC
1. ALLOWABLE SOIL BEARING PRESSURE - ISW PSF
Z ALLOWABLE LATERAL. PASSIVE PRESSURE = ISO PCF
3. GROUT STRENGTH = 2000 PSI @ 28 DAYS,
4. REWTCRaNG STEEL : GRADE 60.
S. 1500 PSI MASONRY COMPRESSION STRENGTH.
6816 6616, OR 6618 CMU
V GROUTED ONLY@ VERT
STEEL
NOTES. -
1. CONCRETE BLOCK SHALL CONFORM TO ASTM C 90
'r DROP-IN BAR
2. CONCIZETE FOR FOOTING SHALL BE 1 PART CEMENT TO 2-112
PARTS SAND TO 3-112 PARTS GRAVEL WITH A MAXIMUM OF 1-112
cxl
GALLONS OF WATER RW SACK. PORTLAND CEMENT SHALL CONFORM
TO ASTM C 150 TYPE RIV. Fc - Z500 PSI
7
#6 57D JOINT'
I REINFORCING STEEL SHALL BE DEFORMED AND CONFORM TO
RETNFORCENFiff @ 24- 01C
ASTMA 615 GRADE 60. PROVIDE 48 BAR DIAMETER LAP.
(3 PLACES - 4 PLACES FOR 7
&8'KALLS).tA5E#5SOD.
4. RE 94R SHALL BE CElVTERED IN 71YE CONCRETE BLOCK CELL IN
FOR SLUMP BLOCX
WHICH rrL5LOCATED.
W0715. PROV
S. CONCRETE BLOCKSHALL BEL'AYED.TNA RUANTAFG80IND
#4 DRLVLIN aqRATEACH
SIDE OFOONTROL J00173,
PATTERN WITH VER77CAL CONIINLTFY OF THE CELLS UNO
BWOPWAUSAND01 WALL
HSG7Irat4AGES
6.ALL BLOCK CELS CONTAINING VERTICAL REM SHALL BE SOLID
GROUTED.
O
7. USE TYPE MORTAR PROPORTIONED USZNGASTM C270 PART
CEMENT TO 1/2 PART LIME TO +1/2 PAR75 DAMP, LOOSE 54ND.
V DOWEL @ CSVTER OF
CHU.
a GROUT FOR CONCRETE BLOCK PER ASTM C476 TO HE I PART
CENSVT TV 3 PARTS SAND (GROUT MAY coNTArN 2 PARTS 318'
PFA GRAVEL JF WEATHER CONDMONSARE FAVOR4&EAND BLOCK
uNowmwTED au Sim is sufmasw To Ailow GOOD GROUT
FLOR). WATER SHALL BEADIDED TO PROM" GOOD GROUT FLOW
WITHOUT SEGREG4770NOFTHE CDN-qMURS.
SEECHART
9. BLOCK STEM MAY BE KIETSET 1-1/2" INTO THE ROOTING WHILE
THECCINCRETEISPLAST1C: &OCKS7EM M4YBE RACED 70
Erma EDGE OF THE TRENai TYPE FoanArG.
ja FOOTING MUST BE PouRED ON OR Lvro LfNDHMRMD
NATURAL SOIL OR ON COMPACTED RU WITH A MINIMUM
-4
COMPAC77ON OF 90 96.
n. apsrjivspwnoN To sEArm Foonw TRENaiEs ARE
READY FOR CONCREETEAND ALL REQWRED STEEL IS TIED IN RACE
DF DVSPEC77ON TO BE WHEN THE REQUIRED VE UXAL IS IN
PEACEAN0THE &00(WALL rSREADY TOGROUT
lZ MAXIMUM CONTROL JOINT SPACING 40'0/C 20' O/C FOR
#4 HORZ CONT
WALLS TO BE MORTAR WASHED OR snxco COATED.'
S'TODAYL161H
MIN. FOOTING DEPTH FOR 5' TO DAYLIGHT"
-
WAAI*lo ku-6) w4.L 0:
-MArT C VNT
2FTI$ TWO(
SEE CHART
FOR REQUIRED REBAR
AND F007TNG DIMENSIONS.
