BWFE2015-0125LICENSED 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 Pr fessions Code,
and my License is in full force and effect.
License Class: B License No.: 774073
Contractor
PIRa
OWNER-BUI FRDECLARATION
I hereby affirm under penalty of perju at 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).:
(_J 1, 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:
(925)354-7845
Llc: No.: 774073
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 6+for which this permit is issued.
\\ have and will maintain workers' compensation insurance, as required by
Sectio 700 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 t is permit is issued, I
shall not employ any person in any manner so as to become subj to the workers'
compensation laws of California, and agree that, if I should bec a subject to the
workers' compensation provisions of Section 3700 of the Lab r ode, I shall forthwith
comply with thoseovisions.
p
Date: Applicant:
WARNING: FAILURE TO SECURE WO051MINAL
'COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER PENALTIESAND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLAR00,000). 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
I agree to comply with all city and county ordinances and state laws relating to
construction, and hereby authorize representatives of this city to enter upon t
mentioned property or inspection purposes.
Date: Signature (Applicant or Agent)
a
78-495 CALLE TAMPICOFAX
4.,-v
VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253
(760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 5/14/2015
Application Number: BWFE2015-0125
Owner:
Property Address: 79020 SHADOW TRAIL
ROMBOUGH
C,
APN: 600400019
80416 RIVIERA
z
Application Description: ROMBOUGH / 10OLF OF
6' CIN STANDARD BLOCK WALL
LA QUINTA, CA 92253
Property Zoning:
ro -�
Application Valuation: $7,000.00
b n f•� —�
Applicant:
Contractor:
v o
TECHNICAL HOME DEVELOPMENT INC
TECHNICAL HOME DEVELOPMEN-INC �
80416 RIVIERA
80416 RIVIERA
m
LA QUINTA, CA 92253
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 Pr fessions Code,
and my License is in full force and effect.
License Class: B License No.: 774073
Contractor
PIRa
OWNER-BUI FRDECLARATION
I hereby affirm under penalty of perju at 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).:
(_J 1, 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:
(925)354-7845
Llc: No.: 774073
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 6+for which this permit is issued.
\\ have and will maintain workers' compensation insurance, as required by
Sectio 700 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 t is permit is issued, I
shall not employ any person in any manner so as to become subj to the workers'
compensation laws of California, and agree that, if I should bec a subject to the
workers' compensation provisions of Section 3700 of the Lab r ode, I shall forthwith
comply with thoseovisions.
p
Date: Applicant:
WARNING: FAILURE TO SECURE WO051MINAL
'COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER PENALTIESAND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLAR00,000). 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
I agree to comply with all city and county ordinances and state laws relating to
construction, and hereby authorize representatives of this city to enter upon t
mentioned property or inspection purposes.
Date: Signature (Applicant or Agent)
FINANCIAL INFORMATION
ESCRI ON' i,4h![ i,*, _ACCdiJ�Nf-
`QTY
p I -DATE
PAID, AID,,
BSAS SB1473 FEE 101-00.0.0-20306.
0
$1.0.0
$0.00
-..oMETHODP.
E EIPT#
d4c CLTD.r W
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1..00 $0.00
4-
FIDESCRIPTION..
7y - , ,,
�bgTY
AMOUNT:
T�
PAID
PAID DATE
,WALL/FENCE - FIRST.100 LF
101-0000-42404
0
$47.86
$0.00
PAID,BY1
.,-RECEIPT #et 4'.
CHECK 1
Ck, -
TD BYE
CL,
��,,RESCRIPTION
PAID'
iPAID.DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
.$60.91
$0.00.
PAID BY
Alx- 54
41:'. -METHOD
C HECK #
CLTD B y
Total Paid forFENCE OR FREESTANDING WALL- $108.77 $0.00
TOTALS: $109.77 $0.00
Description: ROMBOUGH / 10OLF OF 6' CITY STANDARD BLOCK WALL
Type: WALL/FENCE Subtype: Status: UNDER REVIEW
Applied: 5/14/2015 SKH
Approved:
Parcel No: 600400019 Site Address: 79020 SHADOW TRAIL LA QUINTA,CA 92253
Subdivision: TR 31310 Block: Lot: 19
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $7,000.00 Occupancy Type:. Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: 10OLF OF 6' GARDEN WALL INSIDE EAST PROPERTY LINE AND WEST SIDE YARD GATE [CITY SPECIFICATIONS] PRECISION CONCRETE
BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013
CALIFORNIA BUILDING CODES.
CONDITIONS
FINANCIAL INFORMATION
Printed: Thursday, May 14, 2015 5:02:13 PM 1 of 2
CRSYSTfMS
c.. t=n C'•r: - ��� r fi�"'s4'r✓ -- �iw ,�"�''�:,5.�-•`T•� ..+Cl. "•. ?'4"�r��* � �y� - ,��� ., �,A ,� �-n i.,�- �; �=:,,ire, �a:-�
J y -' '?, ,m•ax,,9'84= r. - .i r - ;.�,�s. D ® .yc�G2..�.cw+-a+�F. Y - X"�T ' TXT,
Y °
F3�r�°`I^
w�
;DESCRIPTION
;, "ACCOUNT
CITY,
AMOUNT '
.;PAID
PAID DATE
;, RECEIPT.#
CHECK #
METHOO
; PAID By,
CLTD
ATTACHMENTS
BY
BSAS SB1473 FEE
101-0000-20106
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
WALL/FENCE - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
101-0000-42600.
0
$60.91
$0.00
100 LF PC
Total Paid forFENCE OR FREESTANDING WALL $108.77 $0.00
TOTALS:•• 0•
REVIEWS
URNED
STATUS REMARKS
REVIEW TYPE ' REVIEWER ;SENT DATE DUE DATE RETNOTES
DATE
Printed: Thursday, May 14, 2015 5:02:13 PM 2 of 2 ��WEV srsrents
BOND
INFORMATION
ATTACHMENTS
Printed: Thursday, May 14, 2015 5:02:13 PM 2 of 2 ��WEV srsrents
Bin#
City of La Quinta-
Building 81• Safety Division
P.O. Box 1504, 78-495 Calle'Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
1UIS�6lZ
Project Address: DOw / Cr
Owner's Name: -T�p
A. P. Number: O0_ O1 _C:l
Address: p r6 IV I #F(l.%I
Legal Description:y q to
City, ST, Zip:. QC11A f Cx ZZS
Contractor:
a�✓
e hone• f
C 3
2 S s�
P %
9 4
Address:V0 41 6 l � �C
Project Description:
City, ST, Zip: 4A Q✓rA-/T/; CA9ZZ'l'3
LOO �C Im O' 0Ax4V
Telephone: ?39 31 —7F4
State Lic. # :
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
e one:
P
n r i
Co st uctType: e• anc
Occu
Y P Occupancy:
State Lie. #•
PrJ ct type (circle ne • e w Add'n Alter Repair Demo
Name of Contact Person: X0" S0UGC j
Sq. Ft::
# Stories:
# Units:
Telephone # of Contact Person:
P �. � s 3 ��� %4�.
�
Estimated Value of Project: ��Q
APPLICANT: DO NOT WRITE 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 Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
r
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2 Review, ready for corrections/issue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees '
{
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FOOT_I.N.......G..._...OPTION "A" FO�OT_I..N,G O_PTIONGG _'
f
--.._.._-
..
i `' , #4 HORIZONTAL REBAR
i (USE BOND'BEAM BLOCK)
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1
6" OR 8" BLOCK
..H..
HEIGHT FROM TOP #4 HORIZONTAL AT 32" MAX. O.C. - HEIGHT FROM TOP -
OF FOOTING, OF FOOTING
i F (USE BOND BEAM BLOCK) - _
SEE BLE "A" -�- SEETABLE "8" i r
I i FOR REBAR SIZE, FOR REBAR SIZE ,
4 AND SPACING t• +' AND SPACING
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FINISH GRADE
1
#4 REBAR
�IIII CONTINUOUS12
(2)* #4 REBAR'
11" 10 'CONTINUOUS 1111- ; •;Y, I I
REVERSE ; — ,=III�IIII
DIRECTION OF (FOOTING G WID� (FOOTI G•WIDTH)I
HOOK ON EVERY OOT 1
OTHER REBAR SEE TABLE `B"--'
SEE TABLE `A" r • X ) '
ALL FOOTINGS ADJACENT TO. - T' • s"
SLOPES TO BE AT LEAST 5 TO
DAYLIGHT AS SHOWN BELOW. • f
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4
•
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VERTICAL
jREINFORCEMENT
3' 17"
##4 @ 48" O.C.
