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BWFE2016-0142Applicant: ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA, CA 92253 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 Professions Code, and my License is in full force and effect.' License Class: License No.::CONV:140528101254137829 Date: I 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 any applicant for a a permit subjects the applicant to civil penalty of not more than five hundred dollars A—A)oo)�, -I; as owner of the property, or my employees with wages as their sole compensation, will.do the work, and the structure is notintended 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 4h41, 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 4th Contractors' State License Law.). ( ,I am exempt under Sec. , B.&P.C. for this reason Date.10 / Owner./.,4� r &0Pd 4m Al 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. Q. Lender's Lender's Address: Contractor: ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA, CA 92253 Llc. No.::CONV:140528101254137829 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: Polity Number: r` 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 F T ,� Z Applic04N 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 tothe Building Official 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 actor 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 ordinances and state laws relating to building construction, and hereby authorize.representatives of this city to enter upon the above -menti ned pr perty for inspection purposes. D�ate:y� Z Signature (Applicant or Agent a VOICE (760) 777-7125 78-495 CALLE TAMPICO 0 FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 - COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT. Date: 6/27/2016 Application Number: BWFE2016-0142 Owner: Property Address: 52285 AVENIDA RUBIO ANTHONY AMATO APN: 773252014. 52285 AVENIDA RUBIO Application Description: AMATO / 51LF OF BLOCK WALL CAT REAR YARD LA QUINTA, CA 92253 Property Zoning: . Application Valuation: $1,000.00 Applicant: ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA, CA 92253 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 Professions Code, and my License is in full force and effect.' License Class: License No.::CONV:140528101254137829 Date: I 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 any applicant for a a permit subjects the applicant to civil penalty of not more than five hundred dollars A—A)oo)�, -I; as owner of the property, or my employees with wages as their sole compensation, will.do the work, and the structure is notintended 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 4h41, 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 4th Contractors' State License Law.). ( ,I am exempt under Sec. , B.&P.C. for this reason Date.10 / Owner./.,4� r &0Pd 4m Al 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. Q. Lender's Lender's Address: Contractor: ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA, CA 92253 Llc. No.::CONV:140528101254137829 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: Polity Number: r` 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 F T ,� Z Applic04N 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 tothe Building Official 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 actor 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 ordinances and state laws relating to building construction, and hereby authorize.representatives of this city to enter upon the above -menti ned pr perty for inspection purposes. D�ate:y� Z Signature (Applicant or Agent 19 Description: AMATO / 51LF OF BLOCK WALL 6' AT REAR YARD Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: UNDER REVIEW Applied: 6/27/2016 SKH APPROVED Approved: Parcel No: 773252014 Site Address: 52285 AVENIDA RUBIO LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 9 Lot: 3 Issued: UNIT 1 52285 AVENIDA RUBIO Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $1,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CONTRACTOR Details: 51LF OF 5"/6' GARDEN WALL INSIDE REAR PROPERTY LINE [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013.CALIFORNIA BUILDING CODES. CONDITIONS NAME TYPE NAME ADDRE551 CONTACTS CITY. T2 $TATE ZIP y PHONE, FAX'' EMAIL- APPLICANT ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA CA 92253 CONTRACTOR ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA CA 92253 OWNER ANTHONY AMATO 52285 AVENIDA RUBIO LA QUINTA CA 92253 Printed: Monday, June 27, 2016 10:18:38 AM 1 of 2 , SYS TEtitS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT# CHECK # METHOD PAID BY CLTD BY. WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $0.00 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $0.00 100 LF PC Total Paid for FENCE OR FREESTANDING WALL: $108.77 $0.00 • 0• 00 INSPECTIONS PARENT PROJECTS Printed: Monday, June 27, 2016 10:18:38 AM 2 of 2 MANAF CRVwsysTrms O 71 a Z Goosle ear=h L- QUINTA BUILDING & 86RFETY DEPT. APPROVE® FOR CONSTRUCTI N DA 72 BY x . vo i Bir. # Cite-:... )/ Of. U Q 1f11fd BUM1 ij, 8[ SA'iy-Mlsibn, PA: Box 1504,-78-495.61if iamplco La.Qulnta; CA 92253;-:(760) 777-7012 Building Permit App(rcatron and Tracking Sheet Permit # Project Addressi S Z:Z., . ✓�>U � ,. � S A Ownet's Natne:. ,rrr ,v A P. Number. Address S'zz.BS •N,✓,�. �8 Legal Description: City, ST, Zip: Contractor. Telephone:.?'