BWFE2019-021578-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
T,ihf 4 *(� Q94kAV
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
WALL/FENCE/CITY STANDARD/PRE-APPROVED
BWFE2019-0215
53830 AVENIDA MENDOZA
774173005
MICHEL / 65LF GARDEN WALL AT NORTH PL
$2,500.00
Applicant:
BLOCKWORKS INC DBA A A MASONRY
77-700 DELAWARE PLACE PALM
PALM DESERT, CA 92211
�J
OCT 17 2019
S1
CITY OF LAQUINTA
DESIGN & DEVELOPMENT DEPARTMENT
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: C29 License No.: 804168
Date: ZCh-J7 Contractor:
OWNER -BUILDER DE RATIO
I hereby affirm under penalty of perjury that I am exempt frt LheCon: is 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, 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 N
Lender's Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/17/2019
Owner:
PEDRO & GLORIA MICHEL
53830 AVENIDA MENDOZA
LA QUINTA, CA 92253
Contractor:
BLOCKWORKS INC DBA A A MASONRY
77-700 DELAWARE PLACE PALM
PALM DESERT, CA 92211
(760)360-7388
Llc. No.: 804168
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
oft If vJork for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Sectfon-S700 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: INSURANCE COMPANY OF THE WEST Policy Number: WPL5041637
_ I certify that in the performance of the work for which this permit is issued,
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: /n/,/ //l&f Applicant:
WARNING: FAILURE TO SECURE WORKERSICOMPENSATION 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 upon the above -
mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
V 11
Date: 10/17/2019
Application Number:
BWFE2019-0215
Property Address:
53830 AVENIDA MENDOZA
APN:
774173005
Application Description:
MICHEL / 65LF GARDEN WALL AT NORTH PL
Property Zoning:
Application Valuation:
$2,500.00
Applicant:
BLOCKWORKS INC DBA A
A MASONRY
77-700 DELAWARE PLACE PALM
PALM DESERT, CA 92211
Owner:
PEDRO & GLORIA MICHEL
53830 AVENIDA MENDOZA
LA QUINTA, CA 92253
Contractor:
BLOCKWORKS INC DBA A A MASONRY
77-700 DELAWARE PLACE PALM
PALM DESERT, CA 92211
(760)360-7388
tic. No.: 804168
Detail:65LF OF 6' GARDEN WALL AT NORTH PROPERTY LINES [ANGELUS S1.0LQSPECIFICATIONS] 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
DESCRIPTION
INFORMATION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 10OLF
101-0000-42404
0
$53.67
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 10OLF PC
101-0000-42600
0
$67.08
Total Paid for BLOCK WALL 2019: $120.75
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
Arch/Eng Name:
Address:
City, St, Zip
Construction Type:
Grading:
Occupancy:
Telephone: Bedrooms: Stories: # Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name: New Commercial / Tenant Improvements:
Address: 3 _. S-1 Total Building SF
City, ST, Zip Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
Date: October 16'h 2019
To: The city of La Quinta, CA
My name is Luis Lainez and I am the owner of the property located at 53810 Avenida Mendoza, La Quinta CA
92253. My self and Mr. Pedro Michel agree to build a block wall between his house located at 53830 and my house
located at 53810 Avenida Mendoza. We both agree that the block wall will be placed on the property line.
If you have any questions please feel free to call me at (
Sincerely,
4 ��,I Ice"
4
L is Inez
�G\� 'he- z I
CA
i C
jVIP.,
i
� 1 �
S LIF
wc%a
AA �Jte
5 3 -,,a3o A"e"`�,
CA
BUILDING & SA
APPRC
FOR CONSTI
DATE�n f I BY
INTA
DEPT.
D
sw Ft,ZOv#- oaIS
sAye,e:-� . 53910 AVEM104 14EOOZA