SOTB (11-0539)P.O:•BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000539
Property Address:
43665 MILAN CT
APN:
609-552-009_. - -
`
Application description:
STRUCTURES OTHER THAN BUILDINGS
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2450
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
NAKAGAWA KYLAN Y
43665 MILAN CT
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
. FAX (760) 777-7011
INSPECTIONS (760) 777-7153
0,
Date: 9/27/11
--------------------------- rt2cT 4 ?011
-----------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION WORKER'S'COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided.
License Class: License No.: .. for by Section 3700 of the Labor. Code, for the performance of the work for which this permit is
issued.
Date: Contractor: - _ 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
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 licensedpursuantto 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 1$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 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
1 pursuant to the Contractors' State License Law.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date: 10 2"i 11 '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:
LQPERA1IT
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: 1Appplicanv
WARNING: FAILURE TO SECURE WORKERS' COKAPENSATION 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 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 1 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 county to ent%n the above-mentioned property for inspection purposes.
lZate:42-11Il V Signature (Applicant or Agent)�I-1 ��� j�✓`�
/U�
Application Number . . . . . .11=00000539
Permit . . . BUILDING PERMIT INV FEE
Additional desc .
Permit Fee . . . •108.00 Plan Check Fee
35.10
Issue Date . . . . Valuation . . .
_ 2450
Expiration Date 3/25/12
Qty Unit Charge Per
Extension
BASE FEE
90".00
1.00 18.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
18.00
Permit ELEC-..MISCELLANEOUS INV FEE
Additional desc .
Permit,Fee 33.00 Plan Check Fee
4.13
..Issue Date Valuation . . .
. 0
Expiration Date 3/25/12
Qty Unit Charge Per
Extension
BASE FEE
30.00
2.00 1.5000 PER ELEC DEVICE/FIXTURE 1ST 20
----------------------------------------------------------------------------
.3.00
Permit PLUMBING INV FEE
Additional desc .
Permit Fee 36.00 Plan Check Fee
4.50
Issue Date . ". . . Valuation . . .
. 0
Expiration Date 3/25/12
Qty Unit Charge Per
Extension
BASE FEE
30.00
1.00 6:0000 EA .PLB WATER INST/ALT/REP
6.00
-------=----------7---------------------------------------------------------
Special Notes and Comments
FIELD VISIT ON 5/24/2011 W/ OFFICER
KEVIN MEREDITH TO PROPERTY IN QUESTION.
FREE-STANDING LATTICE COVER MEASURED AT
9FT WIDTH X 13.1 FT LENGTH X.10 FT HGT =
117.9 SF.(BUILDING PERMIT IS NOT
REQUIRED) LOCATION OF LATTICE COVER
MEETS MINIMUM DISTANCE OF 5 FT. FROM
PROPERTY LINE. FREE-STANDING BBQ COUNTER
W/ APPLIANCES REQUIRE A BUILDING PERMIT.
APPLICANT WAS NOTIFIED THAT PERMIT
APPLICATION W/ PLANS ARE TO BE SUBMITTED
IN 30 DAYS.
May 24, 2011 12:21:56 PM bhanada.
OUTDOOR GAS -BBQ W/ OVEN & SIDE BURNER'
LQPEPN1IT
Application Number 11-00000539
Special Notes and Comments
AND -SINK TO DRYWELL (APPROVED PER CVWD).-.
OPEN LATTICE COVER (117 SF) EXEMPT FROM,
PERMIT. **WORK COMMENCING PRIOR TO
PERMIT ISSUANCE, INVESTIGATIVE FEES
ASSESSED PER CBC 109.4.** 2010 CODES.
,.. ---------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid
Credited
Due
Permit Fee Total 177.00 .00
.00
177.00 -
- Plan Check Total .43.73 .00
.00
43.73 _
Other Fee Total 1.00 .00
.00
1.00.
Grand Total .221.73 .00
00
221.73
LQPEUIIT
PAC
F. F.
PLAN
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3Go -1a!i- sayq
CONSTRUCTION HOURS
ctober 1st - April 30
onday - Friday: 7:00 a.m. to 5.30 p.m.
aturday: 8:00 a.m. to 5:00 p.m.
unday: None
-0overnment Code Holidays: None
,May 1st - September 30th
onday - Friday: 6:00 a.m. to 7:00 p.m.
