BWFE2015-0054,r
78-495 CALLE TAMPICO D 4-
LA QUINTA, CALIFORNIA 92253
Application Number: BWFE2015-0054
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Property Address:
77192 CALLE FLORA
APN:
658210042
Application Description:
CLARK MICHEAL BLOCK WALL 60 LN FT
Property Zoning:
Application Valuation:
$12,950.00
VFI,,
Applicant:16
2015BOB
EDWARDS CONSTRUCTION
INCOR
51-455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
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 oABi s and Professions Code,
and my L. ens is in full force and effect.
License ass: Cf27[ License No.:
Date: i� ` J 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 Divisio
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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/16/2015
Owner:
MICHAEL CLARK
58631 BANFIELD DR
LA QUINTA, CA 92253
Contractor:
BOB EDWARDS CONSTRUCTION INCOR
51-455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
(760)777-8202
Llc. No.: 684857
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 certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner.wls to become subject to the workers'
compensation laws of California, and agree th , 'I s uld become subject to the
workers' ompensation provisions of Sectio 70 o the L bor Code, I shall fort ith
compllyy th t ose provisions.
Date: J ' k Applicant: �''v
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 tha a abo e' fo ation is correct.
I agree to comply with all city and county ordinance and sta I s elating to wilding
construction, and hereby authorize representatives of this c' to n er upon t �above--
mention
d pr perty for inspection purposes.
bate: ( ' Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
CITY
'AMOUNT
PAID PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK # CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA; $1.00 $0.00
DESCRIPTION
ACCOUNT
CITY
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
CITY
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 forFENCE OR FREESTANDING WALL• $108.77 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RET WALL <=12 - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT #.
CHECK #
CLTD BY
+ DESCRIPTION `'
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
RET WALL c=12 - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forRETA1NING WALL• $108.77 $0.00
• $0.00
Permit Details PERMIT NUMBER
T City of La Quinta BWFE2015-:0054
Description: CLARK MICHEAL BLOCK WALL 60 LN FT
Type: WALL/FENCE Subtype: Status: UNDER REVIEW
Applied: 3/16/2015 P1U
Approved:
Parcel No: 658210042 Site Address: 77192 CALLE FLORA LA QUINTA,CA 92253
Subdivision: TR 21120 Block: Lot: 15
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $12,950.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: COMBO BLOCKWALL TWO FOOT RETAINING WALL 60 LN FT WITH 6 FT HT X 60 LN FT CITY STANDARD PRECISION CONCRETE BLOCK
SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA
BUILDING CODES.
Printed: Monday, March 16, 2015 9:02:40 AM 1 of 2 CRWrsrfMs
Permit Details PERMIT NUMBER
c ,r City of La QuintalBWFE}201,5=0054
DESCRIPTION
- �-ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD
RESULT
BOND BEAM
BLD
BY
BSAS SB1473 FEE
101-0000-20306
0$1.00
$0.00
FOOTINGS
BLD
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
WALL/FENCE - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
100 LF PC
101-0000-42600
0
$60.91
$0.00
Total Paid for FENCE OR FREESTANDING WALL $108.77 $0.00
RET WALL <=12 - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
RET WALL <=12 - FIRST
101-0000-42600
0
$60.91
$0.00
100 LF PC
Total Paid forRETAINING WALL $108.77 $0.00
TOTALS:•0
SEQID
INSPECTION TYPE
REMARKS
NOTES
INSPECTOR
SCHEDULED
DATE
INSPECTIONS
COMPLETED
DATE
RESULT
BOND BEAM
BLD
FINAL"
BLD
FOOTINGS
BLD
Printed: Monday, March 16, 2015 9:02:40 AM 2 of 2 Ci?WSrsrEMS
Bin #
Permit #
�6
(�`N
Project Address: 77" 1 lZ
City of La Quin to . .
-Building $t Safety Division
0
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking'SheeJVt
Owner's Name:
A. P. Number:
Address:
Legal Descri do :
City, ST, Zip: Z
Contractor:
Telephone:
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Address: —S
Project Description:
City, ST, Zip:
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Telephone:
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State Lic. # 48
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Arch., Engr., Designer:Av
Address: 4iwA
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Construction Type: ecu ancy:
State Lic. #:v?
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circle one New Add'n Alter Repair Demo
Project �Pc onI
Name of Contact Person:
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: l2 ,
APPLICANT: DO NOT WRITE 13ELOW THIS LINE
t!
Submittal
Req'd
Rec'd
TRACMG
PERMIT FEES
Plan Sets
Pian 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
Floodplain plan
Plans resubmitted
Mechanical
Grading plan
2w1 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'rd Review, ready for correctionsCssue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fccs