BWFE2017-0100Titi
78-495 CALLE TAMPICO 0 D Qumro
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BWFE2017-0100
Property Address: 51460 AVENIDA.VALLEJO
APN: 773084011
Application Description: PAVON / 32 LF GARDEN WALL INSIDE PL
Property Zoning:
Application Valuation: .$1,500.00
Applicant:
EUSEBIO PAVON
51460 AVENIDA VALLEJO y 7
LA QUINTA, CA 92253 MAY • 3 1 201 r
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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.:
Date: 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
subj'ects the applicant to a civil penalty of not more than five hundred dollars ($500).:
�Ca) 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
o .h
e 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 the
CC ractors' State License Law.).
( -I am exempt under Sec. . B.&P.C. for this reason
Date:-
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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/31/2017
Owner:
EUSEBIO PAVON
51460 AVENIDA VALLEJO
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.: :.
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- Policy Number: _
I certify that in the performance of the work for which this permit is issued, l
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 u d be ject to the
workers' compensation provisions of Section 37 owe L. e, shall forthwith
comply with those provisions. / //
WARNING: FAILURE TO SECURE WORKERS' COMhNSAION 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 iriformatim, is correct.
I agree to comply with all city and county ordinances and state laws r to wilding
construction, and hereby authorize representatives of this city ent 6n a above-
mentioned property for inspection purposes.
DESCRIPTION '
FINANCIAL
+ . ACCOUNT QTY .
AMOUNT
WALL/FENCE - FIRST 100 LF
i 101m-0000-42404.1- 0,
$50.67
DESCRIPTION
ACCOUNT QTY
AMOUNT "
-WALL/FENCE = FIRST 100 LF PC
101-0000-42600. 0'•
$63.33
'
Total Paid for BLOCK WALL:
$114.00
DESCRIPTION
ACCOUNT
QTY..
AMOUNT .
BSAS.SB1473 FEE +'
101-0000-20306 '
0
$1.00•
Total"Paid for BUILDING STANDARDS ADMINISTRATION, BSA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
'502-0000-43611:
0
$5.00 .
1.
.
`..
Bin #'
City of La Quinta
Building ff Safety Division.
78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit-#
Project Address:) -1&0 cA—>`
=Owner'sName � Euse - o rte. J �
A. P. Number:
Address:
Legal Description:
City, ST, Zip: .
Contractor: WNZB der
Telephone:
Address:
Project Description3
City, ST, Zip:
Telephone:
........
State Lic. # :
City Lic. #;
_
Arch., Engr., Designer:`
o f.
T t ,
1 Tl
Address:
City., ST, Zip:
Telephone: one•
o nstructi n TY e: Occupancy:
P cY:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft: #Stories: #Units:
State Lic. #::.
me o/.::: �.�:::::::
.Naf.Contact Person: (� ��
-Telephone # of Contact Person:-7&0(g4006
-Estimated Value of P ject: 45 0 .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
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 HOUSE:-
'"' 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
FC
�R
#4 HORIZONTAL REBAR
(USE BOND BEAM BLOC
6" OR 8" BLOCK
HEIGHT FROM TOP #4 HORIZONTAL AT 32"
OF FOOTING
(USE BOND BEAM BI
SEETABLE"A"
FOR REBAR SIZE
AND SPACING
(L,0CAl_v fIr.0AR IN CE7N71T.R 0j'CI:fj,!. (LOC
FINISH GRADE
(1) - #4 REBAR
..... I I I I I I I I
CONTINUOUS
(2) - #4 F
0
REVERSE
H
DIRECTION OF
VERTICAL
HOOK ON EVERY
I (FOOTING WIDTH)l
OTHER REBAR
SEE TABLE "A'•
'AX.O.C..
)CK)
;EE TABLE "B"
DR REBAR SIZE-
5,ND SPACING
E Rawi 1.4 cEmv.st or ccui
ALL FOOTINGS ADJACENT -54)
SLOPES TO BE AT LEAST 5' TO
DAYLIGHT AS SHOWN BELOW.
uorigMOF
FOOTING S45' MIN.
(FOOTING WIDTHI
SEE TABLE "B"
B
W
HEIGHT FROM TOO
OFF'OOTING
.. .........
h
H
V �EtLFY A RQlLQjN_G_
PERMIT .. _ -
VERTICAL
,HWt.
REINFORCEMENT
REINFORCEMENT
19" 44 Ca 48" O.C.
17"
#4 Ca 48" O.C:.
4."
20"
#4 @ 48" O.C.
F2
E
3"
#4 Ca 48" 0.clql
VERTICAL REBAR IN PLACE -.INSPECTION PRIOR TO
'29"
#4 Ca 24"' O.C.
'AX.O.C..
)CK)
;EE TABLE "B"
DR REBAR SIZE-
5,ND SPACING
E Rawi 1.4 cEmv.st or ccui
ALL FOOTINGS ADJACENT -54)
SLOPES TO BE AT LEAST 5' TO
DAYLIGHT AS SHOWN BELOW.
uorigMOF
FOOTING S45' MIN.
(FOOTING WIDTHI
SEE TABLE "B"
B
W
HEIGHT FROM TOO
OFF'OOTING
.. .........
h
41"
V �EtLFY A RQlLQjN_G_
PERMIT .. _ -
VERTICAL
,HWt.
REINFORCEMENT
3'
19" 44 Ca 48" O.C.
4'..
22'! #4 0-.48" O.C.
5,'
29" #4 6 481, O.C.,
6';
34" #4-9 24" O.C,*.
NOTES:
1) THIS DESIGN DOES NOT ALLOW GRADE DIFFERENTIALS OF
V �EtLFY A RQlLQjN_G_
PERMIT .. _ -
MORE THAN 6" ON OPPOSING SIDES OF THE WALL. THIS IS
WHEN A PERMIT IS REQUIRED, THE FOLLOWING
NOT A RETAINING WALL.
INSPECTIONS ARE REQUIRED:
2) FENCE HEIGHTS ARE REGULATED - CONSULT ZONING
_jZj: EXCAVATION TRENCH CLEAN WITH
REGULATIONS BEFORE BEGINNING CONSTRUCTION.
STEEL IN PLACE AND SUPPORTED 31' ABOVE AND
3) NO WATER COURSE OR NATURAL DRAINAGE SHALL BE
AWAY FROM THE SURROUNDING EARTH/DIRT.
OBSTRUCTED.
2) RER,�,R/ RRg .,QU,T: BOND BEAM REBAR AND
4) GROUT ONLY THE CELLS CONTAINING REBAR. THIS WALL
VERTICAL REBAR IN PLACE -.INSPECTION PRIOR TO
IS NOT DESIGNED FOR ALL CELLS TO BE GROUTED.
PLACING GROUT.
5) ALL REBAR TO BE ASTM SPEC. .A615, GRADE 40 MINIMUM.
3) FINAL; AFTER GROUT IS PLACED - PRIOR TO ANY
DECORATIVE CAP PLACEMENT.
v) ALL ml=BAH LA, SPLICES TO BE MINIMUM.
7) ALL MASONRY UNITS To BE ASTM C-90 GRADE N.
8) REBAR TO BE CENTERED IN MASONRY CELLS.
WESTERN,RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
'SEE PAGE 2 FOR ADDITIONAL INFORMATION*
tlCU
ALTERNATE DESIGNS <MAY BE POSSIBLE
WHEN PROVIDED WITH AN ENGINEERED
ANALYSIS. USE OF THIS STANDARD DESIGN FREESTANDING BLOCK WALL
IS AT THE USER'S RISK AND CARRIES NO . -1 .1 8�-495 CAI IMPLIED OR INFERRED GUARANTEE AGAINST P 1-1 ONE (76 . 0) 777-7.1.25 -A Q�_ . , .1.'I.92
-* 2,53
Iu I Wr;x,� 0AIJ PORN IA
FAILURE OR DEFECTS.
I ' FAX (760) 777-70,1 1 10/1))201l JCOMMUNITY j)j_,vFL6phiFrrr E)j.,-rrr.1 PAGF 1 01 2
3 y � �� 0 -)?)Z - 10 0 �"3M
1 r + /l am --I - Xq
REBAR PLACEMENT
1 lb ILLUSTRATION t lg 6
Ila
FOC
DESIGN PARAMETERS:
ACTIVE SOIL PRESSURE (PSh
=30
PASSIVE SOIL BEARING (PSh
= 150
COEFFICIENT OF FRICTION
= 0.25
ALLOWABLE SOIL BEARING (PSF)
=1500
WIND = 80 MPH, EXPOSURE C
I, AX (760) 777-70 11
SEISMIC:
NA= 1.3. NV= 1.6. Z=0.4, SOIL PROFILE=SD
-300
8
Rb
6 60.
