BWFE2016-0156LICENSED 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 subjects the applicant to a civil penalty of not more than five hundred dollars
A1:
as owner of the property, or my employees with wages as their sole
nsation, 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
she did not build or improve for the purpose of sale.).
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
tge�fontractors' State License Law.).
JI'm 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:
i
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Ihave 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' compensationinsurance carrier and policy number are: -
Carrier: - Policy Number:
1 certify that in the performance of the work for which this per 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 Section 3700 of the Labor Code, I shall forthwith .
comply with those provisions.
Date: 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.
Date: Signature (Applicant or Agent)
C
CU`
VOICE f 760) 777-7125
78.-495 CALLE TAMPICO
0' D -`
'LA
, .
FAX (760) 777-7011
QUINTA, CALIFORNIA 92253-
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
'BUILDING PERMIT
Date: 7/13/2016 ,
Application Number: BWFE2016-0156
Owner:
Property Address: 51705 AVENIDA VALLEJO
APN: 773131022
TERE IASANLT•ANA
V�AC.C..
Lrt�
Application Description: iFERE RAGESA'(3L.�GK
92413
Property Zoning:
Application Valuation: $5,600.00
JUL 13 2016
Applicant:
Cont cior:. CIT/OF LAQUI NTA .
TERESASANTANA
TERESd%§N TWS .VELOPMENTDEPARTMEN7
51705 AVENIDA VALLEJO
51705 AVENIDA VALLEJO
LA.QUINTAS, CA 92253.
r
LA QUINTAS, CA 92253
(760)989-9006
LIC. No.:
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 subjects the applicant to a civil penalty of not more than five hundred dollars
A1:
as owner of the property, or my employees with wages as their sole
nsation, 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
she did not build or improve for the purpose of sale.).
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
tge�fontractors' State License Law.).
JI'm 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:
i
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Ihave 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' compensationinsurance carrier and policy number are: -
Carrier: - Policy Number:
1 certify that in the performance of the work for which this per 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 Section 3700 of the Labor Code, I shall forthwith .
comply with those provisions.
Date: 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.
Date: Signature (Applicant or Agent)
J'j.`,rx j .,pESCRIPTION,
FINANCIAL IN . •• •
»ACCOLN izt' ; ;QTY§ nr, b AMOUNT, ;qty == x gPAID _. _ ,PAID DATE"
BSAS SB1473 FEE
101-0000-20306 0-• $1.00
$1.00 ' 7/13/16.
'��"� �;•''":• �' '�. �E} 4 S '�¢y. -'. 't i
PAID.BY
•� - k ¢F. wr -t: .. ,�� -: .�
ET u� RECEIPT#r h �
METH
„ $„,..sse ,s::< -`S
'� � D
HECK Y
TERESA SANTANA
CASH - R17053
RSE
Total Paid for BUILDING STANDARDS. ADM INISTRATION BSA: ,'$1.00:. $1.00
§L,
,h ,F ACCOUNT _
QTY
AMOUNTS
PAID t
MAID DATE:'
gDESCRIPTION $
;
COMBINATION GARDEN/RETAINING WALL -
101-0000=42404
0
$95.72
' $95.72
7/13/16
FIRST 10OLF
.
` 4'PAIDBY �'s?xg
METHOD
�CLTDBY
4i�_RECEIPT#i'i�CHECK#f
TERESA SANTANA
CASH-
R17053
RSE
DES , IP.TION a ka`
�E'rkYa
�Q
66
PAID x
PAID DATE=
§b,Y,....h.fA,. ]• ro.-:!?'...+r .r,.1.m.•..a.e-Y ...N2x b�'`v�,�a.
SxTY
i�,ri _".Lv�:.�w�Cvi'
'T' ,o
E -t.§•.,n.:r
COMBINATION GARDEN/RETAINING WALL -
101=0000-42600
0
$60.91
$60.91 '
7/13/16.
FIRST 100LF PC
;
" {.}-"PAID BY `�
:"METHOD' £°^��
RECEIPT#,
CHECK#
CLTf) BY
Y,
TERESASANTANA
CASH -
'1117053
RSE
Total Paid fog COMBINATION GARDEN/RETAINING WALL: $156.63 $156.63
TOTALS: $157.63 $i5i.63o
r
-
Description: TERESA SANTANA GARAGE SALE
Type.: WALL/FENCE ..Subtype-- CITY STANDARD/PRE- Status: UNDER REVIEW
Applied: 7/13/2016 RSE
APPROVED,
Approved:
Parcel No: 773131022 Site Address: 51705 AVENIDA VALLEJO LA dtUINTA,CA 92253, r
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 54 Lot: 10
Issued:
UNIT 5' -
CHRONOLOGY',,
,,h, id'i"i Vh,04: i kA ......... ........
