BWFE2015-031678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
,1--1 1114111111- 110111
1 50
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number:
BWFE2015-0316
Owner:
Property Address:
51911 MADISON ST
MARK RINDLESBACH
APN:
777470021
Property Zoning:
Application Valuation:
$36,190.00
Applicant:
Contractor:
RICE CONSTRUCTION
�
���� I✓ 0 6 2015
RICE CONSTRUCTION
44701 SAN JOSE
44701 SAN JOSE
PALM DESERT, CA 92260
CIiyQFCa,�.�INTA
COMMUNITY
PALM DESERT, CA 92260
DEVELOPhIENT DEPARTMENT
(760)408-6426
Llc. No.: 852723
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 force and effect.
License Class: B License No.: 852723
/ c r
Dat' er r l WContractor: Q t, ( C
OWNER -BUILDER DECLARATION
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 countythat requires a permit to construct, after, 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 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. C.).
Lender's Name:
Lender's Address:
Date: 11/6/2015
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 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: 1` —y(Appl(t
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 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
construction, and hereby authorize representatives of this city to e r upon the
above-mentio,Wd property for inspection purposes.
I a
Signature (Applicant or Agent):
A�TINANCIALINF•• e
DESCRIPTIONR� <£ AMOUNTPAIDNs DATE;
r 4. �t4y +ACCOUNTh .,.x: CtTY xPAID
BSAS SB1473 FEE 101-0000-20306
0 $2.00 $2.00
11/6/15
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PAIDBY METH OD:,g
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RECEIPT #` "a #{a<fCLTD
BY
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y" CHECK
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RICE CONSTRUCTION CHECK
R10660 2332
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Total Paid for BUILDING.STANDARDS ADMINISTRATION BSA: $2.00 $2.00 `
< 3HYf. z <- ..
;
Sµ
ACCOUNT
'QTY
fi
= PAID
PAIMDATE
;DESCRIPTIONr r z
-0r
AMOUNTS x�x,
z >�
WALL/FENCE - EA ADDITIONAL 50 LF
101-000042404
0
$232.00
$232.00.
11/6/15
PAI BYs s
D
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CHECK #gx
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PAID`DATE
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`ens.{ACCOUNT
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y
qQN
>��vA5M0UNT4�,s+PAID
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86.
$47.86
11/6/15
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CHECK
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YY
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DESCRIPTION;&<,
QTY
.
AMOUNTZY'u
`
PAID
�§ pA000UNT ,.
,. it
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PAIQDATEM
WALL/FENCE : FIRST 100 LF PC
101-0000-42600 .,
0
$60.91
•$60.91.
11/6/15
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RICE CONSTRUCTION
CHECK
R10660
2332
SGU
Total Paid for FENCE OR FREESTANDING WALL: °$340.77 .$340.77
Description: GOLDENVOICE / SITE WALL CONSTRUCTION AND ALTERATION
Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: APPROVED
Applied: 11/5/2015 AOR
APPROVED
Approved: 11/5/2015 LUR
Parcel No: 777470021 Site Address: 51911 MADISON ST LA QUINTA,CA 92253
Subdivision: TR 31852 Block:. Lot: A
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $36,190.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
_, ACTION DATE
Details: PERIMETER GARDEN WALLS AT RETENTION BASIN. GARDEN WALLS AT 52 AVENUE ENTRY. 854LN FTX 6FT HT PER APPROVED PLANS
& CITY STANDARDS. FINISH RETAINING WALL AT RETENTION BASIN & ADD 1 COUSRE OF BLOCK TO EXISTING EAST & SOUTHEAST
PERIMETER WALLS, SEE COURSE ADDITION DETAIL. 2013 BUILDING CODES.
Printed: Friday, November 06, 2015 10:33:02 AM 1 of 2
mil LJ SYSTEMS
ADDITIONAL
CHRONOLOGY
CHRONOLOGY. TYPE
STAFF NAME
_, ACTION DATE
COMPLETION DATE
NOTES
TELEPHONE CALL
LUIS URIBE
11/5/2015
SPOKE WITH TOM RICE, PERMIT IS APPROVED AND READY TO
BE ISSUED
CONDITIONS
CONDITION ..
DATE
DATE
DATE
CONTACT_
STATUS
REMARKS
NOTES_
TYPE
ADDED
REQUIRED
SATISFIED
BUILDING
BUILDING
11/5/2015
PENDING
INSPECTION
BUCKET
READY TO ISSUE
BUILDINGNEEDS:
11/5/2015
11/6/2015
COMPLETE
COMP INSURANCE CERTIFICATE-,
CHECKLIST
BUCKET
ASSESSOR'S COPY, -AND VALUATION.
NAME TYPE
NAME.
ADDRESS1
CITY STATE
ZIP PHONE FAX - EMAIL .`.,
APPLICANT
RICE CONSTRUCTION 44701 SAN JOSE
PALM DESERT
CA
92260 tomrice65@yahoo.com
Printed: Friday, November 06, 2015 10:33:02 AM 1 of 2
mil LJ SYSTEMS
Permit Details PERMIT NUMBER
t
City of La Quinta BWFE-20115'=031
• \2 -LA
e:.
s�.
CONTACTS
NAME TYPE NAME ADDRESSI CITY
STATE ZIP PHONE FAX EMAIL
CONTRACTOR RICE CONSTRUCTION 44701 SAN JOSE PALM DESERT
CA 92260 tomrice65@yahoo.com
OWNER MARK RINDLESBACH
0
PARENT PRQJECTS
Printed: Friday, November 06, 2015 10:33:02 AM 2 of 2 cff?
SVSTC•MS
FINANCIAL
INFORMATION
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
CLTD,
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$2.00
11/6/15
R10660
2332
CHECK
RICE CONSTRUCTION
SGU
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2,00
$2.00
BSA:
WALL/FENCE - EA
101-0000-42404
0
$232.00'
$232.00
11/6/15
R10660
2332
CHECK
RICE CONSTRUCTION
SGU
ADDITIONAL 50 LF
WALL/FENCE -FIRST
101-0000-42404
0'
$47.86
$47.86
11/6/15
R10660
2332
CHECK
RICE CONSTRUCTION
SGU
100 LF
WALL/FENCE - FIRST
101-0000-42600
0
$60.91
$60.91
11/6/15
R10660
2332
CHECK
RICE CONSTRUCTION
SGU
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL:
$340.77
$340.77
TOTALS:
$342.77
$342.77
PARENT PRQJECTS
Printed: Friday, November 06, 2015 10:33:02 AM 2 of 2 cff?
SVSTC•MS
Bin # Qty Of La Q uIn to
Building &r Safety Division
Permit #�'� l — A3LIp 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
5111 tso�t St Building Permit Application and Tracking Sheet
Project Address:
Owner's Name: �� 1(/ ► VQ j �-(, ' L �,
A. P. Number: —7 I R—
a_70 — O i (p
Address: C� u 1lv I' S rt $\V a 5I ui't 5 0 l
Legal Description:
City, ST, Zip:
Contractor: c �.,� 1.,
• ���.� `flYi J t r V�•�i 1 1 � �•
01'3 V .: ��U V .;.
Telephone -."52;5- ,•.•yy;�:::::
Address: 9 101-
rJ' 0 tj bSk A oi �
Project Description:
City, ST, Zip: PALM
OS G+[T CA — p` OR a (DQi
aAJ RE L
Telephone: 7W (o-74-oQ 3-
>>::; f•. ;^;;;. ri,;.{x. {a ?,•;.'a'
d.
l�V�
State Lic. # : �� 212
City Lie. #:
Arch., Engr., Designer.
�O S 0 -t fh I Wal
Address:
City., ST, Zip:
Telephone:
State Lie.
;N<•:;..:...:
v's « < _ :: <.:5,<>><::w :.:;.;;: •.:.
f w:v�:�4x9.it>.�v1}:. M1}'{Y
"'�'sr>^'<`tiw"x A>::,s'
Construction Type: I U VIS l Occupancy: �l
Project type (circle one): ew Add'n Alter air Demo
Name of Contact Person:
l i
Sq. FL: # Stories: IA ict
#Units: �j 6l
Telephone # of Contact Person:
Estimated Value of Projec .
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewved, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Pian Check Bala nee
Title 24 Calcs.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"j Review, ready for correctionsfissue
Electrical
SubcontactorUst
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%slue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date or permit issue
School Fees;
Total Permit Fees