BWFE2014-104878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BWFE2014-1048
Property Address: 52390 AVENIDA VELASCO
APN: 773265007
Application Description: BLOCK WALL 90 LF
Property Zoning:
Application Valuation: $3,500.00
Applicant:
LAGUNA FALLS CUSTOM POOLS AN \_ \
P 0 BOX 2322
INDIO, CA 92202
Td4t 4 etP Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
A
SEP 0 2 2014
CITY OF LA QUINTA
TY DEVELOPMENT DEPARTMENT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/2/2014
Owner:
KEN SHIRY
52390 AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor:
LAGUNA FALLS CUSTOM POOLS AND
P 0 BOX 2322
INDIO, CA 92202
(� (760)347-8977
Uc. No.: 818149
--------------------------------�--------------------------------------------------- -- - -- --
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: C53 , License No.: 818149 �--�
.i
Date: y 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.).
(_) 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:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under perialty 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: 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 provisions of SectioL-S=
the Labor Code, I shall forthwith
comply with those provisions. Date: 7 z 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 ter upon the above-
mentioned property for inspection purposes.
Date: 17
Ah
y Signature (Applicant or Agent):
IF
ti
FINANCIAL INFORMATION
;� DESCRIPTION y : ` ACCOUNTu• r=
QTY AMOUNT
PAID , 11:PAID
DATE
BSAS SB1473 FEE 101-0000-20306
0 $1.00.
$0.00 ,
r• r ' ,METHOD'
{ �; 'PAID BY
•RECEIPT #
CHECK#
CLTD BY'.
. Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 x $0.00
¢ a`r DESCRIPTIONS `�
-j', ACCOUNT'. .!.
;.QTY
AMOUNT
�' -N PAID _
PAID DATE
WALL/FENCE -'FIRST 100 LF
101-0000-42404 •
0'
$47.19. ' '
$0.00
.PAID BY3*,�
'.METHOD _
i. RECEIPT # t� �"
CHECK #':' ��
.CLTD BY
;. DESCRIPTION °'''Ij- ,
"° ;� ACCOUNT _ .,
QTYt
AMOUNT..
PAID
PAIb,DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600'
0
$60.06
$0.00
"# t PAID BY ei s
.'METHOD ''"
RECEIPT # i'
r CHECK #
CLTD BY
Total Paid forFENCE OR FREESTANDING WALL- $107.25 $0.00
n DESCRIPTION
`' * `;� ACCOUNT " t
!°QTY '
',AMOUNT
" PAID
;PAID DATE.
RET WALL <=12 - FIRST 100 LF
101-0000-42404
0
$46.21
$0.00
!PAID BY 5
METHOD,—-,
c^"` ' = RECEIPT # •
;CHECK #
CLTD BY
-Total Paid forRETAINING'WALL• $46.21 $0.00
TOTALS:00
Description: BLOCK WALL 90 LF
Type: WALL/FENCE Subtype: Status:'APPROVED
Applied: 9/2/2014 MFA
Approved: 9/2/2014 MFA
Parcel No: 773265007 Site Address: 52390 AVENIDA VELASCO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 85 Lot: 7
Issued:
UNIT 10
ACCOUNT `' QTY
Lot Sci Ft: 0 Building Scl Ft: 0 Zoning: _
Finaled:
Valuation: $3,500.00 Occupancy Type: Construction Type:
Expired: f
w s ,
a �
No. Buildings: 0 No. Stories: 0 No. Unites: 0
.i n BY-
Details: 90LF OF 31" GARDEN W/2' RETAINING PRECISION CONCRETE BLOCK SHALL- BE COVERED WITH STUCCO, PAINT, OR TEXTURED
COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
*�$ Applied to Approved „ 4
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ADDITIONAL SITES Y
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CONDITIONS
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WALL/FENCE - FIRST
101-0000-42404
0
$47.19
$0.00
FOOTINGS
100 LF
BOND BEAM
WALL/FENCE - FIRST
101-0000-42600
0
t $60.06
$0.00
'
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL: $107.25 $0.00
RET WALL <=12 - FIRST
101-0000-42404
0
$46.21
$0.00
100 LF
Total Paid for RETAINING WALL- $46.21
TOTALS:00
7 PARENT PROJECTS
}REVIEW TYPE _ r t RETURNED STATUS° REMARKS 4
REVIEWER , SENT DATE DUE DATE" ;' _ 44 i NOTES '
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BOND INFORMATION
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BOND INFORMATION
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Bin #
City of La Quinta
Building 82; Safety Division
��` O P.O. Box 1504, 78-495 Calle Tampico .
, -. La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
� )"'�0.
Project Address: 5s 3 ?6 ZA,
Owner's Name: 't cS� ter
A. P. Number:
Address: '(' V�I �GeJ
Legal Description:
City, ST, Zip: l C,4 2 2 4-3
Contractor: V Ae1 fQe'"
Telephone: �J_ 0 39 3
Address: S1 7'3 oftd z
Project.Deseription:
City, ST, Zip: ' I VJ. C C44 Gj Z`Z_pf
Telephone:
P ?Qe 1j�7 �i77
•State Lic. # :
City Lie. #: of -1
Arch., Engr., Designer:
Address:
City., ST, Zip:
e:
Telephone:
ContructnYP e: Occupancy:
type a circle one): New Add'n Alter Repair Demo
State Lie. #:Ject
of Contact Person:
Sq. Ft.:
__TName
# Stories:
# Units.
Telephone # of Contact Person:
Estimated Value of Project:0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACIQJVG
PERMIT FEES
i
Plan Sets
PIan Check submitted
[Ch
Amount
Structural Calcs.
Reviewed, ready for corrections
eck Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cala.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'J Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'`° Review, ready. for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
POOL EQUIPMENT
e
1
Property line
IID
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Existing +6
BIOck Wall
Wood Fence
PLANTER
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9
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