BLCK (10-0411)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 10-00000411
Property Address: 52661 AVENIDA NAVARRO
APN: 773-304-019-6 -000000-
Application description: WALL/FENCE
Property Zoning: COVE 'RESIDENTIAL
Application valuation: 256 .
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
CONAWAY ALAN N
52661 AVENIDA NAVARRO
LA QUINTA, CA 92253.
(760) 285-.].991
Contractor:
Architect or Engineer: - T y Owner
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that l 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
fallowing 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 70001 of Division 3 of the Business and Professions Code) or
that he or he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any a cant 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 sale 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 contractors) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&PCS for this, reasort�,
CONSTRUCTION LENDING AGENCY
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: .
LQPEFMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-1153
Date: 5/11/10
i
ivik 12010
CITY OF LA CAUINTA
A
-----------------------------------------------
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
�13.7�00 of the Labor Cod I shall for rith comply with those provisions.
e: �(i Za6 APPlicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATI N 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 Ouinta, 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..) agree to comply with all
city and county ordinances and state laws relating to building constructio , nd hereby authorize representatives
of this county
'to✓enter upon the above-mentioned prope or ins ecti poses.
D/'/(� `�'�y Signature(Appli�ntl:
LQPERMIT
Application Number 10 -00000411 -
Permit . . . WALL/FENCE PERMIT'
Additional desc .
Permit Fee 15.00 Plan Check
Fee
.00
Issue Date Valuation
256
Expiration Date 11/07/10
Qty Unit Charge Per
Extension
BASE FEE
15.00
Special Notes and Comments
CONSTRUCT 16 LN FT X 4 FT HT BLOCK
GARDEN WALL PER CITY STANDARDS'&
-- APPROVED" PLANS &' ONE WROUGHT `IRON GATE. :-
-------------------------- - -- -
Other Fees. . . . . .. . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 15.00 .00
.00
15.00
Plan Check Total .00 .00
.00
.00
Other Fee Total 1.00 .00
.00
1.00
Grand Total 16.00 .00
.00
16.00
All
-
52661 Avenida Navarro • ' ' `
H i
Lot.= 51 1/2' x 1.12' 2 X 2-
616" 10 r • 20 30 40 5 ft , ,
E X I S T 1 N G• B R I C.K • F E N C E ,
.. '
.. . 1.• • • � , Lj 1. .
X
-««« Home = 40 Feet Wide »»»
' A
. ,
L 34 ft Deep' .31 ft Deep L 7
A ^'. 1 n•
;' A
^ ;
Y ti; " t n Y
6' 6" Wide n _ ,E: „ :5 'Wide
Patio
Garage
"
191/2ft Wide x 22 ft Deep -20ftx101/2ft _
36" to 42" High >> 'A4 <<< 27" Long
-� �• , 36"AGATE
43 DRIVEWAY M °
Existiny 'E' Existing
Fence Fence r' y
6 ft 4 >> Ak
f
in 48'xHigh 29 Feet
112
Curb x , ; «««<«« 51 1/2'Feet »»»»»»> " Curb.
. P.O. B.Ox 1504
LA QIJINTA" CALIFORNIA 92247-1504
78-495 CAL.LE.TAMPI'CO -
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTYOWNER'SPACKAGE
(760) 777-7012
FAX (760) 777-701"1
Disclosures & F0'rMs for Owner-wBuilders Applying for Construction Permits
LVPOR NOTICE TO PROPERTY OWNER
Dear Property Owner:..
An. application fora building peth been submi�ted
Ni in your name -listing yourself as the builder of the .property
,improvements specified at 15 2- � GNI Ii LAOwN}A . . .
Ve.areproviding you with an Owner -Builder Acknowledgment and nformation Verification Form to make you aware of your
.responsibilities and possible risk-youmay incur by:baving this pern-Lit. issued in your name as the
Owner -Builder. We will not issue -a'build tng permit until yow ' have.read, initiated your understanding ofeachprovision,
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.
0 "MER'S AU(NO.. WLEIDGMENT AND-VEIMCATION OF INFORMATION
PIRECTIONS: . Read'an&initial each. statement below t,&,signify you uni'derstand'or verify this information.
1. I understand a frequent -practice of unlicensed persons is to have the property owner obtain an "Owner-Buildei"
uildin9 permit. that erroneously implies that the property 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 air► aware of the limits of my insurance -coverage for injuries to workers -
'on. my property.
2. 1 understand. building permits are not required. to be signed by property owners unless they, are responsible for the
0 s6ction and are not hiring a licensed Contractortoassume this responsibility.
3
I understand as' an "Ownei-Builder"' I am the resp'o'nsible.party of record on the permit. I understand that I may 'Protect
from potential financial risk by hifing-a licensed Contractor and laving the permit filed in his or her name instead of 'MY
own.
4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
mits 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 ate and federal law.
�V,6. I understand if I'.am considered an "employee' under state 'and federal. law, I I mu . st register with the state and federal
government,. 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. 1 understand under California Contractors' State License Law, an Owner -'Builder who builds single-family residential
structures 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.
8. 1 understand as an Owner -Builder if I:sell the roe for which this pe it is issued 1 ma be held liable for an
property rh' P Y Y
ancial or personal. injuries sus a ned by any subsequent owner(s) that' result from any latent construction defects in the
workmanship or materials.
9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
ervice, 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 (CS -LB) at I-
800-321-CSLB (2752) or www.csib.ca.gov for more information. about licensed contractors.
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 � letya d fmanc' lly responsible for a proposed construction activity . at the following address:
�l.l. Iagcee that, as the party, legally and financially responsible for this proposed construction activity,.I will abide by all
applicable IAws and requirements that govern Owner -Builders as Vell as employers.
12. d agree to notify the issuer of this form immediately of any additions; deletions, or changes to any of the information I
provided on this form. ice u contract with
P Licensed contractors are regulated by laws designed to protect the public. If yo
someone who does not have a license, 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 ernployee of that individual or firmis injured while working
on your property; you may be held liable 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 are properly licensed 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 issuing; the perInit. Note: A :copy of the property owner's driver's.licensei form no(arizadvn; 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 property 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 understand is my personal responsibility, I hereby authorize
the following person(s) to act as. my agents) 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 above
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:
/3iri #
City of La Quinta
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
�'��
Project Address: 2- C V6131001 4116 W LQ
Owner's Name:
A. P. Number:
Address: Std I X5,3 Oo l u AYA mo, L
86?
M
Legal Description:
Contractortelephone:
City, ST, Zip: 4J 4t.44 Z ZS- j Gl �1
Address: S Z` I pJ ID A
Project Description: iv S+72u d� A
r! 014_ ' ,
City, ST, Zip: G KI C4 'I 2L� J
U—,�ZAI r . 41, G Q{2
Telephone: (O�•s�8 —
State Lic. # :
.•. •l•, ,
r :-:.w , ss„h
City Lic. #:
e
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
P,.
.,.,. tr4„ k :;: _
`>''�:i%o:r.>
y # j
Construction Type: Occupancy:
State Lic. #:Ntl`tiv
Project type (circle on New) Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cale&
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°” Review, ready for corrcctionsrissue
Electrical
Subcontactor Last
Called Contact Person
Plumbing
Grant Deed
Plans picked up ,.
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees