BWFE2017-002878-495 CA LLE TAMPICO
.
LA QUINTA, CALIFORNIA 92253
Application Number:
BWFE2017-0028
Property Address:
81600 SHACKLETON WY
APN:
767870020
Application Description:
SUMMBERS / BLOCKWALLS
Property Zoning:
Application Valuation:
$11,000.00
Applicant:
A S T STONE CORPORATION
1279 W MAIN STR. STE. 205
EL CAJON, CA 92020
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VOICE (760) 777-7125
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DESIGN & DEVELOPMENT DEPARTMENT
PX (7 8)"I
INSPECTIMIS (760 77 -�3�
BUILDING PERMIT
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a)�ty: 27/2017
Owner: D�
ROBERT AND CAROL SUMMERP C:)
81600 SHACK.=LTON ST CD C
LA QUINTA, CA 92253 Z CD ry
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Contractor: --I
A S T STONE CORPORATION z
1279 W MAIN STR. STE. 205 -
EL CAJON, CA 92020
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 ClassrC29. C54 License No.: 816966 A _
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. C.).
Lender's
Lender's
(619)401-8871
Llc. No.: 816956
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a tertifcate of consent to self -insure for workers'
compensation, as provided for by Section :700 of the Labor Code, for the performance
o e ork for which this permit is issued-
ImI have and will maintain worker' compensation insurance, as required by
Section 3700 of the Labor Code, for the pe -formance of the work for which this permit
is issued. My workers' compensation insurance carrier and polity number are:
Carrier: FALLS LAKE FIRE AND CASUALTY COMPANY Policy Number: FLA0003157
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 that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions. /(/��
J r 1 it /1 AiJi
Date: -37.7 1 Applicant:
WARNING: FAILURE TO SECURE WORKERS"COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRI VIINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($10(,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED =0R IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKWOWLEDGEMENT
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 - he 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 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 cancellation.
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 b�jilding
construction, and hereby authorize representatives of this. ciyy�toenter upon tfl/
above-mentioned property for inspection purposes. � � /'/
Date:3-g -12: Signature (Applicant or Agent)
Application Number:
e
BW.FE2017-0028
Property Address:
81600 SHACKLETON WY
APN:
767870020
Application Description:
SUMMBERS / BLOCKWALLS
Property Zoning:
Application Valuation:
$11,000.00
Owner:
ROBERT AND CAROL SUMMERS
81600 SHACKELTON ST
LA QUINTA, 0% 92253
Date: 2/27/2017
Applicant: Contractor:
A S T STONE CORPORATION. AST STONE CORPORATION
1279 W MAIN STR. STE. 205 1279 W MAIN STR. STE. 205
EL CAJON, CA 92020. EL CAJON, CA92020
•(619)401-8871
Llc. No.: 81690-6
-------------------------------------------------------------------------------------------
Detail: 220LF OF COMBO WALL 3 RUNS INSIDE PL. [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR
TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
,,r ::.,;w ;,,.; :;,-,,, • :.;: , .. DESCRIPTION ACCOUNT
QTY
AMOUNT
RETAINING/COMBINATION WALL EA 501-F 101-0000-42400
.0
$76.00
DESCRIPTION ACCOUNT
QTY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404
0
$45.60
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 BLO--K WALL: $235.60,
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS 561473 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
TOTALS:6
1' 1
Bin. #
Cit}r of La Quints
Bullding 8L Safety Division
P.0.,Box 1504,78-495 Calle Tampico
fa.Quinta, CA 92253 - (760) 777-7012
-- tn2f- Building Permit Application' and Tracking Sheet `
Permit #
Project Address l r`
Owner's Name:
A. P. Number. A 42 414aia.)9
Address: .
Legal Description.City,
iii e:x-owt, C04 P -
ST, Zip:
gs,Contractor 3:,::s- t
Telephone: '
Address: '75-161 -161 %* 0 LIP. 11;1(c f-
Project Description:
City, ST, Zip: Wtv� VC444-i' LA- ct?'�-1 �
Telephone: -7W--f 65 -N7 _ .
State Lie. # : 4,10k, City Lia C20 SI 0
Arch., Engr., Designer.
' Address:
t
City., ST, Zip:
P 'Y. y
Telephone:
State Lic. #: ;wrj yv
Name of Contact Person: I•J$6,A O-JMJ CIL.
Construction Type:. -occupancy:
Project type (circle one) New AdCn Alter Repair Demo
Sq. Ft.: #Stories: # Unit$:
Telephone # of Contact Person: -7&0.;42,. t S p—
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMITTEES-
Plan Sets
Plan Check submitted
Item Amount
Structural CRIcs.
Reviewed, ready for corrections
Plan Chcdk Deposit. .
Truss Cates.
Called Contact Person
Plan Chedk Balance
Title 24 Cales.
Pians picked up
Construction
Flood plain plan
Plans resubmitted..
Mechaeicsl
Grading plan
2i4 Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M 1
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review; ready for correetions/iissue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I P.P.
- -.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Pei mit Fees
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