BWFE2018-0068F' C1
78495 CALLE TAMPICO Twit
V 4 Q" VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/28/2018
Permit Type/Subtype: WALL/FENCE/CITYSTANDA PR PPROY UOwner:
Application Number: BWFE2018 0068 RANCO
Property Address: 52420 AVENIDA HERRERA ® 2945 AVENIDA WELASCO
APN: 773264009 018 QUINTA, CA 9.1253
Application Description: FRANCO RESIDENCE / BLOCK LL 50 LF
Property Zoning:
'Application Valuation: $1,000.00 CITY OF 1A QUINTA
Applicant: DESIGN AND DEVELOPMENT DEPARTMENT
contractor:
BLOCKWORKS INC DBA A A MASONRY BLOCKWORKS INC DBA A A MASONRY
77-700 DELAWARE PLACE PALM 77.-700 DELAWAF E PLACE PALM ,
PALM DESERT, CA 92211 PALM DESERT, CA 92211
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 License No.: 804168
•ate: 3.112
l ontractor:
OWNER -BUILDER DECLARATION '
I hereby affirm under penalty of perjury that I am exempt from the C racto ' ate
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 t
($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.).
(_J 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
Lender's Address:
(760)360-7388
Llc. No.: 804168
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one & 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 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: MID-CENTURY INSURANCE COMPANY Policy Number: A09472165
I certify that in the performance of -:he work for which this permit is issued, I
shall not employ any person in any manner so 3s to become subject to the workers'
compensation laws of California, and agree th<t, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
e: A � licant'.
ell
WARNING: FAILURE TO SECURE WORKERS' COLA NSATION COVER WFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,007). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOF. IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES. V
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 appliation 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 cancel6tion.
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>sves'of this city to enter upon the
above-mentioned property for inspection purp*ses.
t
;U re (Applicant •)r Agent):
_t M1-
C4
Date: 3/28/2018
:,dlpph-Qa ion Number. BWFE2018-0068
Owner:
Property Address: 52420 AVENIDA HERRERA
FRANCO
APN: 773264009
52945 AVENIDA VELASCO
Application Description: FRANCO RESIDENCE / BLOCK WALL 50 LF COMBO 100 LF
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $1,000.00
Applicant:
Contractor:
BLOCKWORKS INC DBA A A MASONRY
BLOCKWORKS INC DBA A A MASONRY
77-700 DELAWARE PLACE PALM
77-700 DELAWARE PLACE PALM
PALM DESERT, CA 92211
PALM DESERT, CA 92211
(760)360-7388
4
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---------------------------------------------------
-------------------------------------------------
Llc. No.: 804168
Detail:
Detail: 50 LFOF 6' GARDEN WALL IN REAR YARD AND 100 LF 2'0F RETAINING WITH 6' GARDEN WALL ON SIDE YARD. ANGELUS SPECIFICATIONS] PRECISION
CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA
BUILDING CODES.
J
r
FINANCIAL INFORMATION
;" ` "='• ' `'' ' ° ' DESCRIPTIONACCOUNT
QTY
AMOUNT
RETAINING/COMBINATION WALL EA 50LF 101-0000-42400
0
$31.20
DESCRIPTION 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: $163.83
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
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
TOTALS:
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FO %ISTRUCTION
21
a
NvenAch ti
:ontractor Name:
New SFD Construction:
PERMIT #
PLAN LOCATION:
?roject Address:
Je irs _
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
elephone: 7
C5" qaolf
Patio/Porch .SF
:mail: C
`
Fire Sprinklers SF
tate Lic: City Bus Lic:
kpplicant Name:
kddress:
-7.7 _ b Q
:ity, ST, Zip:.
c
elephone:
;mail:
Valuation of Project $.
:ontractor Name:
New SFD Construction:
address:
Conditioned Space SF
;ity, St, Zip s 2 Oo
Garage SF.
elephone: 7
C5" qaolf
Patio/Porch .SF
:mail: C
`
Fire Sprinklers SF
tate Lic: 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:- C
New Commercial / Tenant Improvements:
ddress: r�P
Total Building SF
ity, ST, Zip
Construction Type: Occupancy: .
-]'phone:.
E760) Ds -o - "
nail:
78495 CALLE TAMPICO
LA QUI NTA, CA -922 53
. 760-777-7000