12-0304 (BLCK)P.O. BOX 1504. VOICE (760) 777-7012
78-495 CALLE TAMPICO n FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
' BUILDING PERMIT `
Date: 3/23/12
�Ap'plication Number: 2-00 00 03 04 1Owner: `
iiProperty Address: 51975 AVENIDA VILLA � - OLIVAREZ ARTEMIO
APN: 773-182-.023-11 -000000- 51975'AVENIDA.VILLA nn1t
Application description: WALL/•FENCE. LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL ---------------- ---------{
Application valuation: 1250 i U p,{; n (j
Contractor: 1ls MAR 2 C 2012
Applicant: Architect or Engineer: Owner s
f CITY OF LA QUINTA
d�N R FINANCE nEPT, y -
. ----------------------------
7
---------------------------
LICENSED CONTRACTOR'S DECLARATION - - WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty ofperjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation,as provided
License Class: License No.: for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Date: " • Contractor: _ 1 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
OWNER -BUILDER DECLARATION - insurance carrier and policy number are:
• I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number
following reason ISec. 7031.5, Business and Professions Code: Any city or county that requires a permit to I certify that,.in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the - person in any manner so as to become subject to the workers' compensation laws of California,
'permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compens tion provisions of'Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code)or 3700 of yte Labor Code, I shat forthwith comply with those pr Bions. Y
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
an pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: Dater s•�- Applicant: ,
(,�) 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). - APPLICANT ACKNOWLEDGEMENT -
(i� 6 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
y 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. _
` property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for "
pursuant to the, Contractors' State License Law.). _ whose benefit work is performed under or pursuant to any permit issued as aresult of this application, 4.'
f am exempt under Sec. , B.&P.C. for this reason 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 - r
G1 2- performed under or following issuance of this permit. '
Date:. /•. J" Owner. 2. Any permit issued as a result of this application becomes null and void if work is not commenced
.4 within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
CONSTRUCTION LENDING AGENCY - permit to cancellation.
I hereby, affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to. comply with all
work for which this permit is issued (Sec.'3097, Civ. C.). city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of s county to enter on the above-mentioned property for inspection purposes. -
Lender's Name: - - - 0 - -
. - - Date ^ /✓7` Signature (Applicant or Agent):
Lender's Address:
LQPERMIT -
Now,
Application Number . . . . . 12-00000304
Permit -. .WALL/FENCE PERMIT .,
Additional desc .
Permit Fee . . . 31.00 Plan Check
Fee
.00
Issue Date . . Valuation
. . .
. 1250
Expiration Date 9/19/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
_. 8.00 2.0000 HND BLDG 501-2,000
16.00
Special Notes and Comments
50 LIN FT X 6.FT HGT "ORCO" DESIGN BLOCK
WALL AT REAR PROPERTY LINE.2010 CODE
-------------------_--------------------------------------------------------.
Other Fees . . BLDG STDS ADMIN.,(SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 31.00 00
.00
31.00
Plan Check Total .00 .00
.00
.00 '
Other Fee Total_ 1.00 .00
.00
1.00
Grand -Total 32.00 .00
.00
32.00
LQPERMIT _
- _
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY 0"' ER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner-Ri.diders.Applying for Construction Permits
Dear Property Owner:
Ari. application .for a building permit has been submitted in your name listing youEsel€ as the buddeF of the ,pFoperty
-improvements specified at
We are providing you with ark Owner -Builder Acknowledgment and In€ormation Verification Form to make you awam of your
Fespeasibilities and possible risk -you may incur by having thispermit•issued in your name as .the
Owner -Builder. We Witt not issue a building, permit until yeAuhave read, InWaled your understaading of eaeh'provision,
signed, and returned this form to us at our official address indicated. An agent of the ovmer cannot execute dki `.notice
unless you, the property owner, obtain the prior approval of the permitting authority.
c MWZWLKH�� A.ND V1) CA:TWN OF MyQI T A
Bead and initial each: statenrenrbetow*tb signify you and'erstand or vel this a¢or .adom
A 6.1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his, or her own labor and material P=6n:1, as
an Owner -Builder, �+
r -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 Molly acting as an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to workers
on my. property. '
AL2. I understand building permits are not 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. .
�3. 1 understand as an "Owner -Builder" I am the res' ible.party of record on the permit. I understand that I may protect
myself from potentialfinancial risk by hiring a licensed Contractor and having the permit filed in his or her name insteud of my
own.
,p 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
/�5. I understand if I employ or otherwise engage any persons; other than California licen.°ed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered 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 state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance: and' contribute to uneutployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk.
✓' '�7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot .legally build them with the .intent to offer them for sale, unless aU 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.
8. I understand as an Owner -Builder if I sell the property for which this peniut is issued, I may be held liable for any
financial or personal. boudes sustained by any subsequent owner(s) that result from any latent construction defects in the
worlananship or materials.
z4 0 9. I understand I may obtain more information regarding my obligations as an ,employee, from the interarat 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 (CSIf.S) at I-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
Alp IO_ 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:
/A1 1. I agree that, as the party legally and ftnaacially responsible for this proposed construction activity, .I will abide by all
applicable laws and requirements that govern Owner -Builders as well at employers.
12.1 agree to notify the issuer of this form immediately of any additions; deletions, or cb*06e6 to any of the information I
have 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 rouble to assist you with any financiat loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in'oivil court. It is also
important for you to understand that if an unlicensed ContraPtor of employee of that individual or firm is injured while Working
on your property; you may be held Iiable for damages. If you obtain a permit as Owner -Builder and wish to him Contractors,
you will be responsible for verifying Mwther or not those Contractors are prope€Iy tieeased and the status of IMF 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 ismilrg; flm-p emit. Now A copy, of tke properg* owner's dWvert:'s..1#ketasey f0m n0taCka0714 or
other verification acceptable to the agency is required to be presenter) when the pe. mit iss in"d to verify the proprersy
owner's signature.
Signature of property owner ( �2 p-,� Date: 3 2 3" ,
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 OWNZWS BEEIAL
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 ageat(s) to apply for, sign, and file the documents necessarX to obtain ari Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work): /d/ P L G
Project Location or Address: 7 S /I - y Cy f L L P L .A 021_111Y714-, CA
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjurythat 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: 3
r .
Bin. #
uln'ta
Bulling 8( SafetyDwon .
P.O. Box 1504,78-495 Calle Tampico.,
14-Quinta, CA 92253 -:(760) 777-7012
Build* Permit Application and Tracking Sheet
Pennit #
12-
Project .Address: - VC
Owner's Name:.
A. P. Number
Address:
7.�
Legal Description:
• — City, ST, Zip: 1-9 mu-/ty�/J, (I a
Contractor.
Telephone:
Projer4 Description: 4,
Address:
City, ST, Zip:
5 T
Telephone:
State Lic. # City Lia #;
Arch, Engr., Designer
Address:
City., ST, Zip:
Telephone:
State LICI#:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n. Alter Repair Demo
Sq. Ft.:
# Stories:
N Units:
Telephone # of C . ontact Person: —TE;Zated
Value of Project:
APPLICANT: DO NOT. WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT' FEES
Plan Sets
Plan Check submitted.
Rem
Amount
Structural Cales.
Reviewed, ready for corrections'
Plan Ch . eck Dtposit.
Truss Cates.
Called Contact Person
Plan Check Balance
Tide 24 Calcr�
Plans picked up
Construction
Floodplain plan
Plans resubmitt.ed.'.
Mechafilcal
Grading plan
2'! Review, ready for corrcctionkll�l
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
ShLL
ILO.A. Approval
Plans resubmitted
Grading'
IN HOUSE--
Review; ready for Correctionsfissuc
Developer Impact Fee
Planning Approval.
Called Contact Person
AXP.P
Pub. Wks. Appr
Date of permit Issue
Schoul Fees
Total Permio Fees
CHART 6
FOR ' TO 8' SITE. WALL W/ TRENCH FOOTINGujujCL
_ - I4 DOWEL ® E404 MDEOF - _ A= � MY NOMM M
-&004-0(/r W/ 04 DROPAN aV -
' ROifETY, Npf 41IMDI"DVOINl
r", KOCK-Our
u p •�p p
o.
-0 6
• Cw-PoOTTNG •p. -o p :o:• .
P P
. F�j
II KpL (vn.0 "71TpM•w(f/RpX
MRSIDEYARDREWRNWAUSWHRE - �1,awwwuwr�wracla°pr
urs
OWMAIGESWAIE Ott /212. A 112 &OCK �rtwa roam.. .
: MAYLEI-TOMPSWALEGRADE FROME mwnYoau .I'-0'
04 VOWEL AND 04 DRORIN &4R ON EA01 .
SIDEOFTNE I/2 &O0f DRAIN =AS
SHOWN. F007ING STEP DETAILC ci
Ty OF
a
LA QUINTA
BUILDING & SAF - QaeFESSjo
A � � EiY DEPT, �9 s
ROVE®
FOR CONSTRUCTION
- W
~ C31925
DATE Bl/ * Exp. 12.31-2012
CITY OF LA
QU
�,�,4:.}Q.
rF .dF 1 :off
C'A1c„ f
WIND MAX. .D.
DESIGN WALL •TRENCH 'X' .DOWEL 'Y' BAR
SPEED 'HEIGHT FOOTING
DEPTH .
#4C� 40° 0/C • ID+I.-9" #4 @ 4)" 0/C
b'-�° 2"-0" 36' 0/C
V U 36'O/C-10'CMU
N Q".
M W � #4� 40" 0/C '-9"-#4 @�4)" 0/C'6'$"2'236' 0/C10+1
S6• o/C - IB: CMU '
Z w
� � 2T 0/C - IB' CMU 2T 0/C - I8 -'CMU
°O � #4C� 24" 0/C" I D+I'-9" #4 '.� 214° 0/C
8'-0° 2�:6e. • IB' 0!C - IB'
36'0/C - IF
CMU
0
TO 8' CMU SITE WALLS
DESIGN CRITERIA: PER THE 2010 CBC
1. ALLOWABLE SOR BEARING PRESSURE = 1SW PSF
2. ALLOWABLE LATERAL PASSIVE PRESSURE =.150 PCF
I GROUT STRENGTH =1000 P51@ 28 DAYS,
4. REINFORCING STEEL : GRADE 60.
S 1500 PSI K45ONRY COMPRESSION STRENGTH.
6816, 6616, OR 6618 CMU
GROUTED ONLY @ VERT
STEEL
'r DROP-IN BAR
06 SID JOINT
REINFORCEMENT @ 14" 0/C
(3 PLACE'S - 4 PLACES FOR 7
B 8' WALLS). USE 05 SOD.
FOR SLUMP BLOCK
NOTE PROVIDE 04 DOWEL &
04 DROP -JN BAR AT EACH
SIDE OF CiONTR011DIM5,
ENOLS OF WALLS AND @ WALL
.HEiwfT at4NGE3
T DOWEL @ COITER OF
CMU.
.1 I 1 f �1 2
I
04 HORZ. CONT.
5' 7D L>AYLIGHT
/y81t . L
iV/1,l
SEE CHART FOR REQUIRED REBAR
AND FOOTING DIMENSIONS.
NOTES'
I. CONCRETESLOC(SHALL CONFORM TO ASTM C 90.
2 CONCRETE FOR F0077AIG SHALL BE 1 PART CEMENT TO 2-1/2
PARTS SAND TO 3-1/2 PARTS GRAVEL WITH A MAXIMUM OF 1-1/2
GALLONS OF WATER PER SACK, PORTLAND CE &ENT SHALL CONFORM
TO.ASTM C 150 TYPE II/V. F: - 2500 PSI
3. REINFORCING STEEL SHALL BE DEFORMED AND CONFORM TO
AWNA 615 GRADE 60. PROVIDE 48 BAR DIAMETER LAP.
4, REBAR SHALL BE CENTERED IN THE CONCRETE BLOCK CELL IN
WHICH IT LS LOCATED.
5. CONCRETE BLOC(SHALL BE LAYED IN A RUNNING BOND
PAT7ERN WITH VERTICAL CONTINUITY OF THE CELLS UNO.
6. ALL BLOCK CEL IS CONTAINING VERTICAL REBAR SHALL BE SOLID
GROUTED.
7. USE TYPE S MORTAR PROPOR7TONED USING ASTM C 170 PART
CEMENT TO 1/1 PART LIME TO 4-1/2 PARTS DAMP, LOOSE SAND.
8. GROUT FOR CONCRETE BLOCK PER ASTM C 476 TO BE I PART
CEMI.7VT TO 3 PARTS SAND (GROUT MAY CONTAIN 2 PARTS 3/8"
PEA GRAVEL IF WEATHER CONDITIONS ARE FAVORABLE AND BLOCK
UNOBSTRUCTED CELL SIZE IS SUFEICTENT TO ALLOW GOOD GROUT
FLOW). WATER SHALL BEADDED TO PRODUCE GOOD GROUT FLOW
K MOOT SEGREGATION OF THE CONSITUENT S
9. BLOC(STEM MAY BE WET -SET 1-1/2"INTO THE FO077NG WHILE
THE CONCRETE 15 MAS77C: BLOC( STEM MAY BE PLACED TO
EITHER EDGE OF THE TRENCH TYPE FW71NG.
10. F0077NG MUST BE POURED ON OR INTO UNDISTURBED
NATURAL SOIL OR ON COMPACTED FILL WITH MINIMUM
COMPACTION OF 90 %.
11. FIRST INSPECTION TO BE AFTER F0077NG TRENCHES ARE
READY FOR CONCRETE AND ALL REQUIRED SIM IS TIED IN PLACE.
SECOND INSPECT70N TO BE WHEN THE REQUIRED VERTICAL IS IN
PLACE AND THE BLOCK WALL IS READY TO GROUP
]I. MAXIMUM CONTROL JOINT SPACING. 40'01C. 20'01C FOR
WALLS TO BE MORTAR WASHED OR STUCCO COATED.
VIN. FOOTING DEPTH FOR 5' TO DAYLIGHT
WALL 0 WALL @ WALL @
SLOPE TOP I FT. SETBACK 2 FT. SETBACK
2 7.01 2'-0" 2'0'
3 T01 2'-0" p F E
r
CITy-nF LA QUINTA
z F- N a
C31g25.
* Exv..12-31-2012 A
sr4l EF C