BWFE2014-100478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
c&tr44Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BWFE2014-1004
80190 VIA CAPRI
777100069
240 L.F. 6FT. GARDEN W WITH (4) PILASTERS
$2,500.00
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 Divi e B iness and Professions Code, and
my License is in force and effect.
Lice a Cla Li ense No.: C288
Date: Contr or: 7—
OWNER-BUILDER ATION
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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/2/2014
Owner:
ORTNER
C/O MONARCH HOMES
49-950 JEFFERSON ST #130
I N DIO, CA 92253
Contractor:
MONARCH HOMES
49950 JEFFERSON STREET
LA QUINTA, CA 92264
(760)413-8863
Llc. No.: C28860
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'
compensatio , as provided for by Section 3700 of the Labor Code, for the performance of
theo r which this permit is issued.
VI have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor 9flde, for the performance of the work for which this permit is
issuecj,� r o ensati i suy a rid ppli�umber are:
Carriye`?i Policy ber. 6�/
I certify that in the performance of the work for whic 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 f I should become subject to the
workers' com .ensation provisions of Sectio 0 abor Code, I shall forthwith
comply thos provisions.
Date: Z Applicant: GJ.S
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 a ws relating to building
construction,. and hereby authorize rep r a -t tives of c' to nter upon the above -
menti property for inspection poses.
Signature (Applicant or A nt):�—
a,
A
-A.
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT`A ::_
QTY.i
,. AMOUNT
,�, PAID"
-PAID DATE
BSAS SB1473 FEE
101-0000=20306
0
$1.00
$0.00 '
s g •+ 'PAID`BY
,
METHOD -
ci ;RECEIPT #
CHECK.#,
'.C'LTD�BY:-
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA
$1.00
$0.00
DE
ACCOUNT
QTY=
-,AMOUNT x _
PAID
PAIDDAT,&
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$90.09
$0.00
PAIf)�BY". ,
;.r METHOD �.�> �s` �; �
e„ RECEIPT #; -
»�
-CHECK #
CLTD BY,.
.° ' DESCRIPTION -,
`• !,ACCOUNT . '
QTY .
Y "AMOUNT _
r,PAID .
•
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.19
$0.00
- ° - -PAID BY � '
= WMETHOD` -• iy r
-•,RECEIPT # •
CHECK #�' :
CLTD'BY'.,
_DESCRIPTION,: ..
r.
ACCOUNT •,
QTY
AMOUNT,'
_- Y ::PAID .y .;
.:PAID DATE'
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.06
$0.00
- PAID BY
:.
METHOD ' ,
RECEIPT #' -
? y CHECK # `;
_ ,CLTD BY
Total Paid forFENCE OR FREESTANDING WALL .
$197.34
1
$0.00
$0.00
-A.
Bin #f
#
City of La Quinta
-Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta,CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheets
Permit #
Project Address: -1 l D
J A �!� '1
Owner's Name: o (l � -,EvL- s t d*w C e
A. P. Number:
Plan Sets
Address: C mo -J444) )-p A Ir s
Legal Description:
Plan Check submitted
City, ST, Zip:
Contractor:el U�
r-
/V(,�- S
Telephone:?s �03 � ' l.p 3�
Address: 45-790 gefTe.�,_fd4 f?_ 11017-o
Project Description:
City, ST, Zip: 401 ko
Reviewed, ready for corrections
of
Tele hone: i
p R s tD 3- l0 3 1
_
w cd . r 7 d cl
State Lic. # :
City Lie.
Called Contact Person
Arch., Engr., Designer:
Plan Check Balance
Address:
Title 24 Calcs.
City., ST, Zip:
Pians picked up
Telephone:
State Lic. #
:.;::,,;.
::>::«<•,•:.:: >:.:::-:_ «•«<.>:....
Construction Type: Occupancy
. Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
&,j t; -7 -Sq.
Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
St- (p 3 T - (p 3 g
Estimated Value of Project: -9? z G
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACHING
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.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
god Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd 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