BWFE2018-006778-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address: .
APN: „
Application Description:
Property Zoning:
Application Valuation:
Applicant:
BRIAN KIETH
T4t!t 4 4 QuiKro
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
WALL/FENCE/CITY STANDARD/PRE-APPROVED
BW FE2018-0067
81753 BAFFIN AVE
767700041
MADISON / BLOCK WALLS
A
MAR 2 7 2018
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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.: 374118
Dat �7 20- Contractor:
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 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.).
( ) 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/27/2018
Owner:
EAST OF MADISON
P 0 BOX 1482
LA QUINTA, CA 0
Contractor:
RICHARD DOAN CONSTRUCTION
P0BOX 8011
RANCHO SANTA FE, CA 92067
(858)756-4930
Llc. No.: 374118
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
cth rk 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: STATE COMPENSATION INSURANCE FUND Policy Number: 1908709
_ 1 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, all forthwith
comply with tthosprovisions.
Dat 2 / :?P/Applicant:
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 actor 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 enter upon the above-
mentioned property for ins ection purposes.
Datnatu�e (Applicant or Agent):
Date: 3/27/2018
Application Number: BWFE2018-0067 Owner:
Property Address: 81753 BAFFIN AVE EAST OF MADISON .
APN: 767700041 P 0 BOX 1482
Application Description: MADISON / BLOCK WALLS LA QUINTA, CA 0
Property Zoning:
Application Valuation:
Applicant: Contractor:
BRIAN KIETH RICHARD DOAN CONSTRUCTION
P 0 BOX 8011
RANCHO SANTA FE, CA 92067
(858)756-4930
Llc. No.: 374118
---------------------------------------------------------------------------------------=---
Detail: 145 LF OF 6' GARDEN WALL [ANGELUS SPECIFICATIONS 5-1.2LQ]WITH [2] PILASTERS [CITY STANDARD] AT SWEST SIDE YARD PRECISION -
CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2016 CALIFORNIA
BUILDING CODES.
R
1
FINANCIAL
DESCRIPTION
.• L•
ACCOUNT
QTY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$15.60
` DESCRIPTION
ACCOUNT
QTY
AMOUNT.
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$52.01.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$65.02
Total Paid for BLOCK WALL:
$132.63
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY. ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
:ontractor Name:
........ _..... _
PERMIT #
PLAN LOCATION:
?roject Address �7S
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
elephone: ,� `j'r 3
Patio/Porch SF
:mail:
Fire Sprinklers SF
tate Li .✓ `I City Bus Lic:
applicant Name:
kddress:
Grf
;ity, ST, Zip:
telephone;
,mail:
Valuation of Project $
:ontractor Name:
New SFD Construction:
address:
Conditioned Space SF
;ity, St, Zip
Garage SF
elephone: ,� `j'r 3
Patio/Porch SF
:mail:
Fire Sprinklers SF
tate Li .✓ `I City Bus Lic:
.r.ch/Eng Name:
Construction Type: Occupancy:
.ddress:
Grading:
ity, St, Zip
Construction Type: Occupancy:
elephone:
Bedrooms:
Stories:
# Units:
mail:
:ate Lic: City Bus Lic:
roperty Owner's Name:
New Commercial / Tenant Improvements:
ddress:
Total Building SF
ity, ST, Zip
Construction Type: Occupancy:
:lephone:
nai l
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LA QU I NTA, CA 92253
760-777-7000
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