13-1369 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO 4,4 a
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENTS—�
BUILDING PERMIT
Application Number:
13-00001369
Property Address:
53323 VIA DONA
APN:
777-420-029-46 -298944-
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
16000
Applicant: Architect or Engineer:
'V
VOICE (760) 777-7612
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
"�.
/2 8 / 13
Owner: —
RYAN THOMAS
53323.VIA DONA
LA QUINTA, CA 92253
(760)777-9920
Contractor:
GJH DEVELOPMENT INC
29207 RIDGELINE CT
TEMECULA, CA 92590
(760)777-9520
Lic. No.: 916227
--------------------------------------------------
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 Prof ssionals Code, and my License is in full force and effect.
License Clas : 13 License No.: 916227
- Date%"Cont actor:
.. OWNER -BUILDER DECLARATION
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 r she is exempt therefrom and the basis for the alleged exemption. An violation of Section 7031.5 by
-
t he e e pt g e p y
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
" 1 _ I 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 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. , BAP.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:
LQPERMIT
D °
OCT 2 8 2013
CITY OF.6A QUINTA
FINANCE DEPT.
------------------
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations: - - I I .
_ 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 EXEMPT Policy Number EXEMPT
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 workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with tho provisions.
Date j /•/ Applicant,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION IeOVERAGE 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 build• .e trY6n, and hereby authorize representatives -
of this county to nter upon the above-mentioned pro rt o �S�Bc ' n purposes.
Date 3 Signature (Applicant or Agen
C-- '
LQPERMIT _,
Application Number.. . . . . 13-00001369
Permit . . . WALL/FENCE PERMIT 2013
Additional desc .
Permit Fee 104.39 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 16000
Expiration Date 4/26/14
dty Unit Charge Per
Extension
• 1.00 47.1900 LS MISC WALL, FIRST 100 LF
47.19
4.00 14.3000 EA MISC WALL, ADDL 50 LF
57.20
----
Special Notes and Comments
BLOCK WALL - INSTALL 280 L.F. OF 6 FT.
HIGH BLOCK WALL WITH (6)24 IN. X 24 IN.
PILASTERS. PROPERTY LINE WALLS TO BE
INSTALLED•WITHIN PROPERTY LINES OF THE
SUBJECT PROPERTY (PER ATTACHED APPROVED
PLAN AND,ORCO BLOCK WALL DETAIL).
PRECISION CONCRETE BLOCK.SHALL BE
COVERED WITH STUCCO, PAINT, OR TEXTURED
COATING WHERE VISIBLE FROM OUTSIDE THE
PROPERTY. 2010 CALIFORNIA BUILDING
CODES.
Other Fees . . . . . ... . BLDG STDS ADMIN (SB1473)
1.00
` PLAN CHECK, WALLS
60.06
Fee summary Charged PaidCredited
Due
-- - -- - - - - - - -- - - -- -
•Permit Fee Total 104.39" .00 .00
104.39
-Plan Check Total .00 .00 00
00
Other Fee Total 61.06 .00 .00'
61.06
Grand Total 165.45 .00 00
165.45
LQPERMIT _,
Bin #
Qty of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Per it #
/
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip: Zg-
Contractor ne%Telephone:
Address:mqpi X
Project Description:
City, ST, Zip:
Telephone: <'.;.r.,: ;;::: �;:.:;:,::;;•;;�:>:;:��:>s':;;;.
O
State Lic. # : City Lie. #:
Arch., Engr., Designer:
40 -
Address:
City, ST, Zip:
Telephone:
P
State Lic. #
:>:;>;;:::;>.•:v<> >>>:s:< :>:::<:.;:;».:;::
:>.a:s::::;•:•>::s:<;:%:t::s:;<zr::i:•»>::••::..
`:` :<:
Construction Type: Occupancy:
Project type circle one): New Add'n Alter Repair Demo
Name of Contact Person: L .
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
god Review, ready for corrections/issue
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 corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person •
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
2 r /'�
CITY. OF LA MANTA -SUB -CONTRACTOR LIST
JOB ADDRESS- 7 V' Q��PERMIT NUMBER�/J7OWNER BUILDER. "-®roxor
This form shall be costed on the job .with the Building Inspection *Card at all times in a con picuous place. Only persons appearing on this list or their employees are aut orized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
de Classification
Trade-/
/
: r Contractor :. :;;
::
:::;:::<:::::>State::Contrac :.:: .....;:
tot .s License . ::..
