BDEM2015-0001C78-495 CALLE TAMPICO 0 D VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
J Date: 3/16/2015
Application Number: BDEM2015-0001 Owner:
Property Address: 54725 AVENIDA RUBIO DENISE CARTER
APN: 774271023 54725 AVENIDA RUBIO
Application Description: CARTER DENISE DEMOLITION OF WALL LA QUINTA, 92253
Property Zoning:
Application Valuation:
Applicant: rjMuNj�ffy
Contractor:
BAGWELL MASONRY 5BAGWELL MASONRY
0 OUTSIDE CITY LIMITS jI 0 OUTSIDE CITY LIMBTS
LA QUINTA, CA 92253 16 20 5 LA QUINTA, CA 922 i3
OF LA QUINTA (760)369-7140
EVELOPMENTDEPARTMENT Llc. No.::LIC 0005315
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:
License No.: :LIC -0005315
te: 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
permit subjects the applicant to a civil penalty of not more than five hundred dollar,
($500).:
(1 1, as owner of the property, ormy 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 Name:
Lender's Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of t ie following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 cf 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 =arrier and policy number are:
Carrier: _ Policy Number:
I certify that in the performance of tFe work for which this permit is issued, I
shall not employ any person in any manner so a: 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 37)0 of the Labor Code, I shall forthwith
comply with those provisions.
'1 —
Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIN^L PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000Q. IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
. APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1: Each person upon whose behalf this appliotion is made, each person at whose
request and for whose benefit work is perform.^d under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the w:ity of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this applic etion becomes null and void if work is
not commenced within 180 days from date of 6suance of such permit, or cessation of
work for 180 days will subject permit to cancel ation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and countyordieances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentioned pr perty for inspection purposes.
pate: Signature (Applicant or Agent):
' t �
h a i;j: E
I
PA D',� n�, Fr
'PAID DATE''
{DESCRIPTION^., car i
FINANCIAL INFORMATION
f W4_1,,V +�ai.tll �y�{ 1
'F tACCOWNT$�a aX ,�3s
•,. .... - K
MOUNT
QTY F S r,A i
DEMOLITION, EXTERIOR
101-0000-42404
0 $24.66
$0.00
14.J+
"��:•?� ac;NupPAID'BY'z ,a ..y;.
aa;„yF ;,. - h rL.1+ zi
>,`a"��iMETHOD;�S�"}
.t ,sa..+n _ ♦ 'sc F.
i` �y RECEIPT#;CHECK#`.?
•y yY� - - s.
GJ rx
CLTDBY``
i , a DESCRIPTIONS �* n' t;w a�
{�� K '"ACCOUNT r t P
wCRTY
PAID; ��'
*PARDATE�
DEMOLITION, EXTERIOR PC
101-0000-42600
0
$87.02
; s .tc�,, r'r*=.i
G r ".PAID BY r * �*' �
`...t,.x, ,t2ti-_n+%.,.s...x•, ...... ..:o-",� r'`...,,
" ; " METHOD r
L ... _.....r
c ".4�n RECEIPT
,.:.r
S
CHECK # �r s{
8'
CLTD-BYE-
Total Paid for DEMOLITION: $111.68 $0.00
TOTALS:00
M I
i
V4
Description: CARTER DENISE DEMOLITION OF WALL
Type: DEMOLITION Subtype: COMMERCIAL/OTHER
Status: UNDER REVIEW
Applied: 3/16/2015 PJU
Approved:
Parcel No: 774271023 Site Address: 54725 AVENIDA RUBIO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 270
Lot:,11
Issued:
UNIT 25
BAGWELL MASONRY
0 OUTSIDE CITY LIMITS
Lot Scl Ft: 0 Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $0.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0
No. Unites: 0
0 OUTSIDE CITY LIMITS
Details: DEMOLITION OF FOUR FT OF ADDED BLOCK WALL TO EXISTING BLOCK WALL PER CODE CASE 14-0939 APPROVED PER AJ.
ADDITIONAL SITES
CHRONOLOGY
Printed: Monday, March 16, 2015 1:24:36 PM 1 of 2 CRI"SYSTEMS
ZIPi" 1 PHONE
NAME TYPEY s' '" a . `NAME"ADDRESSI' a..
CONTACTS
CITY ' STATE-"
APPLICANT
BAGWELL MASONRY
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(
Printed: Monday, March 16, 2015 1:24:36 PM 1 of 2 CRI"SYSTEMS
'
�
_
Printed: Monday, March 16,20151:24:36nw
`
`
BOND INFORMATION
ATTACHMENTS
'
`
CRWYSTEMS
77
INSPECTIONS
�`SEQil)' IN�PECTION TYPE ---�'INSPECTOR
SCHEDULED
TW
DEMOLITION, EXTERIOR
101-0000-42600
0
$87.02
$0.00
PC
PRE -SITE
BLD
FINAL".
Total Paid for DEMOLITION: $111.68 $0.00
TOTALS: $111.68 $0.00
�
_
Printed: Monday, March 16,20151:24:36nw
`
`
BOND INFORMATION
ATTACHMENTS
'
`
CRWYSTEMS
INSPECTIONS
�`SEQil)' IN�PECTION TYPE ---�'INSPECTOR
SCHEDULED
-COMPLETED'
RESULT.'
PRE -SITE
BLD
FINAL".
BLD
�
_
Printed: Monday, March 16,20151:24:36nw
`
`
BOND INFORMATION
ATTACHMENTS
'
`
CRWYSTEMS
`t
Iain # City of La Q uin to .
-Building 8£ Safety Division
Permit # Z:�Q P.O. Box 1504, 78-495 Calle Tampico .
U l La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: .S c Owner's Name:' v�
A. P. Number:
Address: )
Legal Description:
City, ST, Zip:
r
Cont actor:
a � �
Tcicphon : �
:!:iL,J,:;jSisS i`•Si::i�::,'iiyiy':'.j;
Address:
Project Description:
City, ST, Zip:
c- • —
Telephone:
-
State Lic. #.:
City Lie. #c
Arch., Engr., Designer:
Address:
v
City., ST, Zip:
hone:
'
Ccu par
icy: :Tele
Construction Type:
State Lic. #
air,
Project Demo r
Name of Contact Person:
Sq. Ft.: -
#Stories:
#! Units
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Rcq'd
Recd
TRACKING
PERMIT FEES
Plan Sets
PIan 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
Mcchanica'
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd
Plans picked up
S.M.I.
N.O.A. Approval
Plans resubmitted
Grading
IN If OUSE:-
'`" Reyiew, ready for eorrectionsfissuc
Developer:_mpact Fee
Planning Approval
Called Contact:Person
Pub. Wks. Appr
Date of permit'issuc
School Fees
Total Pcrn-it Fccs