12-1178 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-0 0001178
Property Address: 78705 LA PALMA DR
APN: 604-172-010-131 -23269 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 510
Td�v 4 4WQrmtw
Applicant: Architect or Engineer:
a�P
------------------
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals 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
y applicant for a permit subjects the applicant to,a civil penalty of not more than five hundred dollars ($500).:
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.).
(_ 1 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 th' ason
p c
/Date: Y Owner 1 3111 l
CONSTRUCTION LENDING AGfNCY
I hereby affirm under penalty of perjury that there is a construction lending age a performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: P
LQPERMIT
Owner:
GLORIA RODRIGUEZ
78705 LA PALMA DRIVE
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-0
FAX (760) 777-7
6
INSPECTIONS (760) 777-7153
Date: 10/08/12
--------=--------------=-----------------
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 c=at, in the performance of the work for which 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 that, if I should become subject to the workers' compensation pr 'ions of Section
//�� 3700 of the Labor Cod , shall f with comply with s visio
te: I V 2A icant:
WARNING: FAILURCURE WORKERS' COMPENSATION COVERA 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.
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city a county ordinances and state laws relating to building con ction, and hereby authori ives
of �s county to enter upon the above-mentioned prop for i 'tion purposes.
Date: / O t g ature (Applicant or Agent).:
Application Number . . . . . 12-00001178
Permit . . . WALL/FENCE PERMIT
Additional desc . .
Permit Fee . . . . 17.00 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 510
Expiration Date . . 4/06/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 2.0000 HND BLDG 501-2,000
2.00
----------------------------------------------------------------------------
Special Notes and Comments
REPLACE WOODEN FENCE .@ REAR YARD WITH 60
L.F. 6' VINYL FENCING, PER PLANNING
APPROVAL. FOOTINGS NOT TO EXTEND INTO
ADJACENT PROPERTY. 2010 CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
------------------------------
Due
---------------------------
Permit Fee Total 17.00 .00 .00
17.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 18.00. .00' .00
18.00
G
1
k
Gloria Rodriguez
Vinyl Fence,Permit
78705 La Palma Drive
La Quinta, CA 92253
In order to install a vinyl fence, I will follow the instructions provided. Cement will be added at the
bottom so the stakes and fence will properly stay put during wind storms, etc. Stakes will be used to
secure each vinyl panel. The fence will be inserted at about 30 inches below the ground and six inches of
gravel will be added. Please see full instructions attached.
cQ
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t"Uilnlll
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READ INSTRUCTIONS PRIOR TO INSTALLATION/LEA LAS INSTRUCCIONES ANTES DE LA INSTALACION
ASSEMBLY INSTRUCTIONS/INSTRUCCIONES DE ENSAMBLAJE
Fence Location
Mark the fence location using —fes
string and line stakes. - I
Ubicaci6n de la cerca
Marque la ubicad6n de la cerca 1 ��
utilizando una cuerda y estacas
alineadas.
2. Post Location
Measure the width of the fence
panel (X) plush inch for
brackets. Then measure the
width of the post (Y) and add
the measurement to the total
width of the panel and bracket.
This is the on -center
measurement for post hole
location. It is highly
recommended to dig enough
holes to install 3 to 4 sections of
fence at a time to ensure proper
post hole placement.
Materials Needed/Materiales necesarios
2A6
Gm
ATE*HOUSE
Diol
❑ Panel/Panel
0 Vinyl CemenUCemento para vinilo
f) Fill remainder of first hole-
❑ Posts/Postes
❑ Concrete/Concreto
2fi
❑ Post Tops/Remates para poste
❑ Pea Gravel/Gravilla tipo guisante
❑ Brackets/Soportes
❑ Gate Kit/Kit de Puerta
READ INSTRUCTIONS PRIOR TO INSTALLATION/LEA LAS INSTRUCCIONES ANTES DE LA INSTALACION
ASSEMBLY INSTRUCTIONS/INSTRUCCIONES DE ENSAMBLAJE
Fence Location
Mark the fence location using —fes
string and line stakes. - I
Ubicaci6n de la cerca
Marque la ubicad6n de la cerca 1 ��
utilizando una cuerda y estacas
alineadas.
2. Post Location
Measure the width of the fence
panel (X) plush inch for
brackets. Then measure the
width of the post (Y) and add
the measurement to the total
width of the panel and bracket.
This is the on -center
measurement for post hole
location. It is highly
recommended to dig enough
holes to install 3 to 4 sections of
fence at a time to ensure proper
post hole placement.
Ubicaci6n de los postes
Mida el ancho del panel de la cerca (X) y anada'' pulgada (12,70 cm),
correspondientes a los soportes. Luego mida el ancho del poste (Y) y anada esta
medida at ancho total del panel y el soporte. Esta es la medida del centro para
la ubicaci6n de los hoyos para los postes. Es altamente recomendable que cave
varios hoyos para instalar 3 o 4 secciones de cerca at mismo tiempo, con el fin
de asegurarse de que los hoyos para los postes estan correctamente ubicados.
3. Post Installation
a) Dig post hole 12 inches in
diameter and 30 inches deep.
b) Add 6 inches of gravel for
post drainage.
c) If frost line exceeds 30
inches, dig hole to the
appropriate depth. Add 6
inches of gravel for post
drainage. Add concrete
until a depth of 24 inches
remains.
d) Insert post in center of
post hole.
2A6
1.66�
Diol
tinea g.dbb by P—P—
f) Fill remainder of first hole-
with concrete according to
Ubicaci6n de los postes
Mida el ancho del panel de la cerca (X) y anada'' pulgada (12,70 cm),
correspondientes a los soportes. Luego mida el ancho del poste (Y) y anada esta
medida at ancho total del panel y el soporte. Esta es la medida del centro para
la ubicaci6n de los hoyos para los postes. Es altamente recomendable que cave
varios hoyos para instalar 3 o 4 secciones de cerca at mismo tiempo, con el fin
de asegurarse de que los hoyos para los postes estan correctamente ubicados.
3. Post Installation
a) Dig post hole 12 inches in
diameter and 30 inches deep.
b) Add 6 inches of gravel for
post drainage.
c) If frost line exceeds 30
inches, dig hole to the
appropriate depth. Add 6
inches of gravel for post
drainage. Add concrete
until a depth of 24 inches
remains.
d) Insert post in center of
post hole.
2A6
1.66�
e) Level and plumb post.
tinea g.dbb by P—P—
f) Fill remainder of first hole-
with concrete according to
2fi
manufacturer's instructions.
g) Recheck level and plumb. Always allow 2 inches of
ground clearance under panel.
h) Add concrete to next post hole after panel is
installed.
Instalaci6n del poste
a) Cave los hoyos para los postes de 12 pulgadas
(30,48 cm) de diametro y 30 pulgadas (76,20 cm)
de profundidad.
b) Arvada 6 pulgadas (15,24 cm) de gravilla para
el drenaje del poste.
c) Si la linea de penetraci6n de la helada es mayor
a 30 pulgadas (76,20 cm), Cave un hoyo de la profundidad adecuada. Arvada
6 pulgadas de gravilla para el drenaje del poste. Afiada concreto hasta que
quede una profundidad de 24 pulgadas.
d) Inserte el poste en el centro del hoyo.
e) Nivele el poste y verifique que este a plomo.
f) Rellene el espacio restante del primer hoyo con concreto de acuerdo con las
instrucciones del fabricanle.
g) Controle nuevamente que este nivelado y a plomo. Siempre deje 2 pulgadas
(5,08 cm) de separaci6n del suelo debajo del panel.
h) Arvada concreto al siguiente hoyo para poste luego de instalar el panel.
4. Rail Bracket Location
Measure the distance from the bottom
of the panel to the bottom of the lower
horizontal rail (A) and add 2 inches. This
is the location of the bottom bracket.
Measure from the bottom of the lower
horizontal rail to the bottom of the mid rail
(B). This is the location of the mid bracket.
Use the same process to place the top
bracket in the correct location.
Ubicaci6n de los soportes del travesano
Mida la distancia desde la parte inferior del
panel hasta la parte inferior del travesano
horizontal inferior (A) y s6mele 2 pulgadas
(5,08 cm). Esta es la ubicaci6n del soporte
inferior. Mida desde la parte inferior del
travesano horizontal inferior hasta la parte
inferior del travesano intennedio
(B). Esta es la ubicaci6n del soporte
intermedio. Repita el procedimiento para
ubicar correctamenle el soporte superior.
5. Panel Installation
a) Set panel into the brackets on the first
pre-set post.
b) Place the next post (with brackets) in
the hole on the opposite end of the
panel without any concrete in the hole.
c) Ensure posts are flush against panel.
Secure all screws into the panel in the
center bracket slots.
d) Level and plumb post.
e) Level panel horizontally.
f) Add concrete according to
manufacturer's instructions.
g) Repeat install process for other panels.
Instalaci6n del panel
a) Ubique el panel en los soportes del
primer poste preinstalado.
b) Ubique el poste siguiente (con los
soportes) en el hoyo del extremo
opuesto del panel, que no tiene
concreto.
c) AsegOrese de que todos los postes
estan al ras del panel. Ajuste todos
los tomillos del panel en el centro de
las ranuras del soporte.
d) Nivele y aplome el poste.
e) Nivele el panel horizontalmente.
f) Rellene con concreto de acuerdo con
las instrucciones del fabricante.
g) Repita el procedimiento de instalaci6n
para los demas paneles.
CITY OFLAQ
BUILDING
[�&SAFE
'
Aiitl 1 RlO \ V
FOR CONSTRUC
DATE O B /ZBi`6W _
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Pro Series 6 ft. x 6 ft.
