11-0271 (BLCK)4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
c&&t 4 4 Q"
Application Number:
11-00000271
Property Address:
77655 CALLE ENSENADA
APN:
773-294-001-2 -000000-
Application description:
WALL/FENCE
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1732
Ap c t: Architect or En ineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and effect.
License Cl ss: C29 License No.: 804168/J�
Date: m Contractor: , y
OWNER -BUILDER DEd rIOATION
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).:
1 _ 1 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.).
1 _ 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.).
1 _ 1 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 ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
PEREZ RUBEN
77655 CALLE ENSENADA
LA QUINTA, CA 92253
Contractor:
AA MASONRY
77530 DELAWARE PL
PALM DESERT, CA 9221
(760)360-7388
Lic. No.: 804168
VOICE (760) 777-7012
FAX {760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/17/11
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 ARCH INS Policy Number 03DKRM12003
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,
67�
/�/and agree that, if I should become subject to the workers' compensation provisions of Section 0 of the Labor Code, I shall forthwi comply with those Provi i S.
Date: ' Applicant: -
WARNING: FAILURE TO SECURE WORKE 'COMPENSATION CO GE IS UN WFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U UNDRED 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 and county ordinances and state laws relating to building construction, a hereby author' presentatives
of this cou ty to ter upon the above-mentioned property for inspecti oses
Date: Signature (Applicant or Agent):
. (I
Application Number . . . . . 11-00000271
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . . . 41.00 Plan Check
Fee
.00
Issue Date . . . . Valuation
1732
Expiration Date . . 9/13/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
13.00 2.0000 HND BLDG 501-2,000
26.00
----------------------------------------------------------------------------
Special Notes and Comments
74LN FT X 5 FT HT & (6) COLUMNS 5 FT HT
ALL PER ORCO STANDARDS AND APPROVED
PLANS.APPROVAL PER A.J.
----------------------------------------------------------------------------
Other Fees . . . . ..... . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 41.00 .00
.00
41.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 .00
.00
1.00
Grand Total 42.00 .00
'.00
42.00
LQPERMIT
ORCO STANDARD 6' TO 8` CMU SITE WALLS
OPTIONAL RAT GAP Da[MV CRITERIA: PER THE2007C OC
1. ALLOWAMESQU BEARDUG PRESSURE - I" P.SF
Z ALLOWABLElA7ERAL PASAVEPRF-WRE-150 Pa
3. GROUTSTRENGTH = 2OW PST 0 28 DAYS:
4. RUNfORaNG57FEL : GRADE 60.
5.1500 PS7 M45ONR Y COMPREMON STRENGTH
6816, 6616, OR 66181740
GROUTED ONLY @ VERT
NOTES: .
STEEL
1. CONCRETE BLOCK SHALL CONFORM TO ASM C90.
2 CONCRETE FOR FOOTING SHALL BE 1 PART CEMENT 702-1/1
'r DROP-IN BAR
PAR75 SAND 70 3-1/2PAR75 GRAVEL WRHA MAXIMUM OF 1-112
GALLONS OF WATER PER SACX PORTLAND CEMENFSHAIL C7NfORM
TO A57M C 150 TYPEAlK FC=2500 PSI
'6 S7DJOINT
3. RSW)?aNGSTEEL 49MLL BE DEFORMED AND CONFORM TO
RE7NFORC EMENT @ Z4' O/C
AS774A 615 GRADE 60: PROVIDE 48 BAR DIAMETER LAP:
(3 PLACES- 4 PLACFGFOR 7
& S' WALLS). USE BJ; SOD.
4. RE34R SN U BE LFNTERED 1N THE CONCRETEDLOC7C all.VV
FOR SLUMP BLOCK
Wf1011TISLOC47EV.
S. C ONOWIFBLOCX SH&L. BE LAYER INA RUNNING BOND
NOTE: PROV70F?i D01VEL to
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ff4 DR0P-EN BAR AT EA,OE
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SLDEOFC0N7ROLJOBIITS,
GROU7YD.
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WDOWEL @CSWEROF
UNOBSTRUCTEDCFILSME 1SSA:7-7QFNTTOALLOW GOOD GROUT
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WITHOUTSEOREGA77ON OF7NECONSTTURM
v
LEVET. &WEB07H.,2DES
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9. &OCKS7EMMAYBE WET -SET I-W'1NM 7HEfOO77NG WHILE
THE CONCRETEIS PLAS77C AWCX 57EM MAYBE MC EDD TO
ETHER EDGE OIFTHE 7RBValTYPE FOMNG.
10. F0077NG MU5r5EPOURED ON OR INTO UNDISTURBED
NATURAL SOIL OR ON COMPACTED FILL W17T1 A MINIMUM
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1L FIRSTDSPEC170N TO BEAF7ER,F0077W 7ROVOTESARE
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Z CVAU TEFOR fa077NG SHALL SE I PART CFNBVT O Z -I/2
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RAC SAND 7HE&DtXWALL 15READYTD C?C7Uf.
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Bin #
City of La Quinta,,
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # 1
1�
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address:ze
Project Description: Y7 q
City, ST, Zip: _
f It CD
v C- 'S .
Telephone:
"c: � %:: < i;>::< :s# ` :;.>:::::`:;>: >;>
....................:...................
State Lic. # : 0 (0 9
CityLic. #; $
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
•`' :><^,<:>''
s ,:.,f<s:;:,:::.>.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic.#:
Name of Contact Person:
Sq. Ft.:
# Stories: # Units:
Telephone # of Contact Person:
Estimated Value of Project:
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
2" Review, ready for correctionsAssue Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'^' Review, ready for correctionsrssue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
G
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