BWFE2015-0244a
78-495 CALLE TAMPICO 4 4, WNUCl/ D Q V9ICE( 0 7-7125
LA QUINTA, CALIFORNIA 92253 D 0 7-7011
COMMUNITY DEVELOPMENT DEPARTMENTI SPECTIONS 7-7153
BUILDING PERMIT JUL TO 2015
7 20/2015
Application Number: BWFE2015-0244 0 CR OF LAQUINTA
Property Address: 80871 VISTA LAZO S MUNITY DEVELOPMENT DEPARTMENT
APN: 762250010 81871 VISTA LAZO
Application Description: SMITH RESIDENCE/LIONS GATE/GARDEN WALL BERMUDA DUNES, CA 92203
Property Zoning:
Application Valuation: $6,000.00
Applicant: Contractor:
MARK MARTIN MASONRY MARK MARTIN MASONRY
78760 RUNAWAY BAY 78760 RUNAWAY BAY
BERMUDA DUNES, CA 92203 BERMUDA DUNES, CA 92201
(760)345-0977
Llc. No.: 784794
---------------------------------------------------------------------------------------------
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 Professions Code,
and my License is in full forceand ffect.
Lice"C19Lic se No.: 784794 cDatntractor.7—Z®—I`��OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State III,
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
of the Business and Professions Code) or that he or she is exempt therefrom and the ig
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. Q.
Lender's Name:
Lender's Address:
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 so as to become subject the workers'
compensation laws of California, and agree that, if I should beco ubject to the
workers' compensation provisions of Section 370 qP the Labor de I shall orthwit
comply with those provisions. 14 �%�j
Date:�°��� ApplicantI(.:
\.
WARNING: FAILURE TO SECURE WORKERSTION C ' C PENSA�ERAGEIS�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 state laws relating to building
cgfistruction, and hereby authorize representatives of this city to enter on I above-
inentioned property for inspection purposes.
7'z 1
Date: a Signature (Applicant or Ag
r
J
FINANCIAL:
DESCRIPTION� *y
•M
�^ j ACCOUNT QTY=,
AMOUNTi �PAIUx
SPAID'DATE`
y
A 5s Y. 1 :
t"
s Y
BSAS SB1473 FEE
101-0000-20306 0
$1.00 $1.00 7/20/15
• .. •
METHOD # RECEIR ry CHECK
14
ti44,vi� �
MARK MARTIN MASONRY
CHECK MR200 7433 MFA
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00
DESCRIPTIONYfcA000UNT�
`QTY
4,1miPA
�rPAID.DATE:
WALL/FENCE - FIRST 100 LF
101-0000-42404
0 •
$47.86
$47.86
7/20/15
PAID`BY ��F
METHbD
`RECEIPT #'CHECK,
CLTU BYE"
nr k
MARK MARTIN MASONRY
CHECK•
MR200 {
7433
MFA
¢z DESCRIPTION � k
tU ACCOl1NT?
TY'
AMOUNT
y� PAID `
TPAID`bATE'
WALL/FENCE -FIRST 100 LF PC
101-0000-42600'
0-
$60.91
$60.91
7/20/15
�r 3` PAID BY
METHOD
#�
CHECKV,
CL TD BY
p ,>
i`�' s•c _ 7.'
r
8.: x;'�. Y -f G.. �` 9t ,
1 .RECEIPT
kx i Yh"r. �+ 4.:. �<.^..•t'
�yy' ;.4 N
; rv..0
MARK MARTIN MASONRY
CHECK
V. MR200
7433
MFA
Total Paid forFENCE OR FREESTANDING WALL- $108.77 $108.77
• 1• 1• .77
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- FTS..' • ,.
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7
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Description: SMITH RESIDENCE/LIONS GATE/GARDEN WALL
Type: WALL/FENCE Subtype: Status: ISSUED
Applied: 7/20/2015 MFA
Approved: 7/20/2015 MFA
Parcel No: 762250010 Site Address: 80871 VISTA LAZO LA QUINTA,CA 92253
Subdivision: TR 28034 Block: Lot: 30 t
Issued: 7/20/2015 MFA
Lot Sq Ft: 0 - Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $6,000.00 Occupancy Type: - Construction Type: `
Expired: 1/16/2016 MFA
No. Buildings: 0 ti No. Stories: 0 _ No. Unites: 0
Details: 90 LF 6' GARDEN WALL [CITY AND ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT,
OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
r
PProve O SSU J
�ADDITIONAL SITES
4 r
CONDITIONS
CONTACTS
.Y'T': .. � �"•f.t•. •-c .: .: aW <sv.?K.x �F`. :."...... .a6^:'s qy :.. .:� ,,. .-'4...::. w'..%s�`.l•C'.. ''gym"'_ .:� .' %f%✓:..,e-5`i-aY�..'4 x ".:!Y. 'e.: +i..+ti ..K4 x^w�C '*i;.'^':
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?NAME„TYPE- .'^ n,�.. �, NAME... �. � �, ..ADDRESSI,
w'�' .. `. '`�„...� � .�' a �...;,.. ,.... �' `�'. - z ate+” '�� v � �.� .F•w-;.<za, x, v �. ``.'c:5 g--f.:..'Y. � �"�% a� :v%F.t.. '�%<s;>;�sz` �. ;r;tari.s_. �.a�:,��,xf..�:;�.
x<;..��. ,. �....Sm,.., �. ��
APPLICANT MARK MARTIN MASONRY 78760 RUNAWAY BAY BERMUDA . CA 92203
DUNES
INSPECTION
INFORMATION
REMARKS7��',Vl,
TES
C NT
OLIN
BOND BEAM BLD
FINAL" BLD'
FOOTINGS BLD'
MARK MARTIN
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$1.00
7/20/15
MR200
7433
CHECK
-MFA
MASONRY
Total Paid forBUILbING STANDARDS ADMINISTRATION
WALL/FENCE - FIRST
MARK MARTIN
101-0000-42404
a
$47.86
$47.86,
7/20/
MR200
7433
CHECK
:MFA
100 LF
-IS
MASONRY
WALL/FENCE - FIRST
MARK MARTIN
101-0000-42600
0
$60.91
$60.91
7/20/1S
MR200
7433-
CHECK
MFA
100 LF PC
MASONRY
Total Paid forFENCE OR FREESTANDING WALL- $108.77 $108.77
TOTALS: $109.77 $109.77
INSPECTION
INFORMATION
REMARKS7��',Vl,
TES
BOND BEAM BLD
FINAL" BLD'
FOOTINGS BLD'
BOND
INFORMATION
ATTACHMENTS
Bin # .
Cray of La ' Qurnta
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
Permit #
Project Address: C'L
Owner's Name:
A. P. Number: 0 10 Q
Address:
Legal Description: J ' < A LCA
City, ST, Zip: S ��
Contractor:
(aP hon e:
Address: —7� (oC) V_vIjawqa
Project Description:
City, ST, Zip:'L AA O V A-rY cc., 2ZU 3
O J_r Gf f
Telephone-,?(., ne
L C 7 77
n 9 "3
'
,
State Lie. # 7f L % `7' =f
City Lie. #:
Arch., -Engr., Designer:
Address:
City, ST, Zip:
Telephone:
e one:
P
e: ecu
Construction s uction TYP Occupancy:
P Y•
State to Lic. #
Project type (circle rcle ne) New Add'n Alter Repair Demo.
0
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ;9000., e O
APPLICANT: DO NOT WRITE BELOW THIS LINE
4
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales;
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21' 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.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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