Loading...
12-0211 (RER)77 G 'D� F - _ :: 78=495: CAI,LE,TA_IvIP.ICO LA QUINTA, CALIFORNIA 92253 4 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/06/12 Application Number: 12-00000211 Owner: Property Address: 51600 AVENIDA RAMIREZ HUDDY KENNETH W APN: 773-131-006-19 -000000- 41500 TRINITY CIR' Application description: REMODEL - RESIDENTIAL INDIO, CA 92201 Property Zoning: COVE RESIDENTIAL Application -valuation: 2500 Contractor: Applicant: Architect or Engineer: 'Owner F APR 9 2011 Q4t l�Ar C"OF 4urMtA --- ---- F�1MCE DFPr, --------_------------------------- - LICENSED CONTRACTOR'S DECLARATION .WORKER'S COMPENSATION DECLARATION .1 hereby affirm under penalty of perjury that I -am licensed under Provisionsof Chapter 9 (commencing with . I hereby affirm under penalty of perjury one of the following declarations: - Section 70001 of Division 3 of the.8usiness 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 insurance carrier and policy number are: -. 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-.S,'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 mannei 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 w rk rs''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,1 sha o hwith ply, it those provisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by e / • hundred dollars 00).: . any applicant for a'permit.subjects the applicant to.a civil penalty of not more than five.hundred ($5 0 Date: 2 App.'licant: ' - (_ 1 I, as ownerof'tlie property, -or my employees with wages as their sole compensation, will do the work, and - c .• - . the structure is not intended, or offered for sale,(Sec. 7044, Business and Professions Code: The - WARNI G: FAILURE TO SECURE. QRS' COMPENSATION COVERAGE'IS-UNLAWFUL, AND SHALL Contractors' State License Law does not apply to'an owner of property who builds or improves thereon, ,SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or. herself through his or herown employees, provided that the DOLLARS ($100,0001'• 1N ADDITION TO THE COST OF COMPENSATION, DAMAGES. AS PROVIDED FOR IN improvements are not intended or offered for sale., If, however; the building -or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST,AND ATTORNEY'S FEES. one year of completion,;the owner -builder will have the burden of proving that he or she did not build or improve'forthe purpose of sale.). (_ 1 1, as owner of the property, am exclusively, contracting withJicensed 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.). ' (_) I am exempt under Sec: B.&P.C. for this reason A Date: Owner: L_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: LQPERMIT 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 employeesfor 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 cnncon, and a eby th rize representatives of this c u ty o enter upon the above-mentionedpropertyr in purp Date: Z Signature (Applicant or Agent(: LQPERMIT Application Number . . . . . 12-00000211 ------ Structure Information ENCLOSURE FOR REAR PATIO ----- Other struct info . . . . CODE EDITION --------------------------- 2010 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 54.00 Plan Check'Fee 35.10 Issue Date Valuation 2500 Expiration Date .. 10/03/12 Qty Unit Charge Per Extension- xtension-FEE FEE 45.00 1'.00 9. 0000- THOU BLDG 2, 001-25,000 9.00 Permit . _ . . ELECT -. ADD/ALT/REM. , Additional desc . Permit Fee 18.7.5 Plan Check Fee 4.69- Issue Date Valuation 0 Expiration Date 10/03/12 Qty Unit Charge.- Per: Extension BASE 15.'00 ,FEE;. 5.00 -.75:00 PER ELEC -DEVICE/FIXTURE ,1ST 20- ... 3.75 Special `Notes".and Comments° " ENCLOSURE PER CRC SECTION-AH102 AT. EXISTING `REAR :,PAT_ `THIS PERMIT DOES NOT.INCLUDE.ADDITIONAL"CONDITIONED SQUARE. -FOOTAGE OR ALLOW ROOM,-. TO. -BE USED F.OR_SLEEPINGPURPOSES. 