BWFE2019-0151"), Ar" &I'm v
78-495 CALLE TAMPICO Di VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/31/2019
Permit Type/Subtype: WALL/FENCE/CITY STANDARD/PRE-APPROVED Owner:
Application Number: BWFE2019-0151 GREG & CECILE DAHLQUIST
Property Address: 51715 AVENIDA MONTEZUMA P 0 BOX 5639
APN: 773112010 BLUE JAY, CA 92253
Application Description_ DAHLQUIST / 24LF GARDEN WALL
Property Zoning:
Application Valuation: $3,500.00
a
Applicant: P
Contractor:
MODERN TOUCH CONSTRUCTION MODERN TOUCH CONSTRUCTION
67685 BROKEN ARROW LANE JUL 31 2019 67685 BROKEN ARROW LANE
DESERT HOT SPRINGS, CA 92234 DESERT HOT SPRIKIrc rA Q»1n
CITY OF LA QUINTA (760)835-2777
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 1004355
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 License No.: 1004355
Date: 7 �% Contractor—' —CIA,
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 Name:
Lender's Address:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I 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 thesarerl For which this permit is issued.
have 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: NJQRGUARD INSURANCE COMPANY Policy Number: MOWC031859
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.
Date: i App1iC8
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 laws relating to building
construction, and hereby authorize representatives of this city to enter up in the
above -me boned roperLy for inspection purposes.
Oates W% I Signature (Applicant or A nt
Date: 7/31/2019
Application Number: BWFE2019-0151
Property Address: 51715 AVENIDA MONTEZUMA
APN: 773112010
Application Description. DAHLQUIST/ 24LF GARDEN WALL
Property Zoning:
Application Valuation: $3,500.00
Applicant:
MODERN TOUCH CONSTRUCTION
67685 BROKEN ARROW LANE
DESERT HOT SPRINGS, CA 92234
Owner:
GREG & CECILE DAHLQUIST
P 0 BOX 5639
BLUE JAY, CA 92253
Contractor:
MODERN TOUCH CONSTRUCTION
67685 BROKEN ARROW LANE
DESERT HOT SPRINGS, CA 92234
(760)835-2777
Llc. No.: 1004355
Detail: 24LF OF 5' HIGH GARDEN WALL AT SIDE YARD [CITY SPECIFICATIONS] 7' SETBACK ON MONTEZUMA 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
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$53.37
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$66.71
Total Paid for BLOCK WALL: $120.08
DESCRIPTION ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE 101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION ACCOUNT CITY AMOUNT
RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION ACCOUNT CITY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
PERMIT #
W
CAI iFORNI
Project Address:
APN #:
Applicant Name:
Address:
City, ST, Zip:
Telephone:
Email:
Project Description:
261Z
Valuation of Project $ ' 5 �n
Architect/Engineer Name:
Construction
Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: �S�torie�s:#Units:
Email:
State Li c:
City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address:
16 7p
- L) I S� Total Building
SF
City, ST, Zip
V9 Construction Type:
Occupancy:
Telephone:
Email:
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78495 CALLE TAM PICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Plan Sets
Required Received
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
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