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13-1089 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 13-0 0 0 0108 9 VProperty Address: 77929 LAGO DR APN: 658-270-051-26 -4418 Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 2500 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: CHAPPEL, LARRY A 77929 LAGO DR. LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/09/13 Contractor: I �\ Applicant: Architect or Engineer: Owner E C\ � Npr1G ------------------------------------------------------------------------------------------------- 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: - _ 1 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 insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier Policy Number following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become subject to the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions. hat or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by yscant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).: 0`/ 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 `lif+/'i1 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.). �l am exempt under Sec. is on -/Date: f —/ I Owner. V CONSTRUC DING 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 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 ($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 r 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 abov informatioJ� o I agree to comply with all city and county ordinances and state laws relating to but ng cons cti rf, and hereby uthorize representatives pf this county to enter upon the above-mentioned prop y for inspec ' n purposes. Date: 20/ Signature (Applicant or Agent l: Application Number . . . . . 13-00001089 ------ Structure Information EXIST 2201 SF CONDO- LOT 26 ----- Construction Type TYPE V, UNPROTECTED Occupancy Type . . . . . DWELLG/LODGING/CONG <=10 Other struct info . . . CODE EDITION 2010 # BEDROOMS ---------------------------------------------------------------------------- 3.00 - Permit ... . . REMODEL 2013 Additional desc . Permit Fee . . . . 48.62 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 2500 Expiration Date 3/08/14 Qty Unit Charge Per Extension 1.00 48.6200 LS -MISC REMODEL, 1ST 100 SF 48.62 ---------------------------------------------------------------------------- Special Notes and Comments INTERIOR MASTER BATH REMODEL: REPLACE POCKET DOOR TO SWING DOOR; RELOCATE ELECTRICAL SWITCHES; NEW TILE & CABINETS & REUSE PLUMBING FIXTURES. 2010 CODES. **THIS PERMIT DOES NOT INCLUDE EXTERIOR WORK** ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 PLAN CHECK, REMODEL 132.99 Fee summary Charged Paid Credited Due Permit Fee Total 48.62 .00 .00 48.62 Plan Check Total .00 .00 .00 .00 Other Fee Total 133.99 .00 .00 133.99 Grand Total 182.61 .00 .00 182.61 LQPERMIT Rprm� fED Bin # City of La Quinta Building 8r Safety Division AUG 2 9 201 P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 p�CITY OF LA QUI T/ BuildingPermit A lication and Tracking fgpUNIT' DE pP g VELD N Permit # eq Project Address: Z Owner's Name: e A. P. Number: 2 D� Address:. Legal Description: �Jy ' 14.1 City, ST, Z' : I If Z Contractor: C r: o Telephone: Address:Z Project Description: " ;N -f City, ST, Zip: Qi Telephone: >' tiGc J State Lie. # : City Lie. #: Arch., Engr., Designer:,J r P �S Address: City., ST, Zip: Telephone: >r> ancY Cnstrueti n type: Occupancy: State Lie. #: Project type (circle one): New Add'n Alter Repairair Demo Name of Contact Person:Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: ' Estimated Value of Project: 6—c)O APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACIUNG PERMIT FEES 3 Plan Sets Plan Check submitted Item Amount Structural Cates. 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 correction/issue Electrical Subcontactor List .001 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 S� 1ENT f�o P, y i - G Z X cp AV 01-144 CIosc s<Nk-s LA QUINTA 4(iB[7OF NGA SAFETY DEPT. w' 3 •� APPROVED t J� FOR CONSTRUCTION Bak 4i�) ref %tci ivy ` r7:p- ons Aov1 e e. �lec�n ��:/ �p urytbi)v �'o� u �e ek�.S�i ` ��✓� wo® , � r � a � 1 P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE 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 IWORTA.NTt NOTICE Tn PRnPrRIry nwtvFR Dear Property Owner An. application for :a buildingpermit has been submitted in your name listing yourself as the builder of the .property improvements specified at We are providing you with anO -Builder Acknowogment and Information Verification Forth to make you awat',e: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 buildingpermit until you have react, initialed yourunderstanding 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. Read and initial each 'statement below to signify you understand or verify d ds information. I1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" L. permit that erroneously implies 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. property. . . 2. I 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. 43. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that. I may protect if from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on ermits and contracts. .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. 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal overnment, 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. 7A'_7. I 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. 48. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be he'd liable, for any financial or personal. injuries sustained by any subsequent owner(s) that result from any latent construction defects in Ute — workmanship or materials. 9. I 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 (CSLB) at 1- 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 legal y and finaORy responsible for cons c�yon acti ity at the following address: X11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. l2. I 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 may be in -civil court. It is also important for you to understand that if an udktased Contractor or employee of that individual or firm is injured while 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 verdying whether or not those Coutmctors are property licensed and the status of tkir 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 issuiftg.the permit. Note: A copy of the property owner's dr<iver'sAM1sa, farm "WAR0014 or other veriftcadon acceptable to the agency is required to be presented when the permit is issued to ver* the pr'opG1''h' owner's signature. o I FA WJAI� 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 ACTON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize -the following persons) 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 Ager 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 b presented when the permit is issued verify the property owner's signature. Property Owner's Si Date: GovClarityTM W77929 LAGO DR, LA QUINTA,'CA Page 1 of 2 Parcel Number: 658270051 fi ll Site Address : 77929 LAGO DR, LA QUIN TA, CA 92253lip- r Owner 1: CHAPPELL, LARRY A 77929 LAGO DR, LA QUIN Owner 1 Mailing Address TA, CA 92253 Owner 2: CHAPPELL, MAXINE E Zoning : Loading...vp r Lot Size (sf) Assessor: 4,356 ■ ' r Lot Size (sfl Calculated : 4,447 Year Built : 1974 Building Area :2,201 ,Pow-- .# . Notes : 0 Results"•' fir. + • +�-_ Documents : 0 Results Permit Checks Add rh�r L' http://maps.digitalmapcentral.comlproduction/dashboard/vl_34ICity.aspx?SIK=%2fdcl%2f T197%2fb6f... 9/9/2013 GovClarityTM Page 1 of 2 http://maps.digitalmapcentral.comlproductionldashboardlvl_34ICity.aspx?SIK=%2fdcl%2f T197%2fb6f... 9/9/2013