BWFE2017-0044TAtyl4�a w
78-495 CALLE TAMPICO D
LA QUINTA, CALIFORNIA 92253. DESIGN & DEVELOPMENT DEPARTMENT.
BUILDING PERMIT
Application Number: BWFE2017-0044
Property Address:
53659 ROSS
APN:
767680041
Application Description:
HICKOK / CMU RETAINING, COMBO, AND.GARDEN WALLS
Property Zoning:
Application Valuation:
$20,000.00
Applicant:
RMC CONSTRUCTION INC
P 0 BOX 128
THOUSAND PALMS, CA 92276
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: C-8, C29 License No.: 782663
Contractor: `'/�2p1V)C, Cd�'i -'► Ti��C i/ON
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).:
(_) 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.).
(_) 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. Q.
Lender's Na
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS -(760) 777-7153
Owner:
MR AND MRS HICKOK
53035 VILLAGE CREEK
PLANO, TX 75093
Contractor:
RMC CONSTRUCTION IP
P 0 BOX 128
THOUSAND PALMS, CA
(760)275-5304
Llc. No.: 782663
Date: 3/30/2017
WORKER'S COMPEN!ATION DECLARATION
I hereby affirm under penalty of perjury oneof the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3A00 of the Labor Code, for the performance
of he work for which this permit is issued.
I have and will maintain workers'=ompensation 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 INSURANCEFUND Policy Number: 9052994
_ I certify that in the performance clf 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 hat, if I should become subject to the
workers' compensation provisions of Section. 3700 of the Labor Code, I shall forthwith
comply fI with those rovisions.
�
Dater � 3o Applicant:
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 ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKFOWLEDGEMENT
IMPORTANT: Application is hereby made to =he 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 Cit? of La Quinta, its officers, agents, and
employees for any act or omission related tothe work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this appgcation 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 cancellation.
I certify that I have read this application and ;tate 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 enter upon the above-
mentioned property for inspection purposes.
Date: 17 Signature (Applican: or Agent): ` t7
Applicant: Contractor:
RMC CONSTRUCTION INC RMC CONSTRUCTION INC
P 0 BOX 128 P 0 BOX 128
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
(760)275-5304
Llc. No.: 782663
--------------------------------------------------------------------------------------------
Detail: 276 LF GARDEN, 163 LF COMBO WALL, AND 80 LF RETAINING WALLS WITH VARIOUS HEIGHTS [CITY AND 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.
0
Date: 3/30/2017
Application Number:
BWFE2017-0044
Owner:
Property Address:
53659 ROSS
MR AND MRS HICKOK
APN:
767680041
53035 VILLAGE CREEK.
Application Description:
HICKOK / CMU RETAINING, COMBO, AND GARDEN WALLS
PLANO, TX 75093
Property Zoning:
Application Valuation:
$20,000.00
Applicant: Contractor:
RMC CONSTRUCTION INC RMC CONSTRUCTION INC
P 0 BOX 128 P 0 BOX 128
THOUSAND PALMS, CA 92276 THOUSAND PALMS, CA 92276
(760)275-5304
Llc. No.: 782663
--------------------------------------------------------------------------------------------
Detail: 276 LF GARDEN, 163 LF COMBO WALL, AND 80 LF RETAINING WALLS WITH VARIOUS HEIGHTS [CITY AND 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.
0
Wz
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT
QTY
AMOUNT
RETAINING/COMBINATION WALL EA 501-F
101-0000-42400
0
$60.80
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0
$136.80
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:
$311.60
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
TECHNOLOGY• ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
Din rt �D,
Permit �� .
Cv o� .1 -7 0 R LfY.
Project Address: • . &-sq
City of La Quinta
6uifding a Safety Division
78-495 Calle Tampico
La Quinta, CA 22253 - (760) 777-701,2
Building Permit Application and Tracking Sh-et
Y,E. C _O,vncr7Nam"
A. P. Number:
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Legal Description:.
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City Lie.trap-
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
hone:
Cn truction Type: an
Occupancy:
cy:
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State Ltc.#. •
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Pr Ject tyPa circle ne • New Add'n _]ter Repair. r Dcmo*
Name of Contact -Pe -150-11I
# Stories:
#Units:
Tele hone# of Contact Person:
P o-- $ Q g- 3 G
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estimated Value ofPr`oject: 2 D 0.0 O. 00
CyCANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Depo.;it
Truss Calcs.
. Called Contact Person
Plan Check Balar ce.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'a Revic,v, ready for corrections/issue
Electrical .
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
14.0 A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impacl Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks_ Appr
Date of permit issue
jSchool Fees,
Total Permit Fees: