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BWFE2016-021201 78-495 CALLE TAMPICO D �NtiMCl/ LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2016-0212 Property Address: 81382 AMUNDSON AVE APN: 767690015 Application Description: MADISON CLUB / BLOCK WALL Property Zoning: Application Valuation: $48,000.00 Applicant: TRI - STAR CONTRACTING II INC 15 - 501 LITTLE MORONGO ROAD DESERT HOT SPRINGS, CA 92240 OCT r8 2016 CITyOFLAQUI�jT` AA COMMUNITYzZ= PMEWDEPARTHENT LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury 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: B License No.: 915336 �—_ D7Date.— G a V!`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 ($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.). (J 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 Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/30/2016 Owner: DISCOVERY BUILDERS CALIFORNIA.INC DBA DB 14605 N 73RD STREET SCOTTSDALE, AZ 85260 Contractor: DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE, AZ 85260 (480)624-5200 Llc. No.: 915336 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: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Policy Number: YJUB282D7797 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. Date:/ Applicant: 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. 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. Date/15 i G%L- Signature (Applicant or Agent): Application Number:.. BWFE2016-0212 Property Address: 81382 AMUNDSON AVE AM: 767690015 Application Description: MADISON CLUB / BLOCK WALL Property Zoning: Application Valuation: $48,000.00 Date: 9/30/2016 Owner: DISCOVERY BUILDERS CALIFORNIA INC DBA DB 14605 N 73RD STREET SCOTTSDALE, AZ 85260 Applicant: _ Contractor: TRI - STAR CONTRACTING II INC DISCOVERY BUILDERS CALIFORNIA INC DBA DB 15 - 501 LITTLE MORONGO ROAD 14605 N 73RD STREET DESERT HOT SPRINGS, CA 92240 SCOTTSDALE, AZ 85260 (480)624-5200 Llc. No.: 915336 ----------------------------------7---------------------------------------------------------- Detail: 726 LF SITE BLOCK WALL [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $188.50 DESCRIPTION . ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 DESCRIPTION ACCOUNT CITY AMOUNT WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 Total Paid for FENCE OR FREESTANDING WALL: $297.27 t �55D67 f'3d �S DISCOVERY BUILDERS CALIFORNIA, INC. CLIFF WHALL 80-955 AVENUE 52, LA QUINTA, CA 92253 Superintendent TEL (760) 393-5286 FAX (760)398-5788 CELL (6c9) 787-2276. CWHALL@DISCOVERYBUILDERSLLC.COM WWW.DISCOVERYLANDCO.COM CA LIC: #915336 Bin # City of L.a 'Qullito Building 8F Safery Division Permit ,# � � . _ / -495 Caffe Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking -Sheet Project Address: Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: i Contrac tor. 3 D v 26ZL 1_30 ele h Telephone: Po c. Addr ss: -� (J fjv' Project Description: City, ST, Zip: L)$ dJ 11 aLT Q•� �` 1 L s Te leh one a P 11 State Lic: #� zz City Lie. #; - Arch., Eng`r., Designer: ' Address: City; ST, Zip: /� r ! . Tel' eh� P one: C ons cti on Type: an Occupancy: P Y: r 3 State c.#. Pe (circle one): New dd 'n mo roJect Re P air Demo _i of Contact Person: �/�L Sq. Ft.: es: #•Units:Ne Telephone # of Contact Person: �'��'% .— 'ZZ7to Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd 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 restrtfmitted Mechanical Grading plan 2°" Revicw, ready for corrections/issue Electrical SubconlactorList. Called Contact Person Plans picked up _ Plumbing Grant Deed S.M.I. II.O.A. Approval Plans resubmitted Grading IN ROUSE:- ''� Review, ready for correctionsfissue -Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Dale of permit issue s School Fees, Total Permit Fees srALr r - r0' ( I f. •. >' I I I I I I III I I I f .•.`� I I I I I I I Irl ,� I I I p1l, I •Jl �./ r � J l/ l / ARCS PLJ I gONOE /DEEP/ I r 1 I \Lw�S 1 s• 1 1 1\ 1 1 PA 1'.. � •., 1 1 1 1 1 1 i l l l l 1 1 r r I I \• I J I I I I •i l-- r /_ 1 1 1 1 1 • ,1 I I r i ,�{ � �1_�� I I I I:. •�,r r �� I I I I I Ir •I I I 7 I I Lr' _.� I II II I I II 1 11 II I F I I I II I II I I II 1 v IA LOT 22 (NAG Nn rAPPRoI£D PAD: IlN110) �' / / ® I I • , 1��SS }8 A J r tLrvc- l 'I 'tB61 � I I.r Saia WALL 84 + + PER ARaI. 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