Saturday: 8:00 a.m. to 5.00 p.m.
Sunday: None
Government Code Holidays: None
air Construction is HOT PERMITTED
on the following Code Holidays:
Dr. Martin luth 'ng Jr. Day.
President's Day
. emorial Day
i
ndependence Day'
Day
Labor
Veteran's Day,
t:
Thanksgiving Day
Christmas Day
1
1.0
IS
N ADEQUATELY SIZED JB SITED
ON TH
NTAINER
RING ALL
REQUIRED
SHASES OF CONSTRUCTION OL
UST BE
MO DDu
AMPTIED AS NECESSARY R
THE CITY TO HAVE THE
O SO
ONTAINER
AY CAUSE
-.*UMPED AT THE EXPENSE OF
OWNE RI
CONTRACTOR.
�-.
A RE -INSPECTION FEE OF $30
WILL BE CHARGED IF THE APPROVED
TAND JOB CARD ARE NOT ON
IN ECTION. -_
NO EXCEPTION$!
A
G�TICIIL
CIV OF IA QUINTA
BUILDING & SAFETY DEPT. QT•
APPROVED
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RE: Drywell Approval at 43665 Milan Ct, La Quinta, CA 92.253 - Y...
YA- 1-100/® MAIL
Classic
http://us.mcl258.mail.yahoo.com/mc/showMessage?sMd=10&filter..
._....___._..__._.__......_...-......_._
.......... _....._....._._.._.._ _.._....:...._..__.._..__.
RE: Drywell Approval at 43665 Milan Ct, La Quinta, CA 92253
From: "Gilbert Ramirez" <GRamirez@cvwd.org>
To: "J Raymond" <jim.raymond@yahoo.com>
Hi Jim,
Friday, June 17, 20119:54 AM
As per our phone conversation on 6/16/2011, regarding the drywell serving an outside sink located at
43665 Milan Ct, La Quinta. As discussed the sink in question is open to the atmosphere and would post a
concern if it would have been connected to Coachella Valley Water District's (CVWD) Sewer system.
CVWD Regulations Governing Sanitation Service, Part 9 Prohibited Discharges, Section 17 states: Any
stormwater, surface water, groundwater, roof runoff or subsurface drainage are deem prohibited discharges
into the Domestic Sewer System. The sink which is open to the atmosphere with no cover from the
elements would be in violation of CVWD's Regulations Part 9; if it had been connected to the Sewer.
You connecting the sink to a drywell appears the better option.
Any questions feel free to contact me.
Thank You,
Gilbert Ramirez
Source Control Assistant U
Collection System Maintenance I1
Office (760) 398-2661 ext. 3536
Cell (760) 832-2903
Fax (760) 391-9638
Email: gramirez@cvwd.org
From: J Raymond [mailto:jimraymond@yahoo.com]
Sent: Thursday, June 16, 20119: 11 PM
To: Gilbert Ramirez
Subject: Drywell Approval at 43665 Milan Ct, La Quinta, CA 92253
Gilbert,
Per our conversation this afternoon, I am writing to request that the Coachella Valley Water
District approve the drywell that we have installed on our property at: 43665 Milan Ct, La Quinta,
CA 92253.
As I mentioned, we have an outdoor BBQ that has a sink and faucet. The sink drainage runs to a
drywell which is located outside of the BBQ footprint in a flower bed area.
This sink is seldomly used and is basically used to wipe/clean dust off the BBQ countertop,
1 of 2 6/20/2011 10:59 AM
RE: Drywell Approval at 43665 Milan Ct, La Quinta, CA 92253 - Y... http://us.mcl258.mail.yahoo.com/mc/showMessage?sMd=10&filter..
r
occassionally wash hands, or use to water flowers in the yard.
As we discussed, the city of La Quinta needs approval (in writing) from the Coachella Valley
Water District, that this drywell is acceptable here. I understand that our drywell is approved and
am looking for a response via email stating that, so we can take your reply to the city.
