BLCK (14-0142)78180 Masters Cir
14-0142
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P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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VOICE (760) 777-7012
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FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT 4`,,' INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/12/14
Application Number: 14-00 000142 Owner:"
Property Address: y. 78180 MASTERS CIR THOMAS J HAACKER TRUST
APN: 770-360-002- - 78180 MASTERS CIRCLE'
Application description:- WALL/FENCE LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 6400
Contractor: D D
Applicant: Architect or Engineer: M O MASONRY, INC. 1 sy r
80589 SHEFFIELD AVENUE FEB i C 2014
INDIO, CA 92203--0
(760) 574-3313 CNTyof: auINTA
Lic. No.: 920321 FINANCEO>
------------------------------------------------------------------------------------------------•—
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: C29 License Ngo.: 920321 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
pp issued.
Date: 0G W Contractor: • _ 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier STATE FUND Policy Number 1948418-13
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws'of California, -
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 37)000 of the Labor Cod I shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
Q . 2'tT A
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: ate: pplicant
(_ 1 1, 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. '
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.). APPLICANT ACKNOWLEDGEMENT
(_) I, as owner of the property, am exclusively contractingwith licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of - conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for
pursuant to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
I—) I am exempt under Sec. BAP.C. for this reason 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
• I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all
work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property for inspection purposes.
Lender's Name: /
. Date0_ 0- 42 - Signature (Applicant or Agent) i/ .o
Lender's Address:
LQPERMIT
Application Number" . . 14-00000142
Permit . . . WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee 90.09 Plan Check Fee
.00
Issue Date Valuation . . .
6400
Expiration Date 8/11/14
Qty Unit Charge. Per
Extension .
• 1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
3.00 14.3000 EA MISC WALL, ADDL 50 LF
42.90
Special'Notes and Comments
161 LN FT X 6 FT HT ;92 LN FT X 6FT HT
BLOCK WALLS & 2 COLUMNS 6FT HT ALL PER
ORCO STANDARDS AND APPROVED PLANS
PRECISION CONCRETE BLOCK SHALL BE
COVERED WITH STUCCO, PAINT, OR TEXTURED.
COATING WHERE VISIBLE FROM OUTSIDE THE
PROPERTY. 2010 CBC
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.06
Fee summary Charged Paid Credited
Due
Permit Fee Total 90.09 .00 .00
90.09
Plan Check Total .00 .00 .00
.00
Other Fee Total 61.06 .00 .00
61.06
Grand Total 151.15 00 .00
151.15
LQPERMIT
Din #
City of La Quinta.'
Building 8I' Safety Division
P.O. Box 1504, 78-495 Calfe Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: I
Owner's Name: cd
A. P. Number:
Address: Z_ I o 74
Legal Description:
City, ST, Zip:
Contractor: OkMTelephone:
Address: 7:1 e' t
Project Description:
City, ST, Zip: 6 L`O cr- `2_ L
C
W
Telephone:
":'•.s'A<<<`•::> :<<:><::;:::;.:
State Lic. # :,a P3 <2:1
City Lic. #•:
Arch., Engr, Designer.
Address:
® U, (6
1 UJ,
City., ST, Zip:
Telephone:
'?'•'?.'':';::t .;;_:.;:,, :;:::;::;::::.:<.::. ;:.;:•;;<;:.:
.>:.>:.;;;:
Construction Type: Occupancy:
State Lic. #
Project type (circle one): New Add, n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone #,of Contact Person:
40-0 r
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE '
N
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
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 correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
r'a
GENERAL NOTES,
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IN THE CITY OF LA QUINTA, STATE OF 'CALIFORNIA
PRECISE GRADING PLAN
TRADITION LOT 74 _
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NOTE:
CONSTRUCTION NOTES
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APN: 770-380-002 '
MASTERS CIRCLE 2/28/13
BENCHMARK—LOCAL BENCHMARK
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CITY OF LA UINTA
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APN: 770-380-002 '
MASTERS CIRCLE 2/28/13
BENCHMARK—LOCAL BENCHMARK
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CITY OF LA UINTA
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