OFE slov
44
lu
C31925
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OF LA QU. INTA `
IV"
PA
CURBLTNE
Bin #
City of La Quint'a
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
' 1
Project Address:
Owner's Name:
A. P. Number:
Address: 1 qn Vt • Mlk
Legal Description:
City, ST, Zip: LA S)I NTA . A
Contractor: M(9 Lo N NJ L %ko I N 1r
Telephone: e: 0 7t
Address: f o 0' t
Project Description:
City, ST, Zip: go (co Nbo vJb(LL.wi ctk
titi5
rJ oU iitJn.t.v' .
Telephone: 0 3 1 0
7 6 >< S l
State Lic. # :
City Lic. #.:
p
Arch., Engr., Designer:
Address: U
City., ST, Zip:
Telephone: one: \
Construction structi n T YP e: Occupancy:
Y•
State Lic. #:
Project ct hPe (circle one): Add' n Alter Repair Demo
Name of Contact Person: Wil,(, OAiJtq u[ o
Sq. Ft.:
# Stories:#
Units:
Telephone # of Contact Person: b0 7i 2 ' sggH
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
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
2nd Review, ready for corrections/issueElectrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
NOT:CE: THIS IS NOT A BUILDING PERMIT J( L.
DISTRICT
APPLICATION TO CONSTRUCT Permit No
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
Owner t t_.— -- Con tractor_ST Ll
^^^^
Addres Address___ Address— ---_—
f
City j NVA City--- City–__--- — —
/
Phone -s%..L ) Phone _ Phone—
oC
W
I (we) the undersigned, hereby certify and acknowledge that I (we) have read the application and agree that if Curb and Gutter, and
Z
Paving, and/or Dedication of right of way is required by the County of Riverside, the Riverside County Department of Building and Safety
3
shall not make a Final Inspection until said requirements have been met. I am also aware that no work is to be done within the County R/W
O
without an encroachment permit.
NOW, therefore, it is agreed that I (we) will not occupy said property and will not cause said pro rty to be occupied until I (we) have
complied with all laws ofthe County of Riverside and the State of California governing said propert
DATE - 1-- SIGNATURE OF OWNER AND/OR AGENT ` _
Approval by Signature from the Following Departments Listed Below
Must Be Obtained Prior to the Issuing of a Construction Permit.
PACE N0.
USE OF STRUCTURE
>
JOB ADDRESS ,f /J - — SINGLE FAMILY ( DUPLEX
LEG D SCRIPTION OF PROPERTY'- d A
, , APARTMENTS AGRIC.
O LL—`,
n
OC(
COMMERCIAL INDUSTRIAL n
N Q
'^
>_
_
COMMUNITY ERATIONS ❑
Z
NO. OF SUBMITTED PLANS — USE OF PERMIT rLu , Y
6 Q
CASE NO.
-
O 0
c Z
NO. OF P KING SPACES REQUIRED .— — NO. OF BUILDINGS NOW EXISTI G
Q
ZON I SETBACfKS: FRONT SIDE REAR
J m
GRADING PERMIT REQUIRED? YES ❑ NO ❑ LOT SIZE
SETBACK ORDINANCE N OF FEET REQUIRED ON STREET
DATE ' — SIGNATURE OF LAND USE OFFICIAL -
DEDICATION REQUIRED: YES ❑ NO ❑ NO. OF FEET_
F
W
CURB AND GUTTER REQUIRED: YES ❑ NO ❑ —STREET
t-
CAN CURB AND GUTTER FEASIBLY BE INSTALLED? YES ❑ NO ❑
W
HAS AN ACCEPTABLE APPLICATION BEEN MADE FOR ENCROACHMENT PERMIT FOR DRIVEWAY AND STREET
Q
IMPROVEMENT? YES ❑ NO ❑
O
°C
DATE SIGNATURE OF ROAD DEPT. OFFICIAI
S
SWIMMING POOLS PUBLIC
QW
SEWAGE DISPOSAL
_
FOOD ESTABLISHMENT
WATER POLLUTION REMARKS
FLOOD CONTROL—
z AIR POLLUTION
2 DIV OF HWY
c a YOUR PROPERTY MAY BE SUBJECT TO
—
a
c FLOOD. RIVERSIDE COUNTY ASSUMES
NO RESPONSIBILITY IN EVENT OF FLOOD.
284 199A 9/74 CANARY—FILE, PINK—APPLICANT
DEPARTMENT OF BUILDING AND SAFETY APPLICATION CERTIFICATE
COUNTY OF RIVERSIDE PERMIT #
Effective July 1, 1980, Chapter 1301, Section 19825 of the Health and Safety Code requires the execu-
tion of the following applicable declarations prior to the issuance of a building permit. Please
print or type and sign below.