Please let me know if you have any question or need additional information. We look forward to
your response.
Thank you.
Sincerely,
Jim Raymond and Kylan Nakagawa
43665 Milan Ct.
La Quinta, CA 92253
cell: (360) 325-8249
2 of 2 6/20/2011 10:59 AM
BELLA VISTA
June 20, 2011
Re: Bella Vista Maintenance
Kylan Nakagawa
43665 Milan Court
La Quints, CA
Re: BBQ
To Whom it May Concern,
Mr. Nakagawa has provided the information about the BBQ he is putting in his backyard at the above
address. This has been approved by the Homeowners Association.
Sincerely,
Jim McPherson, Community Manager
c/o J&W Management
PO Box 1398
Palm Desert, CA 92261
760-568-0349
v
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (76 0) 777-7011
Disclosures & Forms for Owner-Bullders Applying for Construction Permits
[W -M 'AW! NOTICE TO PROPERTY OWNER
Dear Property Owner.
An. application for a building permit has been submitted in y.our name listing yourself as the builder of the property
impPovements specified at
We are providing you with an Owner -Builder AcknowWgment and Information Verification Foran 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 youtiave read, initialed your understanding of each 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.
OWNER'S AC11Q g0WLE1)(;mWT AND WUNWATION OF WFORTKAnON
DI EMONS. Read and initial each statement below to signify you understated or veru this information.
K`i`p 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the prop rty owner is providing his or her own labor and material personally. 1, 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 m/y"property.
k: 1 understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility..
�JJ 3. I understand as. an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
k0 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor -and materials, I may be considered an "employer
under state -and federal law.
V2 J 6. 1 understand if I am considered an "employer" under state and federal law. I must register with the state and feder
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployme
compensation for. each "employee." I also understand my failure to abide by these laws may subject me to serious financi
risk.
�jj 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family resident
structures cannot .legally build them with the intent to offer them for sale, unless all work is performed by lice,
subcontractors and the number of structures does not exceed four within. any calendar year, or all of the work is perforn
under contract with a licensed general building Contractor.
1L�& I understand as. an Owner -Builder if I sell the property for which this permit is issued, I may beheld liable for any
financial or personal injuries sustained, by any subsequent owners) that result from any latent construction defects in the
worlananship or materials.
I understand 1 may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
v< 10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed construction activity at the following address:
�l 1. I agree that, as the party legally and futancially responsible for this proposed construction activity, I will abide by all
applliccaable laws and requirements that govern Owner -Builders as well as employers.
V u 12. [agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of theinformation I
have provided on this form Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a tkense, the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint Your only remedy against unlicensed Contractors may be in civil court It is also
important for you to, understand that if an unlicensed Contractor or employee of that individual or firth is injured whik working
on your property; you may be heldliable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors a>ee_ properly t e_e and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the. agency responsible for issuibg; the.pertnit. Note: A copy of the property owner's dr&er's Branae, for notaraizattOn-, or .
other verification acceptable to the agency is required to be presented when the permit is issued to verify the property
owner's signature.
Signature of property owner --��— Date:
Note: The following Authorization Form is required to be completed by the proper. ty owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of [Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the abo
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date:
Bin #
City of La .Quinta
Building &r Safety. Division
P.O. Box 1504,78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
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Project Address: 3
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Owner's Name: N
A. P. Number:
Address: y M / AA/ 07
Legal Description:
City, ST, Zip: L /-Oq
Contractor:
Telephone: U �a?... .> :•
Address:
Project Description:
City, ST, Zip:
Telephone:
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State Lic. #.:
Arch., Engr., Designer:
City Lic.
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Address:
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City., ST, Zip:
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Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
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Units:
Telephone # of Contact Person:
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Estimated Value of P jest: $dil5o,,00
APPLICANT:
DO NOT WRITE BELOW THIS LIN
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Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
ZZ
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Tide 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2od Review, ready for correction ssue
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Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Z
Plans resubmitted
Grading
IN HOUSE:-
3d 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
CIVWD
Total Permit Fees
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