13-1659 (PLBG) + 001926 (BLCK)1111111 IIIII III IHH IIII 33
P.O. BOX 1504 IE
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
• Application description:
Property Zoning:
Application valuation:
,_J
13-00001659
54405 AVENIDA ALVARADO
774-235-019-7 -000000-
PLUMBING
COVE RESIDENTIAL
900
'edit 4 4 atima
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
FASANO THEODORE W & DOREEN
54405 AVENIDA ALVARADO
LA QUINTA, CA 92253
(760)413-9159
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/24/13
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 Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: 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
/ �Rj' applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (1500).:
�/ ) 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 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.).
✓ 1 I am exempt under Sec. , B.&P. for this reason
Date: /4/4.50 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:
LQPERMIT
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 the work for which this permit is
issued.
I 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 Policy Number
_ 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.
Date: 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 (5100,000). 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 Director of Building and Safety 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 ordinanc s and state laws relating to building construction, and hereby authorize representatives
o his county to enter�(pon the above-mentioned pr;y Z, for inspection purpo s.
D:�^ nature (Applicant or Agent)
Application Number 13-00001659
Permit
Additional desc
Permit Fee . .
Issue Date . .
Expiration Date
PLUMBING 2013
11.92 Plan Check Fee . . .00
Valuation . . . . 0
6/22/14
Qty Unit Charge Per
1.00 11.9200 EA PLBG BUILDING SEWER
Extension
11.92
Special Notes and Comments
ABANDON SEPTIC, SEWER CONNECT. 2010
CALIFORNIA BUILDING CODES.
Other Fees BLDG STDS ADMIN (SB1473) 1.00
PERMIT ISSUANCE M/P/E 90.57
PLAN CHECK, PLUMBING 11.92
Fee summary Charged Paid Credited Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
11.92
.00
103.49
115.41
.00
.00
.00
.00
.00
.00
.00
.00
11.92
.00
103.49
115.41
Bin #City
of La Quinta
Building 81' Safety Division •
Permit i<{
/3 b 5
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253: (760) 777-7012
Building Permit Application and Tracking Sheet
'P�oj ress:-vl�/ t0ae,„)( Imo r' 1\
�""
Owner's Name: , - - ,e R ��
A. P. Number:
M
j
,- n/w
Address: 6-�/ — / Zo $(.fi, 1(0a
G, ,.te
Legal Description: 1
-y
, 2 ,� `�-r
City, ST, Zip: 4 pu.in C �
Contractor: f Wk4ir 't?( , e - I
Telephone: 60 . !/.'
:r<>> «
r :>; :: ':' 7:805M
Address: {
7Proj D ription: y
City, ST, Zip:
-E—
Telephone:
?:
State Lic. # :
City Lic. #: •
Arch., Engr., Designer:
•
Address:
City, ST, Zip:
Telephone:
'<::;s:<s:.:::<>»>•>=:::»>:;::::•:<:?:>::«:::
,:•:;:... .......... ..........
Construction
o Type: Occupancy:
State Lic. #:
>i#.>r.•;;;::«:>r>>?.>.:::>:#»>:».>:::>:»»:a:»:
•......•;;<
,
Project type (circle one)• New Add'n Alter
Repair Demo
Name of Contact Person:
• Sq. Ft.:
# Stories:�1 •
# Units:
Telephone # of Contact Person: '
/
'Esti' mated - Value of Project: �d�f ir�izt",•'" _!/j____
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal •
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
•
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person •
Plan Check Balance
.
Title 24 Calcs.
Plans picked up
Construction •
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2'. Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees •
•
Total Permit Fees
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
INVOICE Date: 12/24/2013
SUBJECT: 54405 AVENIDA ALVERADO, LA QUINTA
Fasano,Ted
54405 Avenida Alverado
LA QUINTA, CA 92253
Project: 13-5114
Project Date: 12/24/2013
Amount Due: $4,851.00
GEO: 06-06-13-2
Planner: CAROL PFANNKUCHE
TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH
REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK
��Un`its;
e;Descri':tion"ft'1*
Charge Amount
w :Total"AmountY`fi
1.00 SCC -COLLECTION
$2,415.00
$2,415.00
1.00 SCC -TREATMENT
$2,436.00
$2,436.00
1E2).31=
DEC 2 4 2013
BY: ' Y351
$4,851.00
Rabobank. N.A.
P.O. Box 6002
Arroyo G,onde, CA 93421-6002
Customer Service 800-942-6222
/IC:�%L
MEMO . Lv
2 238!1.20I:5 4 5 000800,291 II. "CJCdtC
SUBJECT: 54405 AVENIDA ALVERADO, LA QUINTA
COACHELLA VALLEY WATER DISTRICT
P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651
Page 1
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Permits
imPORTANn NOTICE TO JRQPERTY.OWNER
Dear Property Owner:
An. application for -a building i .- has . sub • • ' }your : , listing as the builder of the .property
impraxements specified at ; Or_ VB/1/ % Co L i/t /7 .?u6 72
We are providing you with an Owner -Builder Acknowledgmentand Inforination- Verification Form. to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the •
Owner -Builder. We will not issue a building .permit until you have read, initialed your. understanding of eac4•provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
OVA'S ACKNOWLEDGMENT AND VERIFICATION OF INFOttrifATION
DIRECTIONS: Read and initial arch statement below to signify you Understand or verify this information.
it,., understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
ding permit that erroneouslyimplies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on my party.
2. I understand building permits are not required to be signed by property owners unless
construction and are not hiring a licensed Contractor to assume this responsibility.
3_ I understand as an "Owner -Builder" I am the responsible party of record on the permit. I
Cm elf from potential financial risk by hiring a licensed Contractor and having the permit filed in
own.
f►, 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of y construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
they are responsible for the
understand that I may protect
his or her note instead of my
4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
its and contracts.
1
;, sir . I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
go emment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
risk
7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
s ctures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
- - - -
111111111111111111111 1111 34
IEBuildin
Address 54-405 Avenida Alvarado
44 aditra
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
Ted W. Faseno
• Mailing
Address
sem
City La cluinta
Zip
92253
Tel.
' '564-0047
Contractor
comer/bldg.
Address
No. 001926
BUILDING: TYPE CONST. •- OCC: GRP.
A.P. Number
"r f� r Jf � r
, f � ", .i - 0 )
Legal Description
Project Description
L ' - • I
70 fit of 6ft blob Tozod fence.
City
Zip
Tel
State Lic.
& Classif.
City
Lic. #
' Arch., Engr:,
Designer
Sq. Ft.
Size •
No.
Stories
No. Dw.
Units
New Et Add ❑
Alter 0 Repair 0
Demolition 0
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION -_•
I hereby affirm 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. - . -
SIGNATUR DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a.
permit to construct, atter, improve, demolish, - or repair any structure, prior to its issuance also
requires the applicant for such permit tbt life a signed statement that he is licensed pursuant to .
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a - permit
' subjects (he applicant to a civil penalty of not more than live 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; Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044,. Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 I am exempt under Sec. • B • & P.C. for this reason .
Date Owner k./7 ') - +
t.
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No .Company
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.) — -
I certify that in the performance of the work for which this permit is issued, I shall not -
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: 1f, after making this Certificate of Exemption you should become
'subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read .this application and state that the above' information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives .of this city to enter the above- '
mentioned property for inspection purposes.
Signature of applicantf- r -�. '"1'•
Mailing Address , •� t
City, State, Zip
Date
HARD COPY
Estimated Valuation$ 595,0
0
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
20.00
Mech.
Electrical'
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
20.00
REMARKS
ZONE:
BY'
Minimum Setback Distances:
Front Setback,from.Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
'Side Setback from Property Line
FINAL.DATE INSPECTOR
Issued by: Date 12-5-05 Permit
•Validated by: •
Validation:
.A3.5Q9
12 9 20.00 CK
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL
SQ. n-.
SO. FT.
SQ FT
SO. FT.
SO. FT.
SO. FT.
SQ. FT.
VALUATION
@
$
ROUGH PLUMB.
BONDING
UNITS
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
2 ND FL.
@
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
YARD SPKLR SYSTEM
REINF. STEEL
POR
®
MOBILEHOME SVC.
WATER HEATER
SERVICE
BAR SINK
GAR.
®
WATER SYSTEM
GRADING
cu yd
POWER OUTLET
LUMBER GR.
ROOF DRAINS
$ plus
FRAMING
CARP.
@
ROOFING
REMARKS:
DRAINAGE PIPING
VENTILATION
WALL '
@
FIRE ZONE ROOFING
FIREPLACE
DRINKING FOUNTAIN
SPARK ARRESTOR
@
GAR. FIREWALL
URINAL
LATHING
ESTIMATED CONSTRUCTION
$
INSULATION/SOUND
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
7/(1,7
MECHANICAL FEES
CERT. OCC.
FENCE FINAL
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
GARDEN WALL FINAL
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET.
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3Ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PL.CK.FEE
CONST. FEE
ELECT. FEE
SMI FEE
PLUMB. FEE
STRUCTURE
PLUMBING
ELECTRICAL
HEATING & AIR COND.
SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
• GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu yd
x$ _$
LUMBER GR.
FINAL INSP.
$ plus
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
-bINAL INSPECTION
7/(1,7
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL