BWFE2016-0119r_
r `
4aw
' VOICE (760) 777-7125
78-495 CALLE TAMPICO ^� FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT /nl
NSPE ONS (760.)777-7153
BUILDING PERMIT UU
MAY N ate: 5 3' o
Application Number: BWFE2016-0119 Owner: 2016
Property Address: 79100 LADERA DR MATT REYNOLD 0M CRyOF
APN:
4271016
Application Description: REYNOLDS DS RESIDENCE / BLOCK WALL LA QUINTAECA 92253UNIryD�ECO MQ�T�EPgq�
MEQ
Property Zoning:
Application Valuation: $3,000.00
Applicant:
ROMULUS CONSTRUCTION
PO BOX 4314
PALM SPRINGS, CA 92263
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: C)29 License No.: 608806
fiat ; 1
—11--NC-o1 t?actor:
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
($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 Name:
Lender's Address:
Contractor:
ROMULUS CONSTRUCTION
PO BOX 4314
PALM SPRINGS, CA 92263
(760)251-1975
Llc. No.: 608806
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 woo br 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, 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.
(' / Q v
Dom: J 3 /UApplicant:
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 informbtion 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.
Signat re Applicant or Agent)::
DESCRIPTION `
FINANCIAL INFORMATION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
$0.00
DESCRIPTION.:
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
.AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
METHOD
RECEIPT #'
CHECK #
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL:
TOTALS:0•
$108.77
$0.00
00
Description: REYNOLDS RESIDENCE / BLOCK WALL
Type: WALL/FENCE Subtype: CITY STANDARD/PRE= Status: APPROVED
Applied: 5/31/2016 MFA
APPROVED
Approved: 5/31/2016 MFA
Parcel No: 604271016 Site Address: 79100 LAQERA DR LA QUINTA,CA 92253
Subdivision: TR 23913 Block: Lot: 85
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $3,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NAME
Details: 35 LF OF BLOCK WALL IN FRONT YARD. CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO,
PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
Printed: Tuesday, May 31, 2016 8:48:11 AM 1 of 2
SYSTEMS
CHRONOLOGY
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP PHONE FAX EMAIL
APPLICANT
ROMULUS CONSTRUCTION
PO BOX 4314
PALM SPRINGS
CA
92263
CONTRACTOR
ROMULUS CONSTRUCTION
PO BOX 4314
PALM SPRINGS
CA
92263
OWNER
MATT REYNOLDS
79100 LADERA DR
LA QUINTA
CA
92253
Printed: Tuesday, May 31, 2016 8:48:11 AM 1 of 2
SYSTEMS
INSPECTIONS
BOND INFORMATION
Printed: Tuesday, May 31, 2016 8:48:11 AM 2 of 2
SYS T(: AAS
CLTD
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
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 for FENCE OR FREESTANDING WALL: $108.77 $0.00
TOTALS:0• i 00
INSPECTIONS
BOND INFORMATION
Printed: Tuesday, May 31, 2016 8:48:11 AM 2 of 2
SYS T(: AAS
Bin #
Permit # I
Project Address:'to
City of La Quinta
Building &r Safety Division
;D .I 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
: LA-9 Name:
A e P m .A
A. P. Number:
Address: (
Legal Description:
City, ST, Zi
Contractor: Ro MLA
Telephone:
Address:
'
Project Description:
City, ST, Zip:
Te lePhne • �n-
o .
ll�..J
P t.. '^ AACe—�:-lyzejur
3S �
State Lic. #:
�\
V
City Lic. #..
K `� L
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:h
0 ne:
Construction on an.
Occupancy:
� YP
cY
to e
S t Lic. #
Project type (circle one): New A d' n Alter Repair r Dem
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: 3 U Do
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
2pd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S_M.L
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
11 r'-ITV nPIALn"i
�D L,4VJe�a 4�R��
iA
BUILDING & S FETY DEPT.
AP R��V D
FOR CONS` RUDTION