� �. :"........ Address: Project Description:: . City, ST, Zip:' v l Telephone: P !It uOG�L . ( i9'�-�- A7 =State Lic. # : City Li, �rL U/�1� l.ocK Arch., Engr., Designer Address: City., ST, Zip: Telephone: P State Lia #:• ' 'µyz Goiistruction Type: Occupancy: Project type {circle one): New Add'n Alter Repair Demo Sq:, Ft.: # Stories: # Unity: Name of Contact Person: iQ ,V j� MO Telephone # of Contact Person: Estimated Value of Project • d APPLICANT: DO -NOT WRITE BELOW THI&LINE, # Submittal &4 -dr 'Reed ,. ,TRACKDVG PERMrr FEES Plan Sets Pian Check submitted . • Item Amount Structural Cales. Reviewed, ready for coreecdons Plan Cheek Deposit, . Truss Calcs. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up 'Contraction Flood plain plan Pians resubmitted Mechanical Grading plan 2',° Reilew, ready for correcGonsAssue Electrical Subeoutactor Ids: Called Contact Person Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Review; readyfor correctionslissae Developer Impact Fee Planning Approval Coiled Contact Person ; A LP.P. Pub: Wks. Appr Date of permit issue School Fees Total Permit Fees BUILDING`& SAFETY -DEPARTMENT 78-4957CALLE.TAMPICO (760) 777-7012 LA' QUINIA, CALIFORNIA 92'253 FAX (760).777-7011 Considering Becoming an •Owner Builder? Important information you needl-to` know BEFORE pulling your permit! The term "Owner -Builder," can mean threedifferent things;: "Owner as Worker ; "Owner as Contractor" or "Owner as Employer" Understand each has Benefits or. Risk;. and itis possible to combine them! Hiring a California Licensed :Contractor means you do, riot.personally perform.any of the comtructiori'work, the permit is not taken out in your name, you are riot personally responsible for the construction and you are not an Owner -guilder. Instead, you, become a "Customer" and California law. provides you'the benefit of protection, from poor workmanship, failure to finish the. job and -financial risk due to workerinjury. BenefiMsk: Ilij!hestBenefits and the Least amount ofRisk Owner -as -Worker is a type of Owner -Builder where you personally perform :the construction. work, the permit is taken out in your name and you are personally responsible'for the.construction management;knowledge; woikmanship, aril completion of the job. You benefit by not paying others to perform this work for you and your; risk dependsb6 your own ability'to coinplete the job successfully. Benefit/Risk: Possible Benefit with Low -Financial Risk Owner=as-Contractor is a type of Owner -Builder where. you personally actas your.own.General Contractor,. the permit istaken out in your name and you hire California licensed sub -contractors to perform portion&of the.construction work. WARNING: The benefit of protection provided "by law when you hire only' California licensed sub -contractors' can'"him to serious financial risk if you hire unlicensed contractors to perform any of the work.. Benefit/Risk Possible`Benefit and'Significani Financial.Risk Owner -as -Employer is iftype of.Owner-Buildei'-where you pay any unlicensed individual to;perform any construction work valued at more than $500.00, the permit is taken .out in your: name` and you `are personally -responsible for their employment requirements, supervision, performance, safety and welfare while on.your property. WARNING: Cost savings benefit can turn'to serious financial risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker. Benefit4bski Possible Benefit with Sienificant Financial Risk fy (Health and Safety Code Section 19827) The California Legislature declares an "urgent and statewide public interest in assuring" that contractors comply with Contractors' License Law, Business and Professions Code and Workers' Compensation Insurance requirements to ensure property owners are informed about, and protected. from the following when improving their property as Owner -Builders: Fraudulent representations - Liability for worker's injuries - Liability for material and labor costs unpaid by contractors • Licensing requirements - Employers tax liabilities Over 20,000 consumer complaints are'filed each year. Many complaints relate to owner/builder projects and include workmanship and workers' compensation issues Homeowners suffer financial harm due to defective workmanship and injured employees. Following are alarming examples of what has occurred with Owner -Builder permits: Example 1: Homeowner received insurance money to rebuild burned -down home. ■ Owner/Builder permit pulled to rebuild structure. Unlicensed contractor built substandard structure — must be torn down and replaced. ■ Estimated financial injury is $225,000. • Additional financial injury - IRS threatened to tax insurance payout if house not completed by the end of the year. Example 2: Brother-in-law had active license but fled an exemption from Workers Comp. • Owner -Builder hires brother-in-law to install a new roof. ■ .Employee falls and sustains multiple spinal and extremity fractures as well as ahead injury and remains in a coma to this day. ■ The Owner -Builder, who has sold the home, is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Example 1 Employee of contractor without Workers Comp is hired by Owner -Builder to install septic system and suffers injury that results in permanent disability.. ■ The Owner -Builder did not have a homeowner's insurance policy on the house against which to submit a claim. _ • The Owner -Builder is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Did you know — unlicensed persons frequently have the property owner obtain an "Owner -Builder" building permit which erroneously implies that the property owner is providing his or her own labor and material personally? Did you know your homeowner's insurance may not provide coverage for injuries sustained on your property by an unlicensed contractor and his/her employees? Did you know — if you are considered an "employer" under state and federal law, you must register with the state and federal government, withhold payroll taxes, provide workers compensation and disability insurance and contribute to unemployment compensation for each "employee"? Did you know - that if you fail to abide by these laws you may be subjected to serious financial risk?. OWNERS BEWARE AND CONSIDER THE RISK BEFORE ACCEPTING FULL RESPONSIBILITY FOR YOUR CONSTRUCTION PERMIT ll P.D. Box 1504 LA QUINTA;- CALIFORNIA 92247-1504 78-495 -CA-LLE.TAMPICO LA. QUINTA, CALIFORNIA 92253 PROIPERTV�_OWNT BUILDING &.SAFETY DEPARTMENT (760)777-7012 FAX (760) 777-7011 Disclosures &Forms'for Owner -Builders Applying for' Permits r n IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit.4s been submitted Zy .,, ubmi'tted in your name. lik yourself as, the builder of the property V,e, improvements -specified at a.I-A 9ZZ We are providing you with an Owner-B6ildei.;kclonbwl64iiiieAt and hiformation'Verificatibn Form to make you aware of your. responsibilities and possible risk y6umay,in6iii by havig''.this' t- di .name as the . _ perm; issue :mypur Owner-Builde'r. Wemill notIs'sitie' a'hu-iildiQ. ... .... . ii 3,66 hav'�,read initialed itiAled yourlunderstanding of each provision, signed; and returned this. form to usatour;officiah address indicated. Aii'a9 ent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. Read and initial each.'statemeni,below to signify; veiify -this information. 1. I 'understand a frequent pradtice. rt of 'unlicensed persons is to have the prope I I .. , ry owner "obtain an "Owner -Builder" building permit that erroneoiisl ' it roperty owner is providing or y implies that the r an p lief 1�& and material personally. 1, as an Owner -Builder, may be held liable and subject to serious firfancial risk for any mjunes, sustained by an unlicensed person and his or her employees while working on my property.`?MjIomeowne,'s insurance may not provide coverage f6r those injuries. I am willfully acting as an Owner -Builder and inn aw'Ai'6* of the limits of my insurance coverage for injuries to workers on my property. .AV2. I understand building permits arenotrequired to. be signed by property owners unless' they are responsible for the construction . and are not hiring a licensed Contractor -to assume.this responsibility. A3. I understand as an.­6w;ner_Builder" I. am the, responsible -party of re"on the penut. I understand that I may protect cord r myself from potential financial risk by hiring a -licensed Conti -actor and having'I ihe:peniiit filed in his or her name instead:of my -own. 144 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. 6. 1 understand if I am considered an "employer" under state and federafliwI must register with the state and federal government, withhold payroll taxes, provide .workers' compensation disability 'ability insuiranbe,-- and contribute to unemployment compensation for each "employee."' I also understand my failure',.',to abide by. these laws may su . bjec' risk. t me to.s6rious financial 7. 1 understand under California* Contractors' State License.Law,* an'. Owner -Builder who builds single-family ly residential structures cannot legally build them with the . intent to o offer them for sale, unless all work is perfo imed by licensed subcontractors and the number of structures does* not -exceed four within any calendar year, or of the work is performed under contract with a licensed general- building Contractor. .1"8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. Ii 9. I understand I 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- 800-32 1 -CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 26-410. 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: and financially responsible for proposed construction activity at the following 'address: 5-7 K v L i o G.,d 4?V;, , GA 9L2 Z 11. 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 asmell as employers. 12. 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 unlicensed Contractor or employee of that individual or firm is 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 permit. Note: A copy of the property 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. -7 Signature of property owne 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 persons) to act as my agent(s) to apply for, sign; and file the documents necessary to obtain an Owner -Builder Permif 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 ver fcation acceptable to the Agency is required to be presented when the permit is issued to verify the property owners signature. Property Owner's Signature: Date: