14972 (BLCK)P.O.' BOX 1504 No. 14972-
Building ' 78-495 CALLE TAMPICO
Address 8"'455 Calle Felipe LA QUINTA, CALIFORNIA 92253
Owner Rocco Balsam
BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address P.O,. Box 3$4
A.P. Number
City Zip . Tel.
La- Quinta,' CA 92253 Legal Description "
Contractor Project Description 951 of 61 high garden wall
Precisidn Masonry
Address
P.U. Box 3938
City Zip Tel.:
PcilM Desert, A 9226. 345-'5448
State Lic. City
& Classif. C29 472843 Lic. # Sq. Ft. No. No. Dw.
Arch., Engr., Size- Stories Units
Designer New ❑ Add ❑ • . Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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. "
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation $2tq
1 hereby affirm that I am exempt from the Contractors License Law for the following,
�%;7 • J�
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also I
'requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT _ AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division '3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a"permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
O 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 54 00
Professions Code: The Contractor's License Law does not apply to an owner of property who •
builds or improves thereon and who does such work himself or through his own employees, Mech.
provided that such 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 Electrical
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-' Plumbing.
struct the project. (Sec. 7044, Business and •Professions Code: The Contractor's License Law
does not apply to an, owner of property who builds or Improves thereon, and who contracts for S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec._ B. 8 P.C. foltHl'Grading
s7eason Driveway Enc.
Date Owner�`�P�� Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)'
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 54.00
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any pperson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you 'should become ZONE: BY: -
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such Provisions or this permirshall bedeemed revoked. Minimum Setback Distances:.
Front Setback from.Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
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, . Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND .
ATTORNEY'S FEES.
This Is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and'state.that the.above information is correct: Issued by. Date Permit
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 the above-.
mentioned property for inspection purposes. Validated by: I 0
Signature of applicant Date ' I
Mailing Address Validation: i
City, State, Zip MAY 0 1 1995
�v
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU F
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP.IEQUIP.
DRAINAGE PIPING
CAR P. I SQ. FT.
TEMP. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN
SQ. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Y. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ Plus -X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL
CASITAS II
P. 0. BOX 116
La Quinta, CA 92253
Rocco Balsamo
P. 0. Box 344
La Quinta, CA 92253
April 13, 1995
Dear Rocco:
This letter will serve as the approval by the Board of Directors of Casitas II
for you to build a concrete block wall in the rear of your residence on a line
that is parallel to 50th Avenue and in such a location on your property that
is consistent with the building code requirements of the City of La Quinta for
such a wall.
Sincerely,
artt XJGU4�
WAYNE 8ARDNER PRES.
Casitas II
WG/rh
PROTO-U'rm WALL SYSTEMS
SPECIAL DEPUTY INSPECTION FORM
DATE:
As an accredited and certified Deputy Inspector of Froto-H Wall
Systems, Uwe hereby witnessed and certified the torqueing of the post-
._ _ -n
tension rods by
This -30 0 day of ,-A, 919 ?SS
A. Wall System Description (Block Product and Height):
6 " l (?1-f �- G-1
B. Location and Builder:
CA
P
C. Length of Wall andnumber of rods and spacing:
05-1
19
D. Torque Applied to each Rod: u I b s
,Deputy Inspector
istribution: Department of Building and Safety
Proto-H Wall Systems
Builder/Developer
Angelus Block Co.
Installer
Aj <-,
PCZ b � 0 C,