0218NOTE:r,� r
With, proper 'validation
tHis 'form constitutes an
encroachment permit,
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs; driveways, pavements, sidewalks, parking lots, sewers;', water mains
and other like p.aublic works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit —.Class I II
DATE: 8-26-86 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ' 79-700 Ave. 50, La Quinta or portion of NE QTR sec. 5 T65 R7E
(Street address or Description of Location)
PURPOSE OF ,. ONSTRUCTION Grading SIS 50th Avenue Sketch (attach construction plans if appropriate)
frcan Sta 2�0 0 to 30 + uu (tuture stxeet mproveamt)
DESCRIPTION OF -CONSTRUCTION expOrt
DIMENSION OF INSTALLATION OR REMOVAL 2000 CU yardS
SIZE OF EXCAVATION; IF NEEDED 2000 cubic yards
APPROXIMATE TIME WHEN WORK WILL BEGIN 8-27-96
APPROXIMATE TIME OF COMPLETION 8-30-86^ '
ESTIMATED CONSTRUCTION COST $ 2-,600.00
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify; defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or ,property
happening or occurring as a proximate result of any work.undertaken under the permit granted pursuant to'this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
+ ' Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this/work.
Signature of Applicant or Agent
Rufus Associates 79-760 Ave. 50, La Quinta CA 92253 564-61,76
Name of Applicant (please print) Business Address Telephone No.
.Birtcher Construction 79-700 Ave..50 La Quinta CA 92253 564-0751
Name of Contractor and.Job Foreman Business Address Telephone No.
:'428629 B81 776
Contractor's License No. City Business License No.
Workman's Caup Hoane ins. Co. New Hapshire, Com' WC 1778247.
Applicant's Insurance Company Policy Number
.FEES: Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit —Class IV: See attached schedule
Inspection Fee $ 84.00
Permit Fee 10.00 II
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 94.00
Receipt No.
Received by Date
Recorded by
PERMIT,VALIDATION
PERMIT NO. 218
DATE APPROVED % 8"26-86
EXPIRATION ATE 9-26-86
DATE.ISSUED 8-26--86
By I
Administrative Authority 1
TELEPHONE: (619) 564-2246
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BIRTCHER
The orchard Project
Birtcher Construction
79 700 Avenue So
P.O. Box 360
• La Quinta, CA 92253-0360
Telephone 619 564 0751
October, 14, 1986
City -of t.._a (_Iuint:a
P.0. Box '1.504
La Quinta, CA. 92253
At'.teentionr. Tom t"ar...t.unfa
Chief Building
Inspector ,
Building & Safety
-Division
_
Reference: Thee Orchard
Clem t lemc� n
c_1n behalf of Rufus Associ.at.ees. B,i.rtr-.he,r Construction requests
a time extension for enc_roar_:hment.
Pc-erm.it. No_? ',18. The heerm.i't:.
is p c. e r,..t:: i, n e n t.. t o .t. h e rough
grading <along the South s:ic:Je of
50th Avenue.
An extension of one mon h'c
should be adegc_Iaik •
Vary 'truly yours,
B I RTC:HER `C_;C..IN'`:;TRUCT.ION
.
Mike Dixc)n
' M1)�e`W
C c_ . 1= i ,l e
le jvei�
•
�
_ LCL/�
Chicago Dallas Denver Houston Irvine Laguna Niguel Los Angeles Milwaukee Minneapolis
Palm Desert Phoenix Portland Salt Lake City Seattle Washington, D.C.
Building 50-001k Jefferson
TQfus Associates
Address P.O.' BOX 299 ,
City lZip Tel.
La Qliinta M53
Contractor
aou.t�
Address
'
sc-M
devioes, swales etc.
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑
State Lic.
& Classif.
City
Lic. #
Arch., Engr.'
Designer
Address
Tel.
City
Zip
State
Lic. #
" 4
P.O. BOX 1504
78-105 CALLE ESTADO `
LA QUINTA, CALIFORNIA 92253
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
I hereby affirm that I am.exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buslness_ and Prolessbns Code: Any d1y or county which requires a
permit to construct, alter, Improve, deraflsh, or .repair any structure, prior to its Issuance also
requires the applicant for such permit to .Me a signed statement that he Is licensed pursuant to.
the . vlsions of the Contractor's License Lew, Chapter 9 (commencing with Section 7000) of
of the Business and Professions Code, or that - he is exempt therefrom, and the basis
leged exemption. Any violation of , section 7031.5 by 'any, applicant for a permit
e applicant to a civil penalty of not more than five hundred dollars ($500).
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, Bulsness and
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,
,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 -bunter will have the burden
of proving that he did not build or knprove for the purpose of sale.) .
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or Improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
s'
O 1 am exempt under Sec- w C. for this reaso
Date Owner
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
❑ Copy Is flied with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed h 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 paon in any manner so as to become subject to the Workers' Compensation
Laws of Californirsa
Date Owner
NOTICE TO APPLICANT: fl, alter making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or the Labor Coda, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is Issued. (Sec. 3097, Civil Code.)
Lender's Name
Ler
AQc.1p Address
a building permit when properly filled out, signed and validated, and is subject to
if work thereunder is suspended for 190 days.
that I have read this application and state that the above information is correct.
I J
tibreeto comply with all cd county ordinances and state laws relating to building
construction, and hereby's Ihoe representatives .of this city to enter the above-.
mentioned property for ns action urposes.
Signature of applicant /1�' ✓w 21,/, bate c /f—
ress
Mailing AddF'• r !— �-
City, State, Zip
BUILDING DIVISION
:No. 002533: '-
4
)ILDING: TYPE CONST. OCC -..GRP..
P. Number
Igal Description 4-i'
oject Description SIE CIFURIb— Pre. rO 4h Mmidi11Q' Ali`
_ Apprpyal is
and cis not
fnr roaxrha�><3,' � of Wr, only •
ImIude stz>ats, frau= '
devioes, swales etc.
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
S& approved
plans.
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure '
.TOTAL
„!a
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date'Q-11-86 Permit
Validated by:
Validation: