14-0465 (BLCK)P.O. BOX 1504
78-495 CALLS TAMPICO \vJ
LA QUINTA, CALIFORNIA 92253
Applicant: Architect or Engineer:. .
-------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with -
Section 7000) of Division 3 of the Business and rofessionals Code, and my License is in full force and effect.
License Class: C53 818149
Date: 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 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
(_) 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 ISec. 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.).
(_ 1 1, 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. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury thatthereis 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
Owner:
STOCKDALE, RONALD S
52500. AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor:
LAGUNA FALLS CUSTOM POOL/:
P.O. BOX 2322
INDIO, CA 92202
(760)347-8977
Lic. No.: 818149
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 4 / 21 / 14',
--------------- - - -
WORKER'S COMPENSATION DECLARATION
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 NORGUARD INS Policy Number LAWC010355
_ I certify that, in the performance f the work for which this permit is issued, I shall not employ any
person in any manner so as t become subject to the workers' compensation laws of California,
and agree that, if I should be ome sub e w 'compensation provisions of Section
/ 3700 of the Labor Code, I all 1Qrth th con}pl with th „ e provisions.
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 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.
certify that 1 have read this application and state that the above i for ' n is correct. I agree to comply with all
city and county ordinances and state laws relating to building co ruction, N thorize representatives
of-thisrcoun y -to,. nter-upon.the above-mentioned property for' s ection ses.
ray
Dater _ `r>Signature'(Applicent or Agent);
Application Number:
14--00000465
Property Address:
52500 AVENI-DA VELASCO
APN:
773-295-001- - -
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
792
Applicant: Architect or Engineer:. .
-------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with -
Section 7000) of Division 3 of the Business and rofessionals Code, and my License is in full force and effect.
License Class: C53 818149
Date: 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 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
(_) 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 ISec. 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.).
(_ 1 1, 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. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury thatthereis 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
Owner:
STOCKDALE, RONALD S
52500. AVENIDA VELASCO
LA QUINTA, CA 92253
Contractor:
LAGUNA FALLS CUSTOM POOL/:
P.O. BOX 2322
INDIO, CA 92202
(760)347-8977
Lic. No.: 818149
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date:. 4 / 21 / 14',
--------------- - - -
WORKER'S COMPENSATION DECLARATION
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 NORGUARD INS Policy Number LAWC010355
_ I certify that, in the performance f the work for which this permit is issued, I shall not employ any
person in any manner so as t become subject to the workers' compensation laws of California,
and agree that, if I should be ome sub e w 'compensation provisions of Section
/ 3700 of the Labor Code, I all 1Qrth th con}pl with th „ e provisions.
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 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.
certify that 1 have read this application and state that the above i for ' n is correct. I agree to comply with all
city and county ordinances and state laws relating to building co ruction, N thorize representatives
of-thisrcoun y -to,. nter-upon.the above-mentioned property for' s ection ses.
ray
Dater _ `r>Signature'(Applicent or Agent);
-� Application Number . . . . . 14-00000465
Permit WALL/FENCE PERMIT 2013
desc .
,Additional
Permit Fee . . . . 94.38 Plan Check Fee
.00 c)
Issue Date . . Valuation . . .
. 792
Expiration Date 10/18/14
Qty Unit Charge Per
Extension '
1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
1.00• 47.1900 LS. MI RET WALL <=12', IST 100'
----------------
47.19 h
-----------------------------------------------------------
Special Notes and Comments
BLOCK WALL ORCO STANDARD 31411X
5216"RETAIN&4.18".X 521611GARDEN ;41X14'
RETAINING , 411411GARDEN WALL.PER ORCO
SPECS.CONCRETE BLOCK SHALL BE COVERED.
WITH STUCCO, PAINT, OR TEXTURED COATING
WHERE VISIBLE FROM OUTSIDE THE PROPERTY.
2013CBC
----------------------------------------- ----------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
120.12
Fee summary Charged Paid Credited
---------- ----
Due
----------------- ----------
Permit Fee Total 94.38. .00 .00•
94.38
Plan Check Total .00. .00 .00
.00
Other Fee Total 121.12 -.00 .00
121.12
Grand Total 215.50 .00 .00
215.50
LQPERMIT
Din #
City Of La Quillta
Building 8Z' Safety Division
P.O. Box 1504, 78-495 Calle.Tampko
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:Z�SpU �Uaj)T
Owner's Name:
A. P. Number:
Address: <2�
Legal Description:
City, ST, Zip:
Contractor: /
Telephone:
P
""•`'-<
Address: `75o (I ( Z
Project Description: +
City, ST, Zip: ' I i�0115 G� 41 7-1-0/
Telephone: ZCo V — 3
% 7
0 r a
s2f6 7i �1 �r $
State Lic. #
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
<.
.(
Construction Type: Occupancy:
S tate Lic #•
ProJect • type (circle ne • New Add'n Alter Repairair Demo
Name of Contact Person: � C
M!
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 1700 c�-
APPLICANT: DO NOT WRITE BELOW THIS LINE "
N
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 IiOUSE:-
'"' 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
._.._.'_.._.._.._"_.._............................................................................................. .._.._.._.._.._.._.._.._.._.._.._..-..-__.._.._.._.._..-..-.._ Proline ........................................... _.._.._--- .- --.._.._.._..-.._.._.._.._--- -
J f
• T t
C L
EXI5TING
I Block Wall• .
Main Gas Meter
w :
8 ft. 6 in. '
e
BEACH ENTRY
A
BBQ Island a
,
3 ? 8 h. 6 n. 'I
• �I 4 ft
EXISTING ,' 12 ft.
Block Wall i;�, .12'x 28'
5' wd
Main Electrical
Panel, 1
,• F
_ lam. QUINA
_BUILDING SAFETY DEP
APP OVED
Precision Block 'Precision Block
1 II 1 II 11 1 � 11
+ 3 4 x 526 Retainingwall with 8 block +4 x 14 Retainin wall with 8 block
1 11 x - 11 ' • . 9 II ' DATE BY
+ 4.8 x 52'6"Garden wall with 6 block +4'x 14 Garden'wall with 6 block
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' . _. _.._ ._ ._ ._ _ ._ ._.............. _. _. ........................_.. ........ _. _. _ ............_ _. _ _. _. _. _. _. ._ ._........................ ._.._. _. _Property llye _.._ _ ._.._-._ ._. _. _. .................................r_ _ _ __ _ _ __ _ _ _.�_ . .... ....... ...................._..
i 52 ft. 6 in. 14 ft.
Laguna Falls Pools, Inc. , Phone: (760) 347-8977 Designed by: LFP14-124 The Stockdale Residence.
81-730 Highway 111, Ste 2 Fax: ` (760) 347-8975 J. Maricilla 52-500 Avenida Velasco
4/18/2014 Designed for: La Quinta CA 92253
' Indio CA 92201 E -Mail: Jaime @lagunafall6pools.com ' _