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12-1051 (PAT)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 12-00001051 52620 AVENIDA CARRANZA 773-291-006-18 -000000- PATIO COVER - RESIDENTIAL COVE RESIDENTIAL 4043 4::;i� Q .6 4 4& j4� /110� � BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CABANILLAS, ABRAHAM & GLORIA 52620 AVENIDA CARRANZA LA QUINTA, CA 92253 Architect or Engineer: �J A Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/09/13 ------------------------------------------------------------------------------------------------- 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 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 700011 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 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 cont cts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). (_ 1 I am exempt under Sec. , B.&P.C. for this re b/ Date:Cl �lwner- UCTION LENDING AGENCY I hereby affirm under penalty of perjury that t is., s a construction lending agency for the performance of the work for which this permit is issued (Sec. ,, Civ. C.). Lender's Name: Lender's Address: LQPERMIT 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 Nu ber I certify that, in the performance of the w for which this permit is issued, I shall not employ any person in any manner so as to becom s bject to the workers' compensation laws of California, and agree that, if I should become b' ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall f ' h mp wit a provisions. i Date: 44a Applicant: WARNING: /FAILURE TO SECURE WORK' RS' CRS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000)• IN ADDITI TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABO ODE, 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 inform ion is correct. I agree to comply with'all city and county ordinances and state laws relating to building constru n, and hereby authorize representatives ter upon the above-mentioned property for inspe ion purpose s. o!;his county to enter 9 /Signature (Applicant or Agent): Application Number . . . . 12-00001051 ----=- Structure Information 304. SF COV. PATIO ----- Construction Type . . . . . TYPE V, UNPROTECTED Occupancy Type . . . . DWELLG/LODGING/CONG <=10 ---------------------------------------------------------------------------- Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . . . Expiration Date . . ELEC-MISCELLANEOUS 18.00 7/08/13 Plan Check Fee 4.50 Valuation 0 Qty Unit Charge Per Extension BASE FEE 15.00 4.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 3.00 ---------------------------------------------------------------------------- Permit . . . Additional desc . . Permit Fee . . . . Issue Date . . Expiration Date . . PATIO COVER PERMIT 72.00 7/08/13 Plan Check Fee 46.80 Valuation 4043 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 THOU BLDG 2,001-25,000 27.00 -----------7----------------------------------------------------------------- Special Notes and Comments 304 SF COVERED PATIO W/ ELECTRICAL PER ENGINEERED DESIGN. 2010 CODES. EARCHITECT: CHARLES GRALAND C11991 ---------------------------------------------------------------------------- ,Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 HOURLY PLAN CHECK 192.50 STRONG MOTION (SMI) - RES 2.50 Fee summary ----------------- Permit Fee Total Plan Check Total Other Fee Total Grand Total LQPERMIT Charged Paid 90.00 .00 51.30 .00 196.00 .00 337.30 .00 Credited Due .00 90.00 .00 51.30 .00 196.00 .00 337.30 -71- — Akl, 4/o 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 # Project Address: IT "�Po wner's Name: A 1'-vt' W6 A. P. Number:Address: Legal Description: City, ST, Zip: AA Contractor: clephone Address: Project Descrigi=o�n-�_ City, ST, Zip: Telephone: .. ... .. .... . . . ..... . ..... State Lic. P City Lic. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. lY Construction Type: Occupancy: Project type (circle one). New Alter Repair Demo Name of Contact Person: sq- Ft,: # Stories: Units: tNa,, elephone # of Contact Person: Telephone Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Rcq'd RccCd TRACKING PERMIT FEES Plan Sets 1;5L— Plan Check submitted 9//J item Amount Structural Calcs. Reviewed, ready for corrections I _1116411A Plan Check Deposit Truss Calcs. Called Contact Person t Plan Check Balance Title 24 Calcs. Plans picked up No Construction Flood plain plan Plans resubmitted I;L echanical Mechanical Grading plan 2" Review, ready for correction slissuc Li Electrical Subcontactor List Called Contact Person 1 Ci. Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ' Review, read), for corrections/issue Developer Impact Fee I Planning Approval Called Contact Person A.I.P.P. / Pub. Wks. Appr Date of permit issue School Fees .—I Total Permit Fees -71- — Akl, 4/o (;(� •40itbA 4 d4p�� P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA_92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits LW0ORTANT! NOTICE TO 1PR FORTY OWNER Dear Property Owner. An. application for a building permit has been submitted builder of the .property improvements specified at�j (� " (" : Vale are .providing you with an Owner -Builder Acknowledgment I ormatien Ve ation 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 yowhave read, initialed your.understaadiag of each prevision, 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_ OV D'S ACIW0WLEAON IT AND VEIf MCATEON OF UgFORi11 M- N D!`RECMNS: Read and initial eccc t.staminmbelow losignifyyou understand or verify this infomadon. A. C. -L 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 property owner is providing his or her own labor and material personalty. 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 my propertY- A(L-_2. 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. C,3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. 