05-5260 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
05-00005260
Property Address:
78691 DEACON
�^ APN:
770-230-009-
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY
Application valuation:
5650
6
Applicant:
DR E
RESIDENTIAL
Architect or
T4ht 4 4 Q"
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 Class: -C29 License b.: 472843
Date: Contractor:.
OWNER -BUILDER DECI AAATION
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, 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 1, 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 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 istssued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address: 13
LQPERMIT
Owner:
APC -STRINGER SR, LLC
PO BOX 3420
PALM DESERT, CA 92260
Contractor:
PRECISION MASONRY
P.O. BOX 3938
PALM DESERT; CA 92261
(760)779-5100
Lic. No.: 472843
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/01/05
-----------------------------------------------
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 STATE FUND 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 work rs' compensation provisions of Section
3700 of the Labor Code, I sha I fo with co ply w' 'those provisions.
Date: ��Applicant:
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 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 constructio , and hereby authorize representatives
of this county to enter upon the above-mentioned property fo pect' pu ce .
Date:Jy Y OS—Signature (Applicant or Agent):
r..%
�f
LQPERMIT
Application Number . . . . 05-00005260
Permit . . . WALL/FENCE PERMIT
Additional desc .
Permit Pee. 81.00
Plan Check
Fee..
.00
Issue Date . .
Valuation
. . .
. 5650
Expiration Date 5/30/06
Qty Unit Charge Per
Extension
BASE FEE
45.00
4.00 9.0000 THOU BLDG 2,001-25,000
36.00
--------------------------------- 7 ---------------
.Special Notes and Comments
-----------------------
226 LF 6' BLOCK WALL PER PROTO SPEC.
Fee summary Charged Paid
Credited
Due
Permit Fee Total 81.00
.00
.00
81.00
Plan Check Total 00
.00
.00
.00
Grand Total 81.00
.00
.00
81.00
11/16/2005 WED 9:16 FAA
Ltuvv-
Bin #
City of La Quints
Building ex Safety Division
P.O. Box 1504, 78.495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ProjectAddress:28-69, Deacon Drive E.
Owner's Name: APC—Stringer SR LLC
A.P.Number:
Address:C/O Andrew Pierce Corp.
Legge1d Description: Lot#19,Tr28470-1,Tradi-
Contr�olr8 Y
Precision Masonry
City,ST,Zip: Palm Desert, CA 92261
Telephone:q60 346-3228
Address: P.O. Box 3938
Project Description:Lot 19 Tract 28470-1
City,ST,Zip: Palm Desert CA 92261
Traditions
Telephone: 760 779-5100
State Lic. #: 472843 City Lic. #:
Arch., Engr, Designer:
Address:
City, ST, Zip:
Telephone:
SmL- Lic. 19:
Name of contact Person: Darren Montgomery
Cmsrrgction Type: Occupancy:
Project type (circleone): ew Add'n Alter Repair Demo
Sq.Ft.: #Stories: #Units:
Telephone R of Contact Person: 7 6 0 779-5100
Estimated Value of Projecr.
APPLICANT: DO NOT WRITE BELOW THIS LINE
9
Submittal
Req'd
Recd
TRACKING •
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Coles.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
I
Plan Cheek Balance
Energy Calcs.
Pians picked op
Construction
Flood plain plan.
Plans resubmitted
Mechanical
Grading.plau
2rA Review, ready for correcdoWssue
Electrical
Subcontaetor List
Called Contact Person.
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Griding
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
TANDY'S INSPECTION SERVICES, INC.
PO BOX 13766 - PALM DESERT, CA 92255-3766
OFFICE / FAX - 951.769.9717
PAGER 760.776.3339
SPECIAL INSPECTION DAILY I WEEKLY REPORT
TYPE OF INSPECTION PERFORMED
N,A-�O),je lg
PERMIT NUMBER
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PROJECTADDRESS
PROJECTNAMEImicwDEcouNTRYcLunusluEsspAR=oRpoRATEcEWERccT. wwq
.4kPc -
ARCHITECT
ENGINEER —oAy- ,-- A S CAT
GENERAL CONTRACTOR
SUB CONTRACTOR
DESCRIPTION
OF WORK INSPECTED
TD SC 1=�- L B(C . 1 iTS ,I S
e- v `to CP�-rjC _ pE'2 0?c (, -�17 l kvu-
WELDING INFORMATION
WELDERS NAME
CERTIFYING AGENCY NAME AND NUMBER PROCESS AND ELECTRODE
SAMPLE INFORMATION
TIME
SUPPLIER
TICKET NUMBER
MIX NUMBER
AIR TEMP
SAMPLE
TEMP
SLUMP
WATER
ADDED
TIME IN
MIXER
SET # 1
LOCATION TAKEN:
SET #2
LOCATION TAKEN:
I HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK, UNLESS
OTHERWISE NOTEDVAX TO THE BEST OF MY ABILITY I HAVE FOUND THIS WORK TO COMPLY WITH
T/HJE APPROVED ,PIANS, S,P.ECCI(FI/CATIONS 11 APPLICABLE BUILDING LAWS.
INSPECTORS SIGNATURE
Te-(' I OC, IJ I ,6 `%
INSPECTORS CERTIFICATION AGENCY AND NUMBER