BWFE2016-01977R)-495 CALLE TAMPICO
i',A QUINTA, CALIFORNIA 92253
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DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BWFE2016-0197
Property Address:
78700 AVENIDA NUESTRA
APN:
770172012
Application Description:
BARBOSA / 70LF OF 6' BLOCK WALL
Property Zoning:
Application Valuation:
$7,400.00
Applicant:
WILLIAM MORRIS DEVELOPMENT INC DBA W M B
52-520 AVENIDA NAVARRO
LA QUINTA, CA 92253
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.: 945496
Date: --7— —` 4 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 70315 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.).
(_) 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 Name:
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/9/2016 •
Owner:
BARBOSA FAMILY TRUST - HENRY & ANA BARBOSA
2592 NIXON WAY
FULLERTON, CA 92835
Contractor:
WILLIAM MORRIS DEVELOPMENT INC DBA W M B
52-520 AVENIDA NAVARRO
LA QUINTA, CA 92253
(760)688-2608
Llc. No.: 945496
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: EXEMPT Policy 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 pr visions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
�p
Date: I ' 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..
Dates �" Signature (Applicant or Agent): -
Date: 9/9/2016
,i
Application Number: BWFE2016-0197
Owner:
Fffbperty Address: 78700 AVENIDA NUESTRA
BARBOSA FAMILY TRUST - HENRY & ANA BARBOSA
• APN: 770172012
2592 NIXON WAY
Application Description: BARBOSA / 701-F OF 6' BLOCK WALL AND 93LF OF 5' WALL
FUL•LERTON, CA 92835
Vroperty Zoning:
Application Valuation: $7,400.00
Applicant:
Contractor:
WILLIAM MORRIS DEVELOPMENT INC DBA W M B
WILLIAM MORRIS DEVELOPMENT INC DBA W M B
52-520 AVENIDA NAVARRO -
52-520 AVENIDA NAVARRO
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(760)688-2608
LIc.,No:: 945496
Detail: 701-F OF 6' GARDEN WALL AT WEST PL AND 93LF OF 5' GARDEN WALL AT FRONT YARD [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE
COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
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FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$29.00
DESCRIPTION
ACCOUNT
QTY
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: $137.77
0
Bin #
City of La Qufflta
Building a Safety Division
Permit # 78-495 Calfe Tampico
La Quinta, CA 92253 - (760)'777-701,2
nd6-o Building Permit Application and Tracking Sheet
Project Address: '7 9 O AVf� OU!!VvTa/* . Owner's Name:
A. P. Number: ?'7 D 17 Z ^017—
Address:
Legal Description:
City, ST, Zip:
Contracto. r• 1 U-4 h-14^ MOnp4 6V
Telephone:
Address: r% �. ZQ 3
Project Description: L e. IL L, --A PkL L 7 ,
City, ST, Zip: bkkutOrPir
CP e
Telephone: � 7ir0
L.
State Lic. #.: �� e A'
CityLie. #::
Arch., Engr., Designer: �j t1A3
l ft Z_
Address:
j►_.Y SD� 5 1
V
City, ST, Zip:,
Telephone:
Construction TYPe Occupancy:
aneY
State a L ic#.
Project type (circle one): New Add'n Alter Repair. Demo
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Name of Contact Person: G V— 7
Sq. Ft.:
# Stories: y
# Units:
Telephone # of Contact Person: 76077 l gZZ 5
Estimated Value of Project: 7 1&0 t
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Rcq'd
Rcc'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 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.
HI.O.A: Approval
Plans resubmitted
Grading
IN If OUSE:-
Jrd Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. \Vks. APPr
Date or permit issue
School Fees,
Total Permit Fees
(E)' RE5LDENDE
+12 F.F.
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THRESHOLD (CRC SMII32) 1 O i I I _
D. EXTERIOR LAD" SHALL BE PERMTTrED. TO HAVE A 1 _ I r-- ----------
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SHALL. MEET THE FOLLO I?I REQUORE INM
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MOISTURE BASED MAT A toMAATICALLY ADA ISTS
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AS WEATHER CONDITION S CWW3E.
B. WEA-tER-BASED CONTROLLERS WITHOUT NTIS3RAL
RAN SENSORS OR O77VdCATTON STSTEMS THAT
ACCOUNT FOR LOCAL RAINFALL SHALL HAVE A
SEPARATE WIRED OR WIRELESS RAN SONOOR WHICH
GROECTS OR CQ7yNLCATE5 WITH THE
GONrROLLEWS2 SOIL MOISTURE BASED GONIROLLER5
ARE NOT RECwRED TO NAVE. RAN SENSOR INPUT.
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PROGRESSIVE DESIGN CONCEPTS
• AlchltnWnaI Dnlgn
• Roafd—IM and Cones clal ,
-Planning and 0e 10Pm t
76-113 Calb Eshdo, Ste. 105
La QuIM, CA 07257
ORLoe (760)'5644707 Fax (760) 56445!
wwwswconeepb.com
Proposed Single
Family Residence
Ana & Henry Barbosa
78-700 Avenida Nuest:
La Quinta, CA 92253
A.P.N.:770-172-.012
Date) Description
N- Nor
Q Pian Check Cactions 07)16!2011
QPian Check Connection. D4111112011
Qj 0w Changes 05/102016
Drava By
App—d By
PioLect Manager.
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