1 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. t4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. k,5. I 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, 1 may be considered an "employer" under state and federal law. C6. I understand if I am considered an "employee" under state and federal law, 1 must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemploymetit 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. t AL -8. I understand as an Owner` -Builder if I sell the -property for which this' permit is issued, 1 may be "held liable for apy financial or personal. irtjrues steed by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. '. ,AA -,9. I understand I may obtain, more information regarding my obligations.as an "employer" from tbe.Internal Revenue Service, the United States Small Business Administration, the California Department of.Beriefit Payments, and the California Division of Industrial Accidents: I also understand 1 may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. �• 0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally d financially ,responsible . for ,proposed . construction ' activity at.. the following address: v� , I agree that, as the partyAlegallyand hnaacWi ly responsible for this proposed, construction activity,.l wilt abide by all applicable Paws and req ►ireutents that govern Owner -Builders as well a3 employers. :12. 1 agree to notify the issuer of this form immediately of any additions. deletions, or changes to any of the information 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 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 maybe inVivil court! It is also important for you to understand that if an vhlicenaed Contractor or employee of that individual or firm is injured white :worlring 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 y respons -verifying whether or not those Coniractors'are property licensed and `the status of their vvo#icers' compensation insurance coverage. A Before a building permit can be issued, ibis form must be completed and signed by the property owner and returned to the agency responsible for isso.itig.Me,Ve rmiL New A copy of the property owner's diiver.'BRcenset form te n; or other verification acceptable. io'the . dgency is required to be presented when the perirrit `is issue] to verW,. the.,property owner's signature. Signature of property owner /6, Date: J 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 AGENTTO ACT ON PROPERTY. OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which 1 understand is my personal responsibility, I hereby authorize the following persons) 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: ry. Name of Authorized Agent: Tel No r Address of Authorized Agent: ' I declare under penalty of perjury that I am the so property owner for the address listed above and I pernally filled out the above, information and certify its accuracy_ Note: A copy of the owner's driver's license,',%rm notarization, or other verification acceptable to the agency is required'tobe preserfted when the permit is issued toverify the property owner's signature. Property Owner's Signature: Date: AL -8. I understand as an Owner -Builder if I sell the property for which this pent is issued, I may be held liable rbX any financial or personal. ioeries surtaihed by any subsequent owner(s) that result from any latent construction defecttZZ.,—_ A the workmanship or materials. ALI 0. I understand I may obtain more information regarding my obligations as an "employer" from the Iffier -1 e�e11U� Service, the United States Small Business Administration, the California Department of Benefit Payments, and the C2a1Q�a Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. LA0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that 11 �rrr the party legally Td financially responsible for roposed co vection activity at the following adder. r- i..-�1 /1,.. /��, rte. n...- i __._ ,- �_Li / A /k� 1 (mss. I agree that, as the party legally and .financially responsible for this proposed construction activity, I will ab"d.e by all applicable liws and requirements that govern Owner -Builders as well as employers. /1(—.12. 1 agree to notify the issuer of this form immediately of any, additions, deletions, or changes to MY of the "Orman I have provided on this form- Licensed contractors are regulated by laws designed to protect the public. If you conlr-act with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any ffrs��ei$1 loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be, in crvrl court. It is also important for you to: understand thatif an uahcensW Contractor or amployee of that individual or firm is injured while firkin on your property; you may be held liable for damages. If you obtain a permit as Owner-Buikkr and wish to hire Con�aors you will be responsMe for -verifying why or not those Contractors are r licensed and the status of thgttr properly -Wor'kers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returaed to the agency responsible for isaaing t e.pertuit. Mete: A copy of the property owner's dsever'alioeiesei form tretasr� or other verifrcation 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 �i�/Date: J7 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 autborize the following person(s) te'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 1 am the property owner for the address listed above and I personally fdledoit the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other vegcalion acceptable to the agency is required to bepresented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 71=780 -San Jacinto Dr: Ste., E2; Rancho Mirage,: Ca.,92270 ph -,(766)834-8860 fax (760) 834-8861 Letter of Transmittal To: City of La Quinta Today's Date: 1-7-13 78-495 Calle Tampico City Due Date: 12-26-12 La Quinta, CA 92253 Project Address: 52-620 Ave. Carranza Attn: Kay Plan Check #: 12-1051 Submittal: ❑ 1st ❑ 4th ® 2nd ❑ 5th ❑ 3`d ❑ Other: We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: Descriptions: Includes: # Of Descriptions: Copies: ❑ Structural Plans ® 1 Revised Struct. Plans ❑ Structural Calculations ® 1 Revised Struct. Calcs ❑ Truss Calcs ❑ Revised Truss ❑ Soils Report Update ❑ Revised Soils Report ❑ Structural P/C Comments ❑ Approved Structural Plans ® 1 Redlined Structural Plans ❑ Approved Structural Calcs ® 1 Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ Other: Comments: Structural content is approvable. JAIN 11 V �(J1 Structural Plan Review Time = 0.75 HR. This Material Sent for: ❑ Your Files ❑ Your Review ❑ Checking Other: ❑ By: John W. Thompson Rancho Mirage Office: ® (760) 834-8860 Other: ❑ BY: 1 ® Per Your Request ❑ Approval ❑ At the request of: