BWFE2018-0066rcv auucl
78-495 CALLE TAMPICO 0 D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/27/2018
Permit Type/Subtype:
WALL/FENCE/CITY STANDARD/PRE-APPROVED
Owner:
Application Number:
BWFE2018-0066
EAST OF MADISON
Property Address:
81771 BAFFIN AVE
P 0 BOX 1482
APN:
767700042
LA QUINTA, CA 0
Application Description:
MADISON / BLOCK WALLS
Property Zoning:
Application Valuation:
$5,000.00
Applicant:
0
Contractor:
BRIAN KIETH
D
RICHARD DOA14 CONSTRUCTION
00BOX 8011
MAR 2 7 2018
RANCHO SANTA FE, CA 92067 .
CITY OF LAQUINTA
(858)756-4930
COMMUNITYDEVELOPMENTDEPARTMENT
Llc. No.: 374113
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.: 3741 .
Date 2 �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).:
( ) 1, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure isnot 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 constructionlending agency for
the performance of 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 declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compe tion, as provided for by Section 37CO of the Labor Code, for the performance
VeVk for which this permit is issued.I have and will maintain workers' compensation insurance, as required by
00 of the Labor Code, for the perfo.mance 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 ofthe work for which this permit is issued, I
shall not employ any person in any manner sc 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 4700 of the Labor Code, I shall forthwith
comply with tho provisions.
D Zo48 Applicant;
WARNING: FAILURE TO SECURE WORKERS' CCMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMIWAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED F03 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 thi; application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is perforrred under or pursuant to any permit issued
as a result of this application , the owner, and -he 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 cancellatior-
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 representa-ives of this city to enter upon the above-
mentione prop fo/r inspection purposes. r.
Dat �•^�/Signature (Applicant or Agent):
Date: 3/27/2018
Application Number:
BWFE2018-0066
Owner:
Property Address:
81771 BAFFIN AVE
EAST OF MADISON
APN:
767700042
P 0 BOX 1482
Application Description:
MADISON / BLOCK WALLS
LA QUINTA, CA 0
Property Zoning:
Application Valuation:
$5,000.00
Applicant:
Contractor:
BRIAN KIETH
RICHARD DOAJ CONSTRUCTION
P O BOX 8011
RANCHO SANTA FE, CA 92067
(858)756-4930
Llc. No.: 3741118
Detail: 247 LF OF 6' GARDEN WALL [ANGELUS SPECIFICATIONS 5-1.2LQ] [4] PILASTERS
[CITY STANDARD] ON SIDE YARDS PRECISION CONCRETE BLOCK
SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY-2016BUILDING CODES.
DESCRIPTION
FINANCIAL • • •
ACCOUNT
CITY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$46.80
DESCRIPTION
ACCOUNT.
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$52.01
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$65.02
Total Paid for BLOCK WALL:
'$163.83
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE .
101-0000-42416
0.
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 .
a
.......... <:1.:\d J iii_ i':7i;:.0 ti:12.i... _------- ...
PERMIT # ' Q
PLAN LOCATION:
?roject Addres. / 77/
`
Project Description: Pool, Remodel, Hdd't, Elect, Plumb, Mech
kPN #:
177
Garage SF
elephone:
applicant Name:
Patio/Porch SF
address:
:ate Lic: City Bus Lic:
;ity, ST, Zip:
tateic-3
'elephone:
:mail:
Valuation of Project $
-ontractor Name:
New SFD Construction:
.ddress:
1
Conditioned Space SF
;ity, St, Zip
r
!�
Garage SF
elephone:
Q x.'7(2 Z
Patio/Porch SF
.mail:
:ate Lic: City Bus Lic:
Fire Sprinklers SF
tateic-3
C City Bus Lic:
.rch/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:
nail:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
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