2010. CALIFORNIA BUILDING: CODES :° - ; April. 6';.2,P12,1':05:27 PM"AORTEdA: -----------------_--------------------------------------------- Other Fees . . .. . . . ., BLDG STDS ADMIN (8B1473) -- - 2.00 ` Fee summary- Charged Paid Credited -----72.7.5 Due Permit Fee Total .00 .00 72.75 Plan Check Total 39..79 ..00; .00-.. _.,,. _ Other'Fee'Total2:00 .00 .00 2.00 Grand Total, 114.54 00 .00,. 114.54. LQPERMIT Bin #. :.�/Of 'Permit # t� ProjectAddtess5 . 6 La Cali�id.:: :: Buffdhtg Br Safety:. Division.}:.:.. .: P.O.. Box.7504,:7B-495:Caffe. Tampfco . La.Qtlfnta, CA 92253=:(760) 7777012. Building:Permit Application and Tracking Sheet cceZ owner's Name:. n r, ;er A. P. Number. Address:.. 5l oo ve- c, c, re_ Legal Description: "City,:ST, Zip: u; a` . Contractor. Telephone: 7 — /— 3 3 Address: Project Description:. City, ST. Zip: c�G i Telephoner State Lia # : City Lia fi: Ard , Eng., Designer Address: City., ST. Zip: . Telephone: Stade Lia #:Project Name of Contact Person: �r Construction Type:. Oocupancy: type (circle one): New Add'n Alter Demo Sq. Ft: # Stories: S Telephone # of Contact Person: (,p - ( l — / 3 3 Estimated Valine of Project .: a 5 Q APPLICANT: DO NOT WRITE BELOW THIS. UNE # Submittal Plan Sets Re9,d ° 11tec'd TRACKIIHG PERIYII'P.FM Plan Check submitted Item Amount Strgctaial Cales. ,Reviewed, ready for corrections Plan Check Deposit. . 'hues Calm Called `Contact Person Qi Plan Check Balance _ Mde 24 Cales. Plans picked up Construction Flood plain plan Pians resubmitted..Mechanical Giading plan . 2' Review. ready for correcti Electrical Snbcontattor ListCalled Contact Person Plumbing Grant Deed Plana pidced;ap SALL B.O.A. Approval Plans r6abmttted Grading IN HOUS.E:- ''`Review; ready for correcdoaslissue Developer Impact Fee Planaing Approval. Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit•issue,, School Fees Total Permit Fees 3�I • is ,arc.. P.O. BOx 1504; LA QUINTA, CALIF.ORNiA 92247-1504 BUILDING & SAFETY DEPARTMENT .78-495 CALLE TAMP16D (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 PROPERTY OWNEWSTACRAGE Disclosures & Forms, for Ov 'r.-Blu lders Appl fair Construction Pelts rtQ�C� 'm Q�t�1�sR'I'i� O�IcIN.�� Dear Friveaty Ownei. application for a building ; permit has 68en�^tsubmitted your ease lisE ,yo�ccself as of the proty specafed at _ 66 /t. 4e � A t�Fe are pmviftg you , an Ov_yaer-)wilder Ad= tedgmcnt-and Wetmatien `!afficatim Fom to mall, ym a :of your er?d P=46[e rim you may intuu by; ving tlxisp •t aed'io yia4vam as .the Owner -Builder. we iiwnat isscte a fi �ldl .emit ung yaa kale read; �..patrr. aade€ctaadin� of oadt` n, signed, and'returned this form to U's'at ottr .of©eik addrm .iadleated, an agem of the owner cannot elteau% fiki$s -00tice unless you, the property owner, obtain the prior approval ofthe pecmiWng authority., II I7U1VS Real d a#W int" eack suutMWgtbe v" o sig y you aridierstaeed orvft* dais Elm 1 I understand a €requent practice of unlicensed persons is to have the' property owner obtain an "Owner-Buddee' ding�t that .p.erroneously Implies that the property owner is providing his. or -her own tabor and peasorrnity. I, as an .Owner -Builder, may be held -liable and subject to serious financial risk -for. any izk i es sustained by an unlicensed person. and his or her employees while working on my ptope ty. Uy homeowner's insurance may not providse coveme, for those injuries. fain willfully actirrg as ac(Owner-13uildesr a>tti am aware o€ th,e limits. of my insurance coverage for iDjuries to worken on sty property. _2. I understand building .puts are not required to 'be signed by propedy owners unless they are re3poasible for th astruetion and are not hiringa licensed Contractor to assume this, brlrty- 3:-I understand >Is an "E)vi�iix Builder" j am .the responsible. party of record on.the