BWFE2017-024278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Hwy 4 lwQum&.
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: WALL/FENCE/CITY STANDARD/PRE-APPROVED
Application Number:
BWFE2017-0242
Property Address:
78251 DEACON DR W
APN:
770280021
Application Description:
DUFFIELD RESIDENCE / BLOCK WALL
Property Zoning:
Application Valuation:
$12,000.00:
Applicant:
moo✓ �a
AST STONE CORPORATION
DEC 0 7 2017
1279 W MAIN STR. STE. 205
EL CAJON, CA 92020
VOICE (760) 777-7125.
FAX(760)777-7011
INSPECTIONS (760) 777-7153
Owner:
DUFFIELD RESIDENCE
78251 DEACON DR W
LA QUINTA, CA 92253
ontractor:
S T STONE CORPORATION
D:EL
279 V1( MAIN STR. STE. 205
CAJON, CA 92020
I�eO /�A'
A CITY OP 0 OUINTA
DRIQN AND DEVELOPMENT OF-PAOTMENTL619No0 -8871
Ic.
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: C29, C54 License No.: 8169 6
�Ee': air>7 I� ntractor
OWNER -B ER 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).:
U 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.).
U 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 I 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 N
Lender's
Date: 12/5/2017
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 370C of the Labor Code, for the performance
of t ork for which this permit is issued.
i I have and will maintain workers' canpensation 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: CYPRESS INSURANCE COMPANY Polity Number: ASWC817597
I certify that in the performance of Eche 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 3'00 o Labor Code, I shall forthwith
comply with those provisions.
A
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 ($100,00[). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR ON 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 applic 3tion is made, each person at whose
request and for whose benefit work is performE-d 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 cancell2tion.
I certify that I have read this application and sta-e 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 upon the
above-mentioned property for inspectZpurpc—.3es.aLwi QSigna e (A
Date: 12/5/2017
Application. Number: BWFE2017-0242 Owner:
r'
Property Address: 78251 DEACON DR W DUFFIELD RESIDE=NCE
APN: 770280021 78251 DEACON DR W
Application Description: DUFFIELD RESIDENCE / BLOCK WALL LA QUINTA, CA S22S3
Property Zoning:
Application Valuation: $12,000.00
Applicant: Contractor:
A S T STONE CORPORATION AST STONE CO F PO RATIO N
1279 W MAIN STR. STE. 205 1279 W MAIN STIR. STE. 205
EL CAJON, CA 92020 EL CAJON, CA 92320
(619)401-8871
Llc. No.: 816966"
-------------------------------------- ----------------------------------------------------------
Detail: 175 LF OF 6' GARDEN WALL [ ANGELUS SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH.ST000O, PAINT, OR TtXTURED
COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. THE AREA BETWEEN THE BACK OF CURB AND ANY FENCING Sr-IALL BE LANDSCAPED, HAVE A
SUITABLE PERMANENT IRRIGATION SYSTEM, AND BE CONTINUOUSLY MAINTAINED BY THE PROPERTY OWNER. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$31.20
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: $148.23
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0.
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATIO4 BSA: $1.00
IESCRIPTION
ACCOUNT'
QTY
'AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMEMT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
/+�r
W W
..._._..--- CENII jrJ�r. DILSERT--_......._...
PERMIT # /4Q 2
PLAN LOCATION:
Project Addres��
5
APN #: �
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
� � � ' Lec
City, St, Zip
i.
Applicant Name:
V
O
Address:
Email:
City, ST,.Zip:
Fire Sprinklers SF.
Telephone: 0 �$ O
City Bus Lic: 0
Email:
Valuation of Project
Contractor Name'
-New SFD Construction -
Address:/
. S
Conditioned Space SF
City, St, Zip
Bedrooms:
Garage SF.
Telephone: O 3
O
Patio/Porch SF
Email:
Fire Sprinklers SF.
State Lic:A 112 q4 4
City Bus Lic: 0
Arch/Eng Name:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:
Stories:
# Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:.
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone.
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
. -a
Submittal" •
Req'd
Rec'd
Plan Sets
Structural Calcs
Truss Calcs
F
Title 24 Calcs
Soils Report R
Grading Plan (PM 10)
Landscape Plan
Subcontractor List
1
Grant Deed
•
+
HOA Approval
'School Fees
•-
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License