BWFE2014-104378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht, 4 4 Q ",
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BWFE2014-1043
Property Address:
53699 VIA MALLORCA
APN:
777390018
Application Description:
115 LF OF 6' BLOCK WALL (ORCO)
Property Zoning:
�
Application Valuation:
$3,000.00
Applicant:
N p
MONARCH HOMES
Z.,
49950 JEFFERSON STREET#130
LA QUINTA, CA 92264
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 siness and Professions Code,
and my License is in full force and effect.
License Class: License No.: C28860
An �
Date:` ' Z�' Contractor: W S I
J OWNER -BUILDER DECLARATION
1 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).:
(_) 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, 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
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner: .
WALTER PISCO
6000 SE 20TH
MERCER ISLAND, WA 0
Contractor:
MONARCH HOMES
49950 JEFFERSON STREET #130
LA QUINTA, CA 92264
(760)413-8863
Llc. No.: C28860
Date: 8/28/2014
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 thrk#or 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 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 Se of the Labor Code, I shall forthwith
comply with those provisions.
Date (ZV' Applica
WARNING: FAILURE TO SECURE WORKE 0 NSATION 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 that the above information is correct.
I agree to comply with all city and county ordinances and st elating to building
construction, and hereby authorize representatives of this c' o . erupsn the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or, Agent):
z
D
o
�
N p
a
Z.,
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 thrk#or 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 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 Se of the Labor Code, I shall forthwith
comply with those provisions.
Date (ZV' Applica
WARNING: FAILURE TO SECURE WORKE 0 NSATION 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 that the above information is correct.
I agree to comply with all city and county ordinances and st elating to building
construction, and hereby authorize representatives of this c' o . erupsn the above-
mentioned property for inspection purposes.
Date: Signature (Applicant or, Agent):
N
'PAID-
' PAID DATE
1 •1•
FINANCIAL
DESCRIPTION'' :: .- ACCOUNT '�
Qt
AMOUNT:
_ BSAS SB1473 FEE r
101-0000-20306 •
0,
$1.00
$0.067
`-PAID BY
METHOD .: M. 1`
: '' -
RECEIPT #,::
-:' 1
" CHECK #
CLTD BY
Total'Paid forBUILDING STANDARDS ADMINISTRATION.BSA
$1.00
$0.00 .,
'°.'.,DESCRIPTION_
- "ACCOUNT...
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - EA ADDITIONAL 50 LF
--101-0006-42404,-.
,O
$61.49
_
$0.00
PAID -BY. �- ,
� METHOD
RECEIPT#
CHECK#"
CLTD BY
:DESCRIPTION,. ,,. _
ACCOUNT , _y
QTY
L AMOUNT
PAID
PAID DATE
„ WALL/FENCE - FIRST 100 LF
101-0000-42404
0
''$47:19
f :. •Y
yp, •.:�
---$0.00
w. PAID BY'' .
METHOD
- '
RECEIPT#
CHECK -#
CLTD,BY
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'DESCRIPTION
"ACCOUNT _a ^ '
QTYr
AMOUNT,
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PAID ,
PAID DATE.
WALL/FENCE - FIRST 100 LF PC
101-0000-42600 , :
.0'
-, $60.06
$0.00
"PAID BY
METHOD
'
RECEIPT #
CHECK#
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL-
TOTALS:
$168.74
$0.00
00
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Description: 115 LF OF 6' BLOCK WALL [ORCO]
Type: WALL/FENCE Subtype: Status: SUBMITTED
Applied: 8/28/2014 SKH
Approved:
Parcel No: 777390018 Site Address: 53699 VIA MALLORCA LA QUINTA,CA 92253
Subdivision: PM 33654 ' Block: Lot: 1 ;:
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 ' Zoning:
Finaled: .
Valuation: $3,000.00 " Occupancy Type: ' r Construction Type:
Expired: _
r
•
No. Buildings: 0 No. Stories: 0• ._ No. Unites: 0
Details: 115LF OF 6' GARDEN WALL WITH 3 PILASTERS AT NORTH AND SOUTH PROPERTY LINE, [ORCO SPECIFICATIONS] PRECISION CONCRETE
BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013
..CALIFORNIA BUILDING CODES.
.• err
ADDITIONAL
, e1.
'•Kei •
'
CONDITIONS
r CONTACTS
.,
NAMETYPE<ADDRES51 CITY. 'STATE -ZIP PHONE FAX.::' EMAIL
APPLICANT MONARCH HOMES 49950 JEFFERSON LA QUINTA CA 92264. .
3
FIN ANCIAL INFORMATION
Printed: Thursday, August 28, 2014 2:48:33 PM r 1 of 2 ^ CR
SYSTEMS
v
CTL D
;DESCRIPTION
%'ACCOUNT
QTY
AMOUNT..
PAID
PAID DATE
RECEIPT
CHECK #
METHOD
PAID BY U
BY
..
t.
s
L.
FINAL**
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
FOOTINGS
Total Paid forBUILDING STANDARDS ADMINISTRATION'
$1.00 $000
BSA:
WALL/FENCE - EA
101-0000-42404
0
$61.49
-$0.00
ADDITIONAL 50 LF
-
WALL/FENCE -FIRST
101-0000-42404
0
$47.19
$0.00
100 LF
WALL/FENCE - FIRST '•
101-0000-42600
-,0
$60.06
$0.00
100 LF PC:
.
Total Paid for FENCE OR FREESTANDING WALL- $168.74 $0.00
TOTALS:• 00
PARENT PROJECTS
REVIEWS
_ RETURNED ST_ ATUS REMARKS
.REVIEW TYPE REVIEWER SENT DATE DUE1DATE DATE k> NOTES,
BOND INFORMATION
Printed: Thursday, August 28, 2014 2:48:33 PM 2 of 2
�"SYS iEMS '
INSPECTIONS
SEQID
,.° '"INSPECTION TYPE t
INSPECTOR
SCHEDULED,
DATE
.COMPLETED
DATE
-RESULT=, .
REMARKS'
� NOTES
BOND BEAM
s
FINAL**
- -
FOOTINGS
PARENT PROJECTS
REVIEWS
_ RETURNED ST_ ATUS REMARKS
.REVIEW TYPE REVIEWER SENT DATE DUE1DATE DATE k> NOTES,
BOND INFORMATION
Printed: Thursday, August 28, 2014 2:48:33 PM 2 of 2
�"SYS iEMS '
Bin #
City of La Quin to
-Building SL Safetybivision
P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
3 Building Permit Application and Tracking Sheet
Permit #
�I,LJ��2oi�—j
Project Address:3• (o/ 2
Owner's Name: 15 0 1 �S t 6U J
A. P. Number: '77- 3 90 - Ql OC
Address: Yo m p4/t.b4 I m vs. S
Legal Description:
City, ST, Zip:
Contractor:
Telephone:
Address: 30 J &-FFtEA-So.J YT 3 0
Project Description:
City, ST, Zip: W ! .LZ-0 /
Its I Q 'W fill Lo
Telephone:
-:,.:.<.,:..;.:.:::.„....:.......::..::•.,
n
State Lic. #:
City Lic..#:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:`€
=':•.::Construction
' ^” "'""- ^' '
:
Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n . Alter Repair Demo
Name of Contact Person: 14106J ST c,,),-j O
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person: 7:5-1) v 3 q . ( p 3 b /
Estimated Value of Project: 3, 0 0 D
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Rec'd TRACIONG 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
2"" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
''° 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 Fecs