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LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BWFE2017-0052
Property Address:
52579 ROSS AVE
APN:
767670012
Application Description:
ESCENA PROPERTIES'LLC / SITE SPECIFIC ANGELUS DETAILS
Property Zoning:
Application Valuation:
$10,000.00
Applicant:
RUCKER MUTH CORP
P0BOX 13017
74125 ACADEMY LN EAST
PALM DESERT, CA 92255
2017
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9
{commencing with Section 7000} of Division 3 of th Business and Professions Code, and
my License is in full force and effect.
License Class: B License No.: 995557
`Date: 3 7) ( 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 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 Na
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/31/2017
Owner:
ESCENA PROPERTIES LLC
19021 GOLDE14 WEST ST
HUNINGTON BEACH, CA 92648
Contractor:
RUCKER MUTH CORP
P 0 BOX 1301'
74125 ACADEMY LN EAST
PALM DESERT, CA 92255
(760)250-4903
Llc. No.: 9955`7
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certific.—te of consent to self -insure for workers'
compensation, as provided for by Section 3770 of the Labor Code, for the performance
of the o for hich this permit is issued.
ve 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: 9148462
_ I certify that in the performance o� 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 fiat,' 1 should become subject to the
workers' compensation provisions of Section 3_ 0 of Labor Code, I shall forthwith
comply with tho a provisions.
Date:3 al 0 Applicant:
WARNING: FAILURE TO SECURE WORKERS' CJMPENSATION 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 ACKNDWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on the 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 Cityof 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 appltation becomes null and void if work is not
commenced within 180 days from date of issrance of such permit, or cessation of work
for 180 days will subject permit to cancellatim.
I certify that I have read this application and sate that the above information is correct.
I agree to comply with all city and county ord-nances and state laws relating to building
construction, and hereby authorize representatives of this city enter mon the above-
mentioned property for inspection purposes. / /'// `i A
Date: 3 3l Signature (Applicant lir Agent)
Date: 3/31/2017
Application Number: BWFE2017-0052 Owner:
Property Address: 52579 ROSS AVE ESCENA PROPERTIES LLC
APN: 767670012 19021 GOLDE•I WEST ST
Application Description: ESCENA PROPERTIES LLC / SITE SPECIFIC ANGELUS DETAILS HUNINGTON BEACH, CA 92648
Property Zoning:
Application Valuation: $10,000.00
Applicant: Contractor:
RUCKER MUTH CORP RUCKER MUTH CORP
P 0 BOX 13017 P 0 BOX 13017
74125 ACADEMY LN EAST 74125 ACADEMY LN EAST
PALM DESERT, CA 92255 PALM DESERT CA 92255
(760)250-490=
Llc. No.: 995537
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Detail: 390 LF OF S1.1LQ DESIGN, 193 LF OF S1.2LQ DESIGN, AND 4 PILASTERS OF S1.10LQ DESIGN FOR A TOTAL OF 583 LF BLOCK WALL [ANGELUS
SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING'AIHERE 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
RETAINING/COMBINATION WALL EA 50LF
101-0000-42400
0 $60.80
DESCRIPTION
ACCOUNT
QTY AMOUNT '
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0 $91.20
DESCRIPTION
ACCOUNT
QTY AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0 $50.67
DESCRIPTION
ACCOUNT
QTY AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0 $63.33
Total Paid for BLOCK WALL: $266.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRAT%ON BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMIENT FEE: $5.00