BWFE2016-008175
O�i
78-495 CALLE TAMPICO D VOICE (760) 777-7125
LA QUINTA, CgFAX (760) 777-7011LIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic d under provisions of Chapter
9 (commencing with Section 7000) of Division 3o he B sinew and Professions Code,
and my License is in full force and effect. /p//
License Class: B License No.: 594043
Date: — 1 t(1 Contractor:
0 &,151.
I hereby affirm under penalty of perjury thathm 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
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
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.).
I ) 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 performanceof the work for which this permit is issued (Sec. 3097,, Civ. C.).
Lender's Name:
Lender's Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following rations:
I have and will maintain a certificate of consent to self -insure for workers'
co— en ation, as provided for by Section 3700 of the Labor Code, for the performance
of te /ork forwhich this permitisissued.Ihave and wilmaintain workers'compensation insurance, as required by
ed 370 a Labor Code,forthe performance of the work for which this permit
isied. 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 ome subject to the workers'
compensation laws of California, and agree that if I sh uld ecome subject to the
workers' compensation provisions of Section 3 0O of a bor Code, I shall forthwith
comply with those provisions.
Date: �� ` 16 Applicant
WARNING: FAILURE TO SECURE WORKERS' COM PONSATION 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 " orm tion is correct.
I agree to comply with all city and county ordinances and stat law rel i to building
construction, and hereby authorize representatives of this ci to enter �j6n the
above-mentioned property for inspection purposes.
Dater -L� Signature (Applicant or Agent):
Date: 3/29/2016.
Application Number:
BWFE2016-0081
Owner:
Property Address:
54135 SOUTHERN HILLS
JIM HIETBRINK
APN:
775101043
541352 SOUTHERN HILLS
Application Description:
HIETBRINK / EQUIPMENT WALL
LA QUINTA, CA 92253
Q p
Property Zoning:
cn
t= w
Z
Application Valuation:
$2,500.00
( c�
1
go
Applicant:
LARRY COIA JR DBA 7 C'S
CONSTRUCTION & M
y �
Contractor: IrN_
LARRY COIA 1R DBA 7 C'S CON- I N &MQ
�y J
O
48-236 VISTA DE NOPAL
48-236 VISTA DE NOPAL .
:;�i
CD
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(760)564-5811
' I
®
�
C:)
Llc. No.: 594043
------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am lic d under provisions of Chapter
9 (commencing with Section 7000) of Division 3o he B sinew and Professions Code,
and my License is in full force and effect. /p//
License Class: B License No.: 594043
Date: — 1 t(1 Contractor:
0 &,151.
I hereby affirm under penalty of perjury thathm 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
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
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.).
I ) 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 performanceof the work for which this permit is issued (Sec. 3097,, Civ. C.).
Lender's Name:
Lender's Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following rations:
I have and will maintain a certificate of consent to self -insure for workers'
co— en ation, as provided for by Section 3700 of the Labor Code, for the performance
of te /ork forwhich this permitisissued.Ihave and wilmaintain workers'compensation insurance, as required by
ed 370 a Labor Code,forthe performance of the work for which this permit
isied. 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 ome subject to the workers'
compensation laws of California, and agree that if I sh uld ecome subject to the
workers' compensation provisions of Section 3 0O of a bor Code, I shall forthwith
comply with those provisions.
Date: �� ` 16 Applicant
WARNING: FAILURE TO SECURE WORKERS' COM PONSATION 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 " orm tion is correct.
I agree to comply with all city and county ordinances and stat law rel i to building
construction, and hereby authorize representatives of this ci to enter �j6n the
above-mentioned property for inspection purposes.
Dater -L� Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION
:ACCOUNT
QTY
AMOUNT
'PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #'
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
.$0.00.
DESCRIPTION
ACCOUNT
QTY
' AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY.