:. '. Workeri Co a sa on:�nsu�ance`:.;;.°..`:..<>:::.
mpn t!
Git . f3iis e s License;:;::..'..
Y n
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(pix/xx/xx)
Carrier Name
(e.g. State Fund,_CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
.(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C712)
CONCRETE (C-8)
FRAMING
STRUCT: STEEL• (G-511
MASONRY (C-29)
s f
Cf r
-
1
` .�,�$
3 /A
0
PLUMBING (C-36)
EATH; PLASTER (C=35) .
DRYWALL (C-9) . <..:
HVAC. (C7201':..::'?.;..
ELECTRICAL. (C=10) :.. ,
SHEET METAL (C43)'
FLOORING (C-:1'5);.
GLAZING (C-17).`
INSULATION 1972)
SEWAGE DISP• (G-42)
PAINTING (C=33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
1
LANDSCAPING (C=27.) .��
POOL (C-53)
D
cr
ORC'O STANDARD 61 TO 8 ` CMU SITE BALLS
OPTIONAL FIAT GAP
DESIGN OZITERIA: PER THE 2010 COC
1. ALLOWABLE SOIL BEARING PRESSURE = 1500 PSF
Z ALLOWABLE LATERAL PASSM PRESSURE= ISO PCF
3. GROUT STRENGTH = 2000 PSI @ 28 DAYS.
4. REINFORCING STEEL : GRADE 60.
5. 1500 PSI MASONRY COMPRESSION STRSVGW - NO SPCL
INSPEG770N
6816, 6616, OR 6618 CMU
GROUTED ONLY@VERT
AND,FOOTING DIMENSIONS.
41 ! f L/V ! d d Q�1! �i
2 S/6' MIN. /TEAR CEU`
0196V REQU� TO LOSE
6616 SLUMPED OLU.
ORCO WIDE CELL SLUMP
V ` 0
S c Fy
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w m
C31925
���EXP . 12-31-2014
CIV0, CA�`FO
Si
N07E5-
1. CONCRETEBLOCX SHALL CONFORM 70AS7M C 90. V40GE1.0a
BLAO4 SLUMP SLOCKANDSPLRFACEBLOCJCAREACOFPTABLE
r DROP-IN BAR
2. CONCRETEROR fOOTINGSHgtt BE 1 PART QrMEi,?TO 2-x/1
t
Q
PARTS S4ND TO 3-W PARTS GRAVEL WITHA MAXIMUM OF I -k2
GALLONS OF WATER PER 54CX PORTLAND CS LENT SH8AU, CONFORM
TO ASTM C 150 TYPE DTV. Fc = 2500 PSI
2
�657DJDINT
6
RQNFtORCEMENT @ 24'01C
3. REINFORCING STEEL SHALL HE DBURMED AND CONFORM 70
(3 PLACES - 4 PLACES FOR T
ASTMA 615 GRADE 60. PROVIDE 48 B4R DIAMETER LAP.
& 8' WALLS). GCSE #5 STD.
4�
FOR SLUMP BLOCK •
4. RLE4R SHALL BE CENT ERM IN THE CONCRETE BLOOC CELL IN
WNICH ITIS LOCATE
Nf
N07E' PROVIDE 04 DOWEL &
x
K
04 DROP-IN 84R AT EACH
SIDE OF CONTROL JOINTS,
5. CONCRE7FBLOCK -91ALL BE LAVED INA RUNNING BOND
PATTERN WnNVERTICALCOn77NUIT7.OF
SVDSOF WAt1SAND (.WALL
THE CEZI UNO.
Q
HEIGHT 01AN.GES
6. ALL BL04 X CEZL.S CONTAINING VER77C4L RE34R SHALL BE SOLID
°p
O
,
GROUTED.
e7.
7Y DOWEL @ CUMOF
USE TYPES MORTAR PROPOR77ONED USING ASTM C 270 PART
CL:MDVT TO 1/2 PART LIME TO 4-1/2 PAR75 DAMP LOQSE54ND.
ip
CMU.
