14-0124 (BLCK)4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/07/14
Application Number: 14-0 00 0 032 4.x,, Owner:
Property Address: 52970 AVENIDA 'RUBIO MUELLER DAVID
APN: 773-313-012-15 -000000- 52970 AVENIDA RUBIO
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL
Application valuation: 2411 D 4
Contractor: FEBApplicant: Architect or Engineer: AA MASONRY B 07
77530 DELAWARE PL
` PALM DESERT', CA 92211
(760)360-7388 PrYOF_LA'QUI, TA
LiC. No.: 804168
FIANCE D�fEJPT .
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LICENSED CONTRACTOR'S ECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under pr ions of Chapter 9 (commencing with
Section 7000) of 6vision 3 of the Business and Professionals C e,.and my License is in full force and effect.
Licehse Class:_ %C2`9 nse No. 04168 .
£.DatEF: y�//(% Contractor. .
%%77- •. OW ER=BUILDER+DEC ATION
I hereby affirm unde(penalty of perjury that I ame mpTfrom the.Contract State License Law for the
following reason (Sec. 7031 .5, Business and Profe ions Code: Any city or co, ty that requires a permit to -
eonstruoL.alter, improve, demolish, or repair any st cture;--prior to its issuance, so requires the applicant for the
permit to file a signed statement that he or she is lice pursuant to the pro ' ons of the • Contractor's State
License Law•(Chapter 9 (commencing with Section 7000) o e Business and Professions Code) or
tharhe 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 civilpenalty 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 structurelis novintended or offered for sale (Sec. 7044, Business and Professions Code: TF e ,
Contractors' Stateticense Law does not apply to an owner of property who builds or imptoves thereon,
and who doesthe work himself or herself through his or her own employees, provided that the -
improvements'arenot intended or offered for sale. If, however, the building --or improvementis 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 _ ) 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:
LQPERMIT
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WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificateof consent toself-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 MARKET INS Policy Number WWC3062241
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 tobecome subject to the workers' compensation laws of California,
and agree that, if I should becom subject to the workers' compensation provisions of Section
700 of the Labor Cod I.shall I with comply with those provisions.
�Dyte//
1/' Applicant: .
WARNING:: FAILURE TO SECUREWORKERS' 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 the above information incorrect. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this counX enter upon the above-mentioned pro rt for inspect
Dat : n purposes.
DaSignature (Applicant or Agent): �
Application Number
Permit . . .
Additional desc . .
Permit Fee . . . .
Issue Date . . . .
Expiration Date . .
. . . . . 14-00000124
WALL/FENCE PERMIT 2013
75.79 Plan Check Fee . .
Valuation . . . .
8/06/14
.00
2411
Qty Unit Charge Per Extension
1.00 47.1900 LS MISC WALL, FIRST 100 LF 47.19
2.00 14.3000 EA MISC WALL, ADDL 50 LF 28.60
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Special Notes and Comments
50 LN FT COMBO WALL 32" RETAINING WITH
6' TOP 80LN FT 6 FT HT 49LN FT X 5 FT HT
4 COLUMNS AT 6 FT HT ALL ORCO
STANDARDS.INSIDE PROPERTY LINE.
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Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
PLAN CHECK, WALLS 120.12
Fee summary Charged
Permit Fee Total 75.79
Plan Check Total .00
Other Fee Total 121.12
Grand Total 196.91
LQPERMIT
Paid Credited Due
.00 .00 75.79
.00 .00 .00
.00 .00 121.12
.00 .00 196.91
Din #
City Of La Q[uihta
Building 8t Safety Division
P.O. Box 1.504, 78-495 Calle Tampico
La Qulnta,'CA 92253 - (760) 777-7012
-Building. Permit Application and Tratking "Sheet
Permit #
Project Address:
r ��
Owner's Name: %La
A. P. Number:
`
Address: -52-17o A V e "I `j 1 O
Legal Description:
- City, ST, Zip: ,
Contractor:AA Mn
Telephone:
Address:_
Project Description: 50 L. b
City, ST, Zip:
� 1
Telephone GC)
<:;:::;.s:: ;:»>s:>:><,:>::.,:.;..,,..::.:>
. :: ,
State Lic. # RID q ICity
Lica
Arch., Engr., Designer:
;S _
Address:
'City., ST, Zip:
Telephone:
.. . . .. ..
f'^•:
-
.nstruction Type• Occupancy:
Pioject.type (circle one): 'New Add'n Alter Repair Demo
State Lic. #:
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
'Rec'd
TRACKING
PERMIT FEES
Plan Sets
Pla'wCheck 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 cocrcclions/issue
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. correctionsrissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue .
School Fees
Total Permit Fees
bin #
.0ty of Ld Q.urn to
..Building 8F Safety Division
P.O. Box. 1504; 78-495 Calle Tampico
La Quinta,-CA 92253 - (760) 777-7012
Building. Permit Application: and Tracking Sheet
Permit #
Project Address: —
Cie
Owner's Name: OlV i
A. P. Number:
Address: j -120-4i 1
Legal Description:
City, ST, Zip:. j elk'
Contractor: A
Telephone:
Address: w et G
Project Description:S 0 r�`.
City, ST, Zip: 7 y' ? C s� �,
O C: > " ^ A .
Tele hone ^�
P
3'
`' `` `' '""
State Lie. # : (,
City Lia. #:
-,
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
;
Construction Type: Occupancy:
State Lie. #:
, Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
41 Units:
Telephone # of Contact Person:Estimated
Value of Project:
APPLICANT: DO NOT WikITE BELOW THIS. LINE
H
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted •
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
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 IiOUSE:
i
'"' Review, ready for correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of.permit issue,
School Fees
'Total Permit Fees
- U. L.F c.ow,,6tA