METHOD
RECEIPT#
CHECK #
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL:
TOTALS:0•
$108.77
$0.00
00
Permit Details PERMIT NUMBER
City of La Quinta BWFE2016-0081
Description: HIETBRINK / EQUIPMENT WALL
Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: APPROVED
Applied: 3/29/2016 TSA
APPROVED
Approved: 3/29/2016 TSA
Parcel No: 775101043 Site Address: 54135 SOUTHERN HILLS LA QUINTA,CA 92253
Subdivision: TR 22432-2 SEE ASSESSORS MB 769/43 Block: Lot: 1,2-P
Issued:
FOR CMS
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,500.00 Occupancy Type: Construction Type:
Expired'.
No. Buildings: 0 No. Stories: 0 No. Unites: 0
STATE
Details: 14LF OF 6' EQUIPMENT WALL AT SIDE YARD [CITY SPECIFICATIONS) PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO,
PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
ADDITIONAL SITES
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESS1-
CITY
STATE
ZIP
PHONE-
FAX
EMAIL
APPLICANT
LARRY COIA JR DBA 7 C'S
48-236 VISTA DE
LA QUINTA
CA
92253
(949)640-1754
CONSTRUCTION & M
NOPAL
CONTRACTOR
LARRY COIA JR DBA 7 C'S
48-236 VISTA DE
LA QUINTA
CA
92253
(949)640-1754
CONSTRUCTION & M
NOPAL
OWNER
JIM HIETBRINK
541352 SOUTHERN
LA QUINTA
CA
92253
(949)640-1754
HILLS
FINANCIAL INFORMATION
Printed: Tuesday, March 29, 2016 2:30:25 PM 1 of 2
SYSTEMS
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Tuesday, March 29, 2016 2:30:25 PM 2 of 2
SYS TERAS
CLTD
DESCRIPTION
_ ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
-
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00 $0.00
BSA:
WALL/FENCE - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
101-0000-42600
0.
$60.91
$0.00
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL: $108.77 $0.00
TOTALS: $109.77 00
INSPECTIONS
PARENT PROJECTS
BOND INFORMATION
Printed: Tuesday, March 29, 2016 2:30:25 PM 2 of 2
SYS TERAS
6 "'(f
.y.
I -�o)sv-
CITY OF LA QUI NTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE BY '11
� {A
- 1
A i .
SITE REQUIREMENT'S
IHT'ERIOR LOT
SIDEYARD: 5 FEET RBAR-YARD: 10 FEET
NU NR" EACH SME
. • ' i . +
MON YARD;' AREA TO
20I LT LAf{DSCOED
q''MimmUNr }
��..••- PROPERTY
LINES .
ti
lBin
City of.La QCdln'ta
Building ST Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Trackilig Sheet
Permit #
Project Address: 3
�� �� P 1��
Owner's Name: l Vv-,
A. P. Number:o
Address: S4• (3 .5 r
Legal Description:
City, ST, Zip:LA
ntra
Co ct r:
o C� �4
telephone:
Address: LV v
�P��,
Project Description:
City, ST, Zip: ,,(A
f�_��
� 4 SJ
l ,(
1 ICY— +tiiA `% r�►'��l e�✓ C -47
Telephone: ne• L s Cl
J
�i .
State Lic. #: 514043
City Lie. #;
Arch., Engr., Designer: Z6`
Movedy.
Address: ` q I N
DZ
City, ST, Zip: -0,
TI�J
-
CQ q�
Te le h ne:� I
r�� l Zd-7
Constructiontruction Type: Occupancy:
State Lic. #:
Project circle one): New n r Repair Demo
Name of Contact Person:
Sq t.: L L,IN F
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: ,-5Co
APPLICANT:
DO NOT WRITE BELOW THIS LINE
tl
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check
submitted
Item
Amount
Structural Calcs.
Reviewed, ready
for corrections
Plan Check Deposit
Truss Cates.
Called Contact
Person
Plan Check Balance
Title 24 Calcs.
Plans picked
up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd 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 I40USE:-
'"' 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
Ky