0 LICENSED CONTRACTORS DECLARATION
I hereby affirm 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
Q OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reasons:
Q 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. If I sell within one
year of completion, I understand I will have the burden of proving I did not build or
improve for the purpose of sale (Sec. 7031.5, B.&P.C.).
[] I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 7044, B.&P.C.).
[ I am exempt under Section B.&P.C. for this reason;:
Date q- I<—kO Owner
M WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a Certificate of Workers'
Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. Code).
Policy No. Insurance
Q Certified copy is hereby furnished.
Certified copy is filed with the County of Riverside, Department of Building and Safety.
Date Applicant
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed if permit valuation is for $100.00 or less.)
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.
I further understand that if after making this Certificate of Exemption, I should become subject to
the Workers' Compensation provisions of the labor code, I must forthwith comply with such provisions
or this permit shall be deemed revoked.
Date 67—<— <p'Q Applicant
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued (Sec. 3097, Civ. Code).
Lender's Name
Lender's Address
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION
I hereby certify that no excavation five (5) or more feet in depth into which a person is re-
quired to descend, will be made in connection with work authorized by this permit, and that no
building, structure, scaffolding, falsework, or demolition or dismantling thereof, will be
more than thirty-six (36) feet high. (Chap 3.2, Grp 2, Art 2, Sec 341, Title 8, C.A.C.)
Q As owner -builder, I will not employ anyone to do work which would require a permit from the
Division of Industrial Safety, as noted above, unless such person has a permit to do such work
from that division.
[] Division of In(,dustrial Safety Permift'No.
Date .c ) Applicant 1E : /%/%_r /)AJIX ALA 4-1i,
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY
I certify I have read this application and state that the information given is correct. I agree to
comply with all state laws and county ordinances relating to building construction, and authorize a
representative of the County of Riverside, Department of Building and Safety to enter upon the pro-
perty for which I have)'appl•ied for this permit for the purpose of makinginspections.
K -i --h l), . ? 1j.) hoc ' _ 4- <
Signature of Applicant/Agent' Date
,RI' 'il A/ A. i 121 nlNf )( i Tl
Print'Applicant/Agent Name
284-2000 7/80
It
J
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER VERIFICATION
Owner',.
Address
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary.delay in processing and issuing your
building permit. No building permit will be issued until this verifi.cation.is
received.
1. I personally plan to provide the major labor and materials for con-
struction of the proposed property improvement (yes or no)
2. I (have/have not) signed an application for building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the pro-
posed construction:
Name Phone
Address City
Contractors License No.
4. I plan to provide portions of the work, but I have hired the following
person to coordinate, supervise, and provide the major work:
Name Phone
Address City
Contractors License No.
5. I will provide some of the work but I have contracted (hired) the-fo.1-
lowing persons to provide the work indicated:
Name Address Phone Type of work
284-2002 7/80
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF RIVERSIDE
OWNER -BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder
of the property improvements specified.
For your protection you should be aware that as owner -builder you are the responsible party of re-
cord on such a permit. Building permits are not required to be signed by property owners unless.
they are personally performing their own work. If your work is being performed by someone other
than yourself, you may protect yourself from possible liability if that person applies for the pro-
per permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and, where
required, to have a business license from the city or county. They are also required by law to put
their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract,
you should be aware of the following information for your benefit and protection.
If you employ or otherwise engage any persons other than your immediate family, and the work
(including materials and other costs) is $200 or more for the entire project, and such persons are
not licensed as contractors or subcontractors, then you may be an employer.
If you are an employer, you must register with the state and federal government as an employer and
you are subject to several obligations including state and federal income tax withholding, federal
social security taxes, workers' compensation insurance, disability insurance costs, and unemploy-
ment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are
especially serious with respect to workers' compensation insurance.
For more specific information about your obligations under federal law, contact the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information
about your obligations under state law, contact the Department of Benefit Payments and the Division
of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed
to perform their work personally or through their own employees, without a licensed contractor or
subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -
builder" building permit, erroneously implying that the property owner is providing his or her own
labor and material personally. Building permits are not required to be signed by property owners
unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License
Board in your community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that
you are aware of these matters. The building permit will not be issued until the verification is
returned.
Sincerely,
DEPARTMENT OF BUILDING AND SAFETY
Leopoldo Rojo, Jr.
Director
A
284-2001 7/80