BDEM2019-001078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
LUIS AGUILAR
67685 QUIJO RD
CATHEDRAL CITY, CA 92234
T^ur °& la QuIiI&
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
DEMOLITION/SINGLE FAMILY
BDEM2019-0010
54840 AVENIDAJUAREZ
774266005
SALZ / DEMO BLOCK WALL [21 COURSES
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
Salz Casey & Sandy
54840 AVENIDAJUAREZ
LA QUINTA, CA 92253
zu Contractor:
LUIS AGUILAR
67685 QUIJO RD
MAY 0 9 2019
CATHEDRAL CITY, CA 92234
CITY OF LA QUINTA (760)449-3900
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 1038189
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect. '
License Class: B License No.: 1038189
Date: 5 J — C �1 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).:
(_) 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.).
() 1, 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
Date: 5/9/2019
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work forwhich this permit is issued.
k1anVhave 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: NQRgUARD JNSURANCE COMPANY , Policy Number: LUWC978005
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, i I should become subject to the
workers' compensation provisions of Section 37 of the ,,,Labor Code, I shall forthw
comply with those provisions.
Date' ' � AQplieanv
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 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 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! ws relating to building
construction, and hereby authorize representatives of this city)entre upon the
above -mentioned property for inspection purposes. 11
Pat —� Signature (Applicant or Agent):
10
Date: 5/9/2019
Application Number:
BDEM2019-0010
Owner:
Property Address:
54840 AVENIDA JUAREZ
Salz Casey & Sandy
APN:
774266005
54840 AVENIDAJUAREZ
Application Description:
SALZ / DEMO BLOCK WALL [21 COURSES
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
Applicant:
Contractor:
LUISAGUILAR
LUISAGUILAR
67685 QUIJO RD
67685 QUIJO RD
CATHEDRAL CITY, CA 92234
CATHEDRAL CITY, CA 92234
i (760)449-3900
Llc, No.: 1038189
-----------------------------------""--- r -------------
-----------
--------------------
i
Detail: DEMO OF TOP (2) COURSES OF BLOCK WALL 61LF ADDED TO k'ISIPING 5' iB�OCK WALL. RETURNING BLOCK WALLTO PRIOR 5' HIGH STUCCO
FINISHED CONDITION. PER 2015CALIFORNIA BUILDING CODES. f
FINANCIAL
DESCRIPTION
INFORMATION
ACCOUNT
QTY
AMOUNT
DEMOLITION, EXTERIOR
101-0000-42404
0
$40.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEMOLITION, EXTERIOR PC
101-0000-42600
0
$120.07
Total Paid for DEMOLITION: $160.09
DESCRIPTION
ACCOUNT
CITY
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
PERMIT #
_. (AL 1FORMA .__..
PLAN LOCATION -
Project Address: 5lt /C) Project Description:
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plicant Name:kv� 4� 4,0 ��cdress: �' ui m «�ec�L1.
City, ST, Zip: C[' �' `3�_� Q cry Q re rra sec 1
Telephone: 0
Email; j Valuation of Project $
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Property Owner's Name:
Address: S C( G o 6u,
City, ST, Zip
Telephone:
Email:
t S z New Commercial / Tenant Improvements:
UOL yr Total Building SF
�22$3 Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
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RECEIVED
MAY 092019
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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