. .......
....
. .. . ....... .. ...... ........ CONDITIONS
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,600.00 Occupancy Type: Construction Type:
Expired:
No. -Buildings: 6 No. Stories: 0 No. Unites: 0
Details: 74LF OF VRETAINING WALL [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR
,TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
4 a
.. .. ... .. .
CONTACTS
. . . . . . . . . . .
. ....... ... ... .. ..
... ...... ........ APPITIONAL
... . ...... . . .......
I . . . . . . . .
61TE&�:-,. . ..... .....
..... ...... ............. . ,,,71 .... .. . . . .
. ....... ....
CHRONOLOGY',,
,,h, id'i"i Vh,04: i kA ......... ........
. .......
....
. .. . ....... .. ...... ........ CONDITIONS
.. . . ......... ..... ...... .. ....
Jim . . . ....... ............. ............
. .. .... .. ..Y n.
. ..... . . . . . ...
...... .....
VALLEJO
92253
OWNER TERESA SANTANA.
INFORMATIOW- . ...... .... .
Printed: Wednesday, July 13, 2016 9:39:12 AM' 1 of.2
srs1cnns
CONTACTS
...........
... . ...... . . .......
NA
.. . . ......... ..... ...... .. ....
4
APPLICANT
TERESA SANTANA
51705 AVENIDA
LA QU I NTAS
CA 92253
VALLEJO.
CONTRACTOR
TERESA SANTANA
51705 AVENIDA
LA QU I NYAS
CA 92253
VALLEJO
92253
OWNER TERESA SANTANA.
INFORMATIOW- . ...... .... .
Printed: Wednesday, July 13, 2016 9:39:12 AM' 1 of.2
srs1cnns
. -
�',.'A000UNTa"
PAID DATE,
RECEIPT#x
- -
R:DESCRIP:TION
,�
•QTY
AMOUNT;
PAID :
'.'. Y. .�.. .,. .,y 1; vt^
-.
.Z ..t "�M... `' � �. "..i
+:. �A, t;.
h
,.§�`��v;§?
a
'Z :' 1�.�.K .F 4':
F
Sg•�g'�e,-
�g
t`'
`� E :1,..; .x"a
:uBY
BSAS SB1473 FEE'
101-0000-20306
0.
$1.00
$1.00
7/13/16
R17053
CASH,
TERESA SANTANA
VtRSE
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
BSA:
COMBINATION
GARDEN/RETAINING
101-0000-42404
.:O
$95.72
$95.72
7/13/16
R17053
CASH
TERESA SANTANA -
RSE ,
WALL - FIRST 100Lf .
COMBINATION
GARDEN/RETAINING
101-0000-42600
0
$60.91
$66.91
7/13/16
R17053
CASH
TERESA SANTANA
RSE
WALL -FIRST 10OLF PC
Total Paid, for COMBINATION GARDEN/RETAINING WALL-.
$156.63
$156.63
'
TOTALS:
$157.63
$1S7.63
A .R.
REVIEWS
7T77s:. $ x, :. }. "'f <,.-
*.. RETURNED STATUS "%REMARKS _ -
REVIEW TYPE REVIEWER SENT DATE DUE DATE
NOTES
DATE
�*
y
DO•Dae •
ATTACI NTS"s
Printed:. Wednesday, July 13, 2016 9:39:12 AM-
2 of 2'
Cflrwlysrrms
Iain #
Permit #
ProjectAddressc $�
Qty of La Quin to
Building 8t Safety Division
78{495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
`n Vtfl'I�t2D Owner's Name:
A. P. Number:
Address:
Legal Description:.
City,ST Zi LA- C : 91�3
Contractor:ele
T h one: d
P
Address:
Project Description:
City, ST, Zip:
Telephone:
P ,
1 Ur a
� n�
State Lic. # :
City Lic. #;
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Con tructi n T e
s oOccupancy-
YP �
State L ic.#•
Project type (circle nNew Add'n Alter Repair
Demo
Name of Contact Person:
Sq. Ft.: 3
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: ,z
APPLICANT: DO NOT WRITE BELOW THIS LINE
H
Submittal
Req'd
Reed
TRACKING !
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes..
Called Contact Person
Plan Check Balance
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review,xeady for-corrections/issue
Electrical ,
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! Review, ready for correetionstiissuc
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees
FOO.T.11NIG.O..PTIIO.-N.."..'-A'.'