FOOTING OPTION B
(TYPICAL)
_LS AND BOND BEAM
3 WITH REBAR TO BE
GROUTED
.ID GROUT ENTIRE WALL - USE
)P MESH AS APPROPRIATE)
-�" (TYPICAL)
REBAR SHALL HAVE A
MUM OF 3" CONCRETE
OVER AT FOOTINGS
WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
FREESTANDING BLOCK WALL
PIIONI. (760) 777-7125
78-495 CAUL; TAMPIC:O
IA OUINTA, C %MFORNIA 92253
I, AX (760) 777-70 11
10/9/`1014 COM1IMUti l'IY DF:V151 O1'btFa 1' UF;1'i'. f :1Gi> 2 OI 2
Td y
P.D. Box 1504-
'LA
504 'LA QUINTA, CALIFORNIA 92247-1504BUILDING & SAFETY DEPARTMENT
78-4.95 CALLE TnMPiCo (760)777-7012
LA QUINTA, CALIFORNIA 92253 FAX (760) 7.77-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Formslor•Owner-Builders Applying for Construction Permits
IMPORTANT. NOTICE TO PROPERTY OWNER
i`
Dear Property Owner:. •, '
An application for a building .peiTrvt has been su Veed in y ur name .listing yourself s e builder of the property
improvements specified at O �
.We are providing you with an Owner -Builder Acknowledgment and Information Ve ' ication Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,.
signed, and returned this form to us at our official address indicated. An agent of the 'owner cannot execute this notice `
unless you, the property owner, obtain the prior approval of.the permitting authority:
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signs you understand or verify this information. -
VI understand a frequent practice of unlicensed. persons is. to have the pi perty bwner.obtain an "Owner -Builder"
ui,42p6r'rnit that erroneously.impl es�that.the property owner is providing his or her own'labor and material personally. I, as
an Owner -Builder; inay be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage.for those
injuries, I am willfully acting as an Owner -Builder, and am aware .of the limits of my insurance coverage for injuries to workers
on my property.
.�k 2. I understand building permits are aiot required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
JLq 3. 1 understand as an."Owner-Builder" I am the re nsible
spo party of record on the permit. I understand that I may protect
myself from potential financial risk:by hiring a licensed Contractor and having the permit fled in his or her name may
of my
own.
�4. I understand Contractors are required b law to be licensed and d bonded in California and to list their license numbers on
X5.1
tsand contracts.
understand if I employ or otherwise engage any persons, other than California licensed Contractors and
the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may, be co' an "employer
under state and federal law,
6. I understand if I am considered.an."employer" under state and federal law, I must register with the stat
govemmeut, withhold a oll taxes a and federal
payroll , provide workers' compensation disability insurance; and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these la
ris ws may subject me to.serious financial
7' I understand
under California Contractors State License Law, an OwnerBuilderwho builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is' performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or,all of the work is performed
under contract with a licensed general building Contractor.
68. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
iLI understand I may obtain more information regarding my, obligations as an."employer" from the Internal Revenue
Service, the United States Small.Business Administration, the -California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov.for more information about licensed contractors.
tk10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally, and financially responsible for proposed construction activity at the following address:
I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
app 'cable laws and requirements that govern Owner -Builders asmell as employers.
12.1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
ave provided on this form Licensed contractors are regulated by laws designed
to protect the public. If you contract with
someone who does not have a license, the Contractors' 6tate License'Board may be unable to assist you with any financial loss
you may sustain as a result of a!complaint. Your!dnly remedy against unlicensed Contractors may be in civil court. It is also
important for you to.understand that if an unLcensed Contractor or employee of that individual or firm is injured while working
on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and. wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this f4•m must be completed and signed by the property owner and returned to
the agency responsible for issuing the permit. Note. A copy of the property owner's driver's license, form notarization, or
other verification acceptable Id the agenc r r to be presented when the permit is issued to verify the properly S
owner's signature. ,,
Signature of property owner Date: XAY 1
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO. ACT ON PROPERTY OWNER'S BEHALF i
Excluding the Notice to Property -Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign; and file. the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description_ of Work):
Project Location or Address:
Name of Authorized Agenf:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the.owner's driver's license, form notarization, or other verification.
acceptable to the agency is required to be presented when the permit is issued to verify the property owner s signature.
Property Owner's Signature: Date: