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BWFE2017-024478 495rCALi£;TAMPICO LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT VOICE.(760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/7/2017 Permit Type/Subtype: WALL/FENCE/CITY STANDARD/PRE-APPROVED Owner: Application Number: BWFE2017-0244 HOLOUBEK & BAFBOSA RESIDENCE Property Address: 78550 AVENIDA LA.FONDA 78550 LA FONDA APN: 770142012 LA QUINTA, CA 9253 Application Description: HOLOUBEK / 225 LF BLOACK WALL AT PL Property Zoning: Application Valuation: $12,000.00 N Applicant: o tractor: A A MAX QUALITY CONSTRUCTION ® MAX QUALITY CONSTRUCTION 31325 VIA LAS PALMAS27 1 25 VIA LAS PALMAS THOUSAND PALMS, CA 92276 Q�C O 11 OUSAND PALMS, CA 92276 CITY OF LA QUINTA (760)844-4045 PESIQN AND DEVELOPMENT DEPARTM€KTNo.: 919733 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. C54, C-8 License No.: 919733e , Date:C�onl tractor: 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 �) 1, 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 Lender's Ad WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one ofthe following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 37013of the Labor Code, for the performance Z t e_ k for which this permit is issued. veered will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfornance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: STATE COMPENSATION INSURANCE FUND Polity Number: 9033995 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 to become subject to the workers' compensation laws of California, and agree tha_, if 1 should become subject to t workers' compensation provisions of Section 3:00 of the La e, sha hwith comply with pose p ovisions. Date:" T Applicant .�.Y 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,OOC). 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 th 2 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 i!!suance of such permit, or cessation of work for 180 days will subject permit to cancellrdtion. I certify that I have read this application and state that the above information is I agree to comply with all city and county ordin antes and state laws relating to construction, and hereby authorize representat ves of this city to ente on t� above-ment ed p,p6perty for inspection purposes. Date: '12/7/2017 Application dumber.;• 8u1/�FE2017-0244. Owner: Property Address: 78550 AVENIDA LA FONDA HOLOUBEK & BARBOSA RESIDENCE APN'. 770142012 78550 LA FONDA Application Description: HOLOUBEK / 22S LF BLOACK WALL AT PL LA QUINTA, CA 9°2253 Property Zoning: Application Valuation: $12,000.00 Applicant: Contractor: A A MAX QUALITY CONSTRUCTION A A MAX QUALITY CONSTRUCTION 31325 VIA LAS PALMAS 31325 VIA LAS PALMAS THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276 (760)844-4045 LIc. No.: 919733 Detail: 255 LF OFY GARDEN WALL AT SOUTH, EAST AND NORTH EAST PROPERTY LINES[C1TY SPECIFICATIONS] THIS PERMIT INCLUDES (4) PILASTERS [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. THE AREA BETWEEN THE BACK OF CURB AND ANY FENCING SHALL 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 ACCOUNT WALL/FENCE - EA'ADDITIONAL 50 LF 101-0000-42404 0 $46.80 0 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $52.01 DESCRIPTION ACCOUNT ZtTY 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 MANAGEMENlr FEE: $10.00 DESCRIPTION ACCOUNT iQTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY.ENHANCEMENIT FEE: $5.00 Contractor Name:�X �� -&A PERMIT #pe Address: Q. PLAN LOCATION. Garage SF. Project Address: -74 Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech APN #: ;State Lic:l City Bus Lic: State Lic: City Bus Lic: Applicant Name: !��/A� 1tzSn/« -rAddress: �3 f 3 Zs- Vt A LA S ;City, ST, Zip: JS� 10, ,Telephone: Email: ~d"`�� Q't/S ( r Valuation of Project $ Contractor Name:�X �� -&A New SFD Construction: Address: Conditioned Space SF ;City, St, Zip Garage SF. Telephone: Patio/Porch SF Email: Fire Sprinklers SF ;State Lic:l City Bus Lic: Arch/Eng Name: Construction Type: Occupancy: Address: Grading: City, St, Zip Construction Type: Occupancy: Telephone: Bedroom's: Stories: # Units: Email: State Lic: City Bus Lic: ._Property Owner's Name: New Commercial / Tenant Improvements: Address. JQj Q�� Total Building SF City, ST, Zip �n/ Construction Type: Occupancy: Telephone: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 E OFFICE USE ONLY # Submittal Req'd -Rec'd Plan Sets • i Structural Calcs Truss Calcs Title 24 Calcs { ' Soils Report Grading Plan (PM 10) Landscape Plan Subcontractor List Grant Deed HOA Approval ' School Fees Bun-tecDebrisPlan Planning approval Public Works approval Fire approval City Business License • i ei! Q a X