6' MAX
FINISH GRADE
I., 711.1�
RETAINED
EARTH
2; MAX,
3 MAX --O
4"
FOOTING
#4 HORIZONTAL REBAR
(USE BOND BEAM BLOCK)
#4 VERTICAL REBAR AT 24"
MAX. SPACING
(REBAR IN CENTER OF CELL)
#4 HORIZONTAL REBAR CONTINUOUS
AT 3211 MAX. ABOVE TOP OF RETAINING WALL
(USE BOND BEAM BLOCK)
NON -RETAINING PORTION OF WALL
811 BLOCK ...
(2)-#4 HORIZONTAL REBARS
AT TOP OF RETAINING WALL
(USE BOND BEAM BLOCK)
RETAINING PORTION OF WALL
8" BLOCK
(SOLID GROUT_ALL_CEL LS)
FINISH GRADE
OMIT HEAD JOINTS
—RETAINErINEC
FOR DRAINAGE
EARTH.
(FIRST COURSE ONLY).
(3) - #4 HORIZONTAL REBARS
=- �'., \.
— 4"
#4 REBAR
AT 24". SPACING
NWH 6" MIK HOOKS AT ENDS FOR OPTION -B")
6' MAX
3" MAX. I
2' MAX
r tmt
12"
TH9_EQLL0 IN9_[N5EEQTIQKS-Af3T REQUIRED; - -w ALL FOOTINGS ADJACENT TO
1).EQQTlNja: EXCAVATION TRENCH CLEAN WITH STEEL IN PLACE AND SUPPORTED SLOPES TO BE AT LEAST 5' TO
3" ABOVE AND AWAY FROM THE SURROUNDING EA H I S SHOWN BELOW.
2) REBAE3ZPREmQRQUT: BOND BEAM REBAR AND
YV. T A(WL4A Q U I
INSPECTION PRIOR TO PLACING GROUT.. NTA
Am
3) FINAL: AFTER GROUT IS PLACED -PRIOR TO ANY D COP' lU'PWQ-&SkFETY DEPT.
NOTES: C% V
APPRO ED 7
1) FENCE HEIGHTS ARE REGULATED -CONSULT ZONI GREGED%Q0lNbc-'-lRUCT
BEFORE BEGINNING CONSTRUCTION. of 5 MIN.
2) NO WATER COURSE OR NATURAL DRAINAGE SHALLb.ATE it VOO�TING
OBSTRUCTED. left BY
3) ALL REBAR TO BE ASTM SPEC. A61 6, GRADE 40 MINIMUM. DITIONAL-INF-ORMATION-'-.-
4) ALL REBAR LAP SPLICES TO BE 24" MINIMUM.
5) ALL MASONRY UNITS TO BE ASTM C-90 GRADE N. WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
6) NOT DESIGNED FOR SURCHARGE LOADS FROM
VEHICLES OR STRUCTURES.
DISCLAIMER:.
ALTERNATE DESIGNS MAY BE POSSIBLE BLOCK WALL
WHEN PROVIDED WITH AN ENGINEERED
ANALYSIS. USE OF THIS STANDARD DESIGN ATOP 2RETAINING WALL
IS AT THE USER'S RISK AND CARRIES NO (760) 777-7125 78-195 CALLE , TANI PICO
PHONE
IMPLIED OR INFERRED GUARANTEE AGAINST LA QUINTA, CALIFORNIA 92253
FAILURE OR DEFECTS. FAX (760) 2
REB -AR. -PLACEMENT
ILLUSTRATION
(SEEPAGE 1 FOR SPECIFIC REQUIREMENTS)
---- -- --
(TYPICAL)
FOR THE RETAINING PORTION OF WALL '
ALL CELLS TO BE GROUTED
(TYPICAL)
FOR NON -RETAINING PORTION OF WALL
ONLY CELLS AND BOND BEAM COURSES
WITH REBAR TO BE GROUTED ��
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
FOOTING OPTION .B
PICAL)
3AR SPLICES
N. OVERLAP
(TYPICAL)
=BAR SHALL HAVE A
F 3" CONCRETE COVER
4T FOOTINGS
WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
qj.
u� BLOCK WALL
OF 11 ATOP 2' RETAINING WALL
PHONE, (760) 777-7125 78-495 CAIA r TAMPICO
LA QUINTA, CALIFORNIA 9225:3
PAX (760) 777-7011. 10/9/201'1 COMMUNPIYDEVELOI'hfi NTD61'P. I'ACE20112