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P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
To: Greg Butler, Building & Safety Manager
From: Les Johnson, Director -Planning
Permit k
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To CDD:
Due Date: 145A0
Status:_ /c/ 014
Building Plans Approval
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description:
Address or General Location: 78- 705 64 �PaWtA _ Aa -
Applicant Contact:
The Planning Department finds that:
❑ ...these Building Plans do not require Planning Department approval.
...these Building Plans area roved b the Planning'
PP y Department.
n
❑ ...these Building Plans require corrections. Please forward a copy of the
attached corrections to the applicant: When the corrections are made
please return them to the Planning Department for review.
Les Johnson rector -Planning Date
OCT Al" x'111/
Plarning Departmerif
10, 1 .,
gyp®
F, ffld P, ' Mtt.0
I
/ I
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA„CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Fo "kms” for Owner -Builders Applying for Construction Permits
111Q1t'TA�YT! NQTICE TQ PRQPERTY OWNER
Dear Property Owner.
An. application for a building permit �ha�s been submi ed in your name lis yourself as the b der of the j,moperty
improvements specified at t/J . ,
We are .providing you with Owner -Builder Acknowledgment and I lien Ye eatron orm o make you aware of your
Fegronsibilities and possible risk you may incur by having this permit. issued in your name as the
Owner -Builder. We will not issue a buildingpermit until yowhave 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.
OV R'S ACKNOWLEDGMENT AND VERIFICATION OF MORKAMN
DFRECTIONS. Read and initial each: sratementbdowly signify you understand or verify this information.
A 1 understand a frequent practice of, unlicensed ons is to have the
y mp F� property owner obtain an "Owner -Builder'
g permit that erroneous) implies that, the property owner is providing his or her own labor and material personally. 1, as
an Owner -Builder, may 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.
I understand building permits are not required lobe signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
I.understand as an "Owner -Builder" I am there : nsible
res: party of record on the permit. I understand that 1 may protect
�2yselfrom potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
q4,,l understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
Is and contracts.
5. I understand if 1 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 considered an "employee'
under state and federal law.
I understand if I am considered an "employee, under state and federal law, 1 must register with the state and federal
40itment, withhold' payroll taxes, provide workers' compensation disability insurance, and' contribute to unemployment
risk
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
hl�l
understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
9t6ctures 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.
z
1 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.
I understand I may obtain more information regarding my obligations as an "employee' from the lierrral 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.
Y I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
p4arty legally and financially responsible for proposed construction activity at the following address:
agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
,J able laws and requirements that govern Owner -Builders as well 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' State License Board may be unable to assist you with any financial loss
you may sustain ,as a result of a complaint.. Your only remedy against unlicensed Contractors may be in'civil court It is also
important for you to understand that if an unlicensed 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 10 hire Contractors,
you will be responsible for verifying whether or not those Contractors are property licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuiag, the permit. Now A copy of the property owner's driver'slkcensej form netar404'0n-, or
other verification acceptable to the agency is required to be presented when the permit is issued to verify the property
owner's signature. _ . _
�► moi. - � � ��/ LyI V - W1104
�61
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
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 Agent:
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:
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 sualained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
I understand I may obtain more information regarding my obligations as an "employee' from the laterRal 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 I -
800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
I 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:
'able . I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
i
laws and requirements that govern Owner -Builders as well as employers -
12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the info matiun I
'✓have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If yan contract with
someone who does not have a liege, the Contractors' State License Board may be unable to assist you with airy financial loss
you may sustain`as a result of a complaint. Your only remedy against unlicensed Contractors may be in'eivil ewwi It is also
important for you to. understand that'if an unlicensed Contractor or employee of that individual or firm is injured wbik 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 form must be completed and signed by the property owner and returned to
the agency responsible for issnift.tthe.pearmit. Nota: A copy of the property owner's drivea'sh fwm ntbi`*Wlvn� or
other verification acceptable to the agency is required to be presented when the permit is issued to verify tke property
owner's signature. _
Signature of property owner
Date L -t 19 --
Note:
9—
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
Excluding the Notice to Property Owner, the execution of which 1 understand is my personal responsibility, l hereby authorize
the following person(s) to act as my agents) 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
Name of :Authorized
Address of Authorized
I declare under nal of
Property Owner's Signature..`
Page 1 of 1
BID.
City 6f` [, t uta
&d1dfn9 at Safety Division -
PerinatP,Oa Box f5'04,'78-495 Calfe Tamplco
-'• . ��� 4.Qdnta, CA 9:2253 • (760) 777-7012
Building Permit Appffcatlon4 and Wracking Sheet
Pratt ct Atldtess:: Owner"s Name:
,
1 Address: `
•
Legni Desai tion.- City. ST; Zap: )A A '
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Sq. F'L, 0 jo # Stories
Name of Contact Perm:
Telephone -9 of Contac¢ Feraoh:
Estimated Vatue of i'nojex�
COW Conbetpersoa
A"LICAUT: DO NOT WRITE BELOW THIS LINE
PIuntibipg
if
Submittst',
Reci'd
Recd ..
T'RA.CCCIM
SAU,
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