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BWFE2016-012178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 4 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BWFE2016-0121 Property Address: 51840 AVENIDA RUBIO APN: 773162005 Application Description: GOMEZ / 80 LF OF BLOCK WALL SOUTH PL Property Zoning: LA QUINTA, CA 92253Ec� Application Valuation: $5,600.00 Applicant: PANCHO'S CONCRETE INC 68895 PEREZ ROAD SUITE 9 CATHEDRAL CITY, CA 92234 LICENSED CONTRACTOR'S DECLARATION• I hereby affirm under penalty of perjury that Iam 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 forceand effect. License Class: C-8 license No.: 791390 oe (Date: Contr 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).: (_J 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 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760j777-7153 Date:. 6/2/2016 Owner: SILVIA QUETZALLI GOMEZ 51840 AVENIDA RUBIO LA QUINTA, CA 92253Ec� Contractor: PANCHO'S CONCRETE INC68895 PEREZ ROAD SUITE 9 CATHEDRAL CITY, CA 92234(760)324-2484 Llc. No.: 791390 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 t**tvprk for which this permit is issued. . have and will maintain workers' compensation insurance, as required by ection 700 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: _ Polity Number: _ ' 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 Or'Code, Is all fort ith comply with those provisions. Date: — Ap 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: ,e'J :;K- ;K6 Signature (Applicant or A y i FINANCIAL INFORMATION DESCRIPTION i+ 1 `. ACCOUNTS QTY 'AMOUNTI`' 's« PAID PAIDDATE'F , _ .a { A 3 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/2/16 l t' PAID BY `_ METHOD ¢_`. ., z ; , RECEIPT # ¢ x ,CHECK # x CLTD BY PANCHO'S CONCRETE INC CHECK R1S937 1030 SKH Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 DESCRIPTION. ` ` `a ACCOI'1NTe ..y #g FQTY Y fAMOUNTy PAID s PAID DATE, 4 , = . �� 1 a s, b � WALL/FENCE - FIRST 100 LF 101-0000-42404 0 r $47.86 $47.86 6/2/16 PAID BY'' +. a -,..,E METHOD °i '; "' ; RECEIP.T # € r ' �, = `CLTD BY.- j , , CHECK ,# PANCHO'S CONCRETE INC CHECK r' R15937 1030 SKH ;DESCRIPTION ACCOUNT _ QTY; ° tAMOUNT.� c A" PAID 'PA ID DATE' , WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $60.91 6/2/16 PAID BY •, `�_ METHOD =RECEIPT # �` CHECK # CLTD BY;' _ < ." ;. , PANCHO'S CONCRETE INC CHECK R15937 1030 SKH Total Paid for FENCE OR FREESTANDING WALL: $108.77 $108.77 TOTALS:0• 0• .77 y i i 4 = r\ Description: GOMEZ / 80 LF OF BLOCK WALL SOUTH PL Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: FINALED Applied: 6/2/2016 SKH APPROVED Approved: 6/2/2016 SKH Parcel No: 773162005 Site Address: 51840 AVENIDA RUBIO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 34 Lot: 20 Issued: 6/2/2016 SKH UNIT 2 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: 6/20/2016 DCL Valuation: $5,600.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 80LF OF BLOCKWALL AT SOUTH PL [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. 18 — 0 4 "Nimm 0e,1111111-- 0 I Applied to Approved Approved to Issued Issued to Finaled Printed: Friday, January 27, 2023 1:37:05 PM 1 of 3 WSYSiEMS CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES SPOKE TO CONTRACTOR. WALL WILL BE 5' IN HEIGHT, 8 TELEPHONE CALL DUANE CLAYTON 6/14/2016 6/14/2016 COURSES MAX, 6" BLOCK(APPROVAL FOR THIS WALL SIZE ONLY). CONDITIONS CONDITION DATE DATE DATE CONTACT STATUS REMARKS NOTES TYPE ADDED REQUIRED SATISFIED READY TO ISSUE STEPHANIE NEEDS LETTER AND DRIVER'S LICENSE OF 6/2/2016 6/2/2016 6/2/2016 COMPLETE CHECKLIST KHATAMI ADJACENT PROPERTY OWNER, WALL ON PL. CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT PANCHO'S CONCRETE INC 68895 PEREZ ROAD CATHEDRAL CA 92234 SUITE 9 CITY Printed: Friday, January 27, 2023 1:37:05 PM 1 of 3 WSYSiEMS Printed: Friday, January 27, 2023 1:37:05 PM 2 of 3 RWsYsrEMS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE EMAIL CONTRACTOR PANCHO'S CONCRETE INC 68895 PEREZ ROAD CATHEDRAL CA 92234 SUITE 9 CITY OWNER SILVIA QUETZALLI GOMEZ 51840 AVENIDA RUBIO LA QUINTA CA 92253 DESCRIPTION ACCOUNT QTY AMOUNT Printed: Friday, January 27, 2023 1:37:05 PM 2 of 3 RWsYsrEMS FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY PANCHO'SCONCRETE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/2/16 R15937 1030 CHECK SKH Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: WALL/FENCE - FIRST PANCHO'S CONCRETE 101-0000-42404 0 $47.86 $47.86 6/2/16 R15937 1030 CHECK SKH 100 LF INC WALL/FENCE - FIRST PANCHO'S CONCRETE 101-0000-42600 0 $60.91 $60.91 6/2/16 R15937 1030 CHECK SKH 100 LF PC INC Total Paid for FENCE OR FREESTANDING WALL: $108.77 $108.77 TOTALS:0• 0• .77 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE FOOTING FOR STANDARD GARDEN WALL IS 34". MAX UNLEVEL BACKFILL FOR STANDARD GARDEN WALL IS 6". IF 6" EXCEEDED USE COMBINATION WALL DETAIL FOOTINGS DCL 6/9/2016 6/9/2016 APPROVED WITH 8" BLOCK. CORRECT DETAIL FOR WALL NOT ON SITE. FOOTING APPROVED. WALL WILL BE 5' IN HEIGHT, 8 COURSES MAX, 6" BLOCK. BOND BEAM DCL 6/14/2016 1 6/14/2016 1 APPROVED I WALL HEIGHT AND FOOTINGS OK. Printed: Friday, January 27, 2023 1:37:05 PM 2 of 3 RWsYsrEMS Printed: Friday, January 27, 2023 1:37:05 PM 3 of 3 WsYsrEMS BOND BEAM DCL ATTACHMENTS 6/16/2016 6/16/2016 APPROVED CREATED OWNER DESCRIPTION FINAL" DCL ETRAKIT ENABLED 6/20/2016 6/20/2016 APPROVED FINAL.JPG FINAL.JPG Printed: Friday, January 27, 2023 1:37:05 PM 3 of 3 WsYsrEMS ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED IMAGE 6/20/2016 DUANE CLAYTON FINAL.JPG FINAL.JPG 0 IMAGE 6/16/2016 DUANE CLAYTON BOND BEAM.JPG BOND BEAM.JPG 0 IMAGE 6/14/2016 DUANE CLAYTON PHOTO BOND BEAM MID HEIGHT.JPG PHOTO BOND BEAM MID HEIGHT.JPG 0 IMAGE 6/16/2016 DUANE CLAYTON BOND BEAM.JPG BOND BEAM.JPG 0 Printed: Friday, January 27, 2023 1:37:05 PM 3 of 3 WsYsrEMS 06-14-2016 11:26:34 AM 06-16-2016 11:07:34 AM 1%: y'. - ':� - _-�.�' �� - c � I" �pIII' 91�� r r" t Bin City of La Quinta Building 81: Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #f Project Address: �.. �' Owner's Name: A. P. Number: ' . Address: _fq6 AveA1,4,4 Au4,-6 Legal Description: • k ,6 City, ST, Zip: Contractor: ,4 ele h ntillQ .. T e. Address:KFU 1 L Project Descr iption: City, ST, Zip: �j Tel e ne• Po . h ...City State Lic. L. Lic. Arch., Engr., Designer: Address: City., ST, Zip: Telephone: Ph o . n Co tructi s on Type: Occupancy: ane Y: State te Lic. #• Project ect tYPa (circle one): New Add'n Alter' Repair Demo Name of Contact Person: Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: 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 2°" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"! Reyiew, 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 Jun 02 16 07:58p p.1 �� I N P� p-1Z� 04- 51 v rl b AVe, P&,k o , k_61 4)u I n f -zt-. , C-it- .7-vi S 'is m C4t;- --7 ll3q&) RECEIVE® JUN 0'2 2016 CITY OF LA QUINTA COMMUNITY DEVELOPMENT x2z,6-�4 Y-ev, -00 tet'_ — Bin.# City. .0f S:d Qi.1(Citd Building a.. Safety Division .' P.O. Box 1504,76-495 Caife Tampico La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:. S—Cbt-(o , bio " Owner's Name:. A. P. Number Address:, S �_ Legal Description:. Contractor. � rY ' City, ST, Zip: Telephone &ssc Project Description: Address: Sb _ 5 S -C-\t; , 4 -1>-. City, ST, Zip: vu cht ala a s t•. N'4 Telephone: v 33�✓-�alogp �; ."k?" ? State Lic. # : City Lid. #; Arch., Engr., Designer Address: City., ST, Zip: Telephone: ` State Lic. #: ,atw»%' Name of Contact Person:Sq. Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Ft.: #Stories: # Units: Telephone # of Contact Person': Estimated Value of Project: , 3$-D . APPLICANT: DO NOT WRITE BELOW RqWNE # Submittal Req'd Rec'd rgp PERMIT FEES Plan Sets Structural Cales Pian Check SUIT149FOitem .e Review y ed, read for confectio s 0 �U 1` Amount Plan Check Deposit. . Truss Calcs. Called Contact Person C Plan Check Balance. Title24 Cales. Pians picked up '� Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan 2'i Review, ready for correctionsfissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Pians picked up SALL H.O.A. Approval Plans resubmitted Grading IN ROUSE:- ''d Review; ready for correctionsfissae Developer Impact Fee Planning Approval Called Contact Person A:I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 5 5,3 SAY. APR 10 2012 6) T p t --.IL I011 i I I'l 11. iii i - , pQR 1 � 20�`l ��6