4' 20"
#4 @ 48" O.C.
5' 1 23"
#4 @ 48" O.C.
6' 1 29"
,,1 #4:@.24",O.C.
SLOPES TO BE AT LEAST 5 TO
DAYLIGHT AS SHOWN BELOW. • f
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8017fOM - F=
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4
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#4 @, 24". O.C.a
± ' ! { - • • i 4 t _� C�I�CK W. }�TH� B�1�LOtNG DEPA�iTMENT TQ
1lERIFY'IF A BUILDING PERMIT -IS REQUIRED=
1) THIS DESIGN DOES NOT ALLOW GRADE DIFFERENTIALS OF
MORE THAN 6" ON OPPOSING SIDES OF THE WALL. THIS IS s _
1 t !
4 I , WHEN A PERMIT I.S REQUIRED, THE FOLLOWING
NOT A RETAINING WALL. ' INSPECTIONS ARE REQUIRED:
2) FENCE HEIGHTS ARE REGULATED — CONSULT ZONING 1) FQQTINQ- EXCAVATION TRENCH CLEAN WITH
REGULATIONS BEFORE BEGINNING. CONSTRUCTION. S + , STEEL IN PLACE AND SUPPORTED 3" ABOVE AND
3) NO WATER COURSE OR NATURAL DRAINAGE SHALL HE : _ AWAY FROM°THE SURROUNDING EARTH /DIRT.
OBSTRUCTED. 2) REBAR4fff.R QU T;`BOND BEAM REBAR AND
I VERTICAL REBAR IN PLACE - INSPECTION PRIOR TO
4) GROUT ONLY THE CELLS CONTAINING REBAR. THIS WALL c_
UT.
I PLACING GRO'
IS NOT DESIGNED FOR ALL CELLS TO BE GROUTED. 7 . EI' ' 3) FINAL: AFTER GROUT IS PLACED - PRIOR TO ANY
5) ALL REBAR TO BE ASTM SPEC. A615. GRADE 40 MINIMUM.+ + + .i. DECORATIVE CAP PLACEMENT.
6) ALL REBAR LAP SPLICES TO BE 24", MINIMUM.
7) ALL MASONRY UNITS TO BE, ASTM C-90 GRADE N.
8) REBAR TO BE CENTERED IN MASONRY CELLS.
,� • _ " _ �_ rt
.—,WESTER
N RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
`SEE PAGE 2 FOR ADDITIONAL INFORMATION*- - - ^ e
""� D `'�
ALTERNATE, DESIGNS._ MAY, BE POSSIBLE FREESTANDING BLOCKWALL.,
WHEN PROVIDED WITH AN ENGINEERED jc ' ,' � , ,, . -
ANALYSIS. USE- OF THIS STANDARD DESIGN-
IS AT THE USERS RISK AND CARRIES NO 78-495 CAI,LE TAMPICO
IMPLIED+OR 1NFEF2RED'GLIARANTEE'AGAINST - PHONE (7607 777; 7.7.25" LA QUINTA. CAUFORN[A 92253. .
FAILURE E O_ R DEFECTS._ N _ FAX (760),777-747 3. '.. h/9/sola COMASU>\m UEYELOPMENT DEPP. PAGE I OF:
FOO
DESIGN PARAMETERS;
ACTIVE SOIL PRESSURE (PSF) = 30
PASSIVE SOIL BEARING (PSF) =150
COEFFICIENT OF FRICTION = 0.25
ALLOWABLE SOIL BEARING (PSF) =1500
WIND = 80 MPH. EXPOSURE C'
SEISMIC:
NA= 1.3. Nv=1.6. Z=0.4, SOIL PROFILE=SD
WESTERN RIVERSIDE COUNTY CODE
Wt
FREESTANDING BLOCK WALL
�Ot IN I
PHONE (760) 777-7125 78-49:
LA QUINT,
FAX (760) 777-701 1 1 10/x/2014 jC0MMUKtTYDrWM0PliEWr
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