,
8. GROUT FOR CONoL-m iLOCK PER ASTM C 476 TO BE 1 PART
CEMENT 70 3 PARTS SAND (GROUT MAYCONTAIN 2 PARTS 3/8'
C
PEA GRAVEL IF WEATHER CONDI770A5AREFAVOR48LEAND BLOOC
UNOBSTRUCTED CELL SIZE ISSUFF7abVr70ALLOW GOOD GROUT
i
FLOW). WATER SHALL BEADDED 70 PRODUCE GOOD GROUT FLOW
WITHOUT SEGREGATICNN OF THE CONS77UENT R,
Z
2 SEIB4 SEE CIiART
9. BLOCK STEM MAYBE WET -SET I-1/2'INTO THE F0077MG WHILE
+n
L
7HECONCRE7E5PLASTIC BLOCK STEM AMYHEPLACED TO
I go
L71HER EDC£, Of THE 7RL3Y0y TYPE FOOTING.
D
_III—
10. F00TING MUST BE FARM ON OR INTO UNDISTURBED
-nt
2
i 1—III 1 MAX.
NATURAL SOIL OR ON COMPACTED FILL WITHA MMMUM
COMPAC770N OF 90%.
cz
Sl. FIRST DWEC77ON TO BE AFTER FOOTING TRENCHES ARE
Q
READYFOR CONORE7EAADALL REQUIRED STEEL IS TIED IN PLACE.
SEC13ND INSPECUOIN 700E WHEN THE REQUIRED VERTIC4ISIN
m
i
PLACEAND 7HE BLOCK WALL IS READYTO GROUT.
�I
#4 HORZ. 'CONT.
12. M4A7MUM CONTROL JOINT SPAC2NG: 40' O/C 20'01C FOR
$
WALLS TO BE MORTAR WASHED OR STUCCO COATED.
7h
5' TO [DAYLIGHT
NEIN. F0077NG DEP7;4 FOR 5'T0 DA LIGHT
""
to a I,
SLOPE
wal @ wAll ® WALL
DONT
TOP 1 FT. SEMCK 2 FT. SFnMa
2701
26' 1-0'
SEE CHART FOR REQUIRED REBAR 3 To 1
z -r
AND,FOOTING DIMENSIONS.
41 ! f L/V ! d d Q�1! �i
2 S/6' MIN. /TEAR CEU`
0196V REQU� TO LOSE
6616 SLUMPED OLU.
ORCO WIDE CELL SLUMP
V ` 0
S c Fy
� � m
w m
C31925
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CIV0, CA�`FO
t
F
l8 -LV4
N DuonulSNOO a0=l' F
s 'ld3 Jll3JVSOgf ,zIRMF R 6' %0 8`.�M WALL W1 TRENCHFoo7yNG
..w. w� 1 ilrld{Cl7rjvl lw=gl( J)'ACJ/11Ci /HAT
5 CLOSER TOGE7HER THAN THE 16" LONG BLOCK SPAQNG. FOR BAWL E.•
48" O/C SPAQNG FOR 16" LONG BLOCX REVER75 TO 45" O/C FOR
18" LONG BLOG4 40" FOP. 16" BLOCK GOES TO 36" O/C FOR 18" BLOCK - ETC
#4 DownfAOaswEOF
BWa-OL?W/04 DROalN BAR
.. - wwmrairmrw�Kw•cswr
8'X8'BL=-Otff
v .moo 0
o I
L'I- ..CONI ii1DTIhG .v ••v v • v'
MRMDEYAWMnONWAILSWNHtE
_ 1mt w,vnr�mmsnraaw"esr
j.
MAYIB•7�CWI®SWALEGRAD!A PROVLOIE
04 DOWN AMD 04 DROP -0.1 BAR ON F40/.
. SME CF THE 112 BLOCX DRAIN -AS
SHOWN.
F00774'G STEP DETAIL
CITY OF LAQ111NTArr SS
tDN
BUILDI &SAFETY DEPT.-- �.7.
APPROVED.
� � � m
P,evT��y�y TdFOR CONSTRUCTION w m
C/! %197 LA QUI I /-I C331-2 N A
� EXP. 1231-2014 �
DAT `v
• BY s v
yr C�v��,
- - E OF CAL\FO
WIND
MAX.
D $
DESIGN
WALL
TRENCH r
'X'
SPEED
FOOTING DOWEL
'Y' BAR
HEIGHT
DEPTH
=a#4@
6'-0",
48" 0/C D+2'-0"
2'-0"
#4 @ 48" 0/C
U V
48' 0/C FOR '6'
48' 0/C FOR 6'
Lu
SLUMP• BLOCK
SLUMP BLOCK
K) x
111.
6'-8"
2'-2" #4@ 48" 0/C D+2' -O"
#4 @ 48" 0/C
z
Z .W
.
40' 0/C FOR 6-
40' O/C FOR 6'
' .. SLUMP BLOCK -
SLUMP BLOCK
w
1 N
IL
7'-4"
#4@ 40" 0/C D+2'-0"
2'-4"
)
#4 @ 40" 0/C
z I—
32' 0/C FOR 6'
e
32' 0/C FOR 6'
w
:3
1'
SLUMP BLOCK
SLUMP BLOCK
Lo
co (D
8'-0"
#4@.32" 0,/C D+2'-0"
2'-6"
#4• @ 32" 0/C
9 24' 0/C FOR b' I
24' O/C FOR 6'
j SLUMP BLOCK
SLUMP BLOCK
..w. w� 1 ilrld{Cl7rjvl lw=gl( J)'ACJ/11Ci /HAT
5 CLOSER TOGE7HER THAN THE 16" LONG BLOCK SPAQNG. FOR BAWL E.•
48" O/C SPAQNG FOR 16" LONG BLOCX REVER75 TO 45" O/C FOR
18" LONG BLOG4 40" FOP. 16" BLOCK GOES TO 36" O/C FOR 18" BLOCK - ETC
#4 DownfAOaswEOF
BWa-OL?W/04 DROalN BAR
.. - wwmrairmrw�Kw•cswr
8'X8'BL=-Otff
v .moo 0
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L'I- ..CONI ii1DTIhG .v ••v v • v'
MRMDEYAWMnONWAILSWNHtE
_ 1mt w,vnr�mmsnraaw"esr
j.
MAYIB•7�CWI®SWALEGRAD!A PROVLOIE
04 DOWN AMD 04 DROP -0.1 BAR ON F40/.
. SME CF THE 112 BLOCX DRAIN -AS
SHOWN.
F00774'G STEP DETAIL
CITY OF LAQ111NTArr SS
tDN
BUILDI &SAFETY DEPT.-- �.7.
APPROVED.
� � � m
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� EXP. 1231-2014 �
DAT `v
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D
QL4
c— OR 85' & 95 MPH FPO
' D o WIND CONDI TIONS.
►�Z0 _
®
cg),
I 1'I
CMN.FOOTING DEPTH FOR TO DA Y�ICHT
mWALL ® WALL WALL 0
TOP I PT SE7840( 2FT. SETR40,
� 1 2 6' 21' Ic6'
TO1 1.�, V-4'
PRECAST CAP------,,
24' SO. PILASTER - SEE
DETAIL £LOW
(4) #4 ERr DROP-IN BARS
0 EA. C RNER CELL
,#3 77ES 024' 0/
Z
�o
(4) 14 DOWELS W/ 24' A4/N.
EXTENSIOj I INTO CMU.
0 EA. CO NER CELL 133`
9.
2 £QUAL
v
ail►
a
#4 HORZ 0 8' 0/C E. .
24' S0.
2'-9' SOUAR£
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0
"4Q'P
DI211C.V OU1FRIA: PER THE 2010 CBC
1. ALLOWABLE SOIL SEARDYG pREygM . 1500 pSF
Z. ALLOW.ABLELA75W PASSIVE PRE35UREa 150 p0y
3. GROUT STRENGTH - 2000 PSI 028 DAYS
4. RE7N)VRQNGS7EQ : GRADE 60.
5. SEE"C-7096 ONE SFC ACCaM77CML
6. 1500 PSI MASONRY COMPREMON STREi UM,
1. CONOWIF &OQYSHAL L CONFORM TO ASTM C.90. ORCO STD.
PRSOWO , SRJTFACF SLUMPED, OR WEDGaOCK&00(M4YBE
USED
2. GtiWCRE7F FOR R7OAMG SKALL BE 1 PART O'sfavT TO 1-1/1
PARTS S4ND To 3-112 PARTS GRAVEL WITH A M4)QNUM OF 1-112
GALLONS OF WATER PER SACC PORTLAND CWSSHALL CONFORM
TO A5774 C 150 TYPE Y Fc a 2500 P&
3. RETNi0ROW STEL SHALL BE DGURMED AND CONFORM TO
ASTM A 615 GRADE 60. PROVIDE 48 BAR DIAMEnR LAP.
4. REB4R SHALL BE 090FRED IN THE CDNCRETF &Do( CaL IN
WHICH IT IS LOCATED.
S. CONORUFBLOLX &*LL BELAYED INA RUNALTNG BOND
PA77FRN WITH VERTICAL CQVnNUITYOF THE CELLS UNO.
6. ALL &= CELL GONNA iVG M71CAL REH4R SHALL BE SOLID
GROUTED.
7. USE OBP TYPES MORTAR PROPOR770NED USDYGASTM 0170. I
PART CEM6VT TOW PART LIME To 4.112 PARTS "4P, LOOSE
S4ND,
B. GROUT MR C0 oZE7E &OC(PER ASTM C476 7D BE 1 PART
LF74BVT TD 3 PAR7S SWD (GROUT MAY CONTAIN 2 PARTS 418'
PEA GRA PR IF WFA7N& ComD17TONSARE FAVORABLE AND &OLX
UNOBSTRULER aU=FLSS(1MCMTTOALLOWGtOODGROUT
ROW). WATER SWU BEADDED TO PRODUCE GOOD GROIT FLOW
WI7){O1T SEGRErATION OF THE covsr m
9. BLOC(STFM MAYBEWET-SET 1-1/1' L71R0 7HE FOOTM N9LILE
THE CONCRETE ISPLASnC &=57EMMAYBEPLACED T0
UMER =E OF THE 7R&," TYPE FOO71FAV
10. FOOTIirG MUST BE POURED ON OR INTO UADISTURBED
itATURAL SOIL OR ON CoMpAC7FD FILL WITH A MD&fUM
COMPACTION OF 90%
11. FIRST INSPEC77ON TO BEAFTER M07M TRBVOY SARE
READY FOR ETFAND ALL Rwmw STL$ IS 77ED IN PLACE
....NDFOR
70 BE WHEN THE REQUIRED K)MCAL IS IN
PLACEAND THE BLOC( WALL L4 READY TO GROUT.
11. At4X AMN CONTROL JODVT SPAam 40'01C 0R 20'01C IF THE
WALL 1S TD BEsnxw ca47ED.
VOID AREA - DO NOT
'- — #3 77£S 0 24' O/C
04 VERT 0 EACH CORNER
8816 SPLIT FAC£ CMU - BLOCK
CELLS TO BE SOLID GROUTED ONLY.
61
'- — #3 77£S 0 24' O/C
04 VERT 0 EACH CORNER
8816 SPLIT FAC£ CMU - BLOCK
CELLS TO BE SOLID GROUTED ONLY.
CITY OF LA OUINTA
*+�* CUSTOMER RECEIPT **+�
Date: 18/28/13 81 Receipt no:
4138
Year Number
Amount
2813 1251
49487 GUIJARRO PL
LA OUINTA, CA 92253
BP BUILDING PERMITS
:148.23
Trans number:
283598
HOT PURPLE ENERGY
Tender detail
CK CHECK 5473 $148.23
Total tendered $148.23
Total payment $148.23
Trans date: 18/28/13 Time: 14:16:57
*** THANK YOU FOR YOUR PAYMENT ***
,y x�yr�yydpp vrrvn n'.�r.+rN yxir+xnr_. .: �nNww rraxxlVw
cn� nnrcrtnuc ni rnaC Col I 7tti41-777-7159
s� 3z3
a
4� DEMAND 1 CHECK REQUEST
OF
Return check to requestor Mail check
Name / Title of person requesting check
lopff,vkaA;&,� &MM & �rr.
■ .. -.
J�W�
Check payable to:(IJ-0 A / n
1 )� �fi�ipmo Mo-,' Amount: $
(Name) (Vendor No.)
�/ - - -- -
i4J . h j I I s��` Account Number:
(Address) �T - - -
�/� v1225 _ Project Number:
Check description and invoice number:
Signature:
(Departmentead)
(Date)
APPROVED FOR PAYMENT
(Finance Department Use Only)
BY.
BY:
ACCOUNT NO.
DESCRIPTION
�[.
10/28/2013
228.80
228.80
1182
10/28/2013
228.80
GJH DEVELOPMENT 53323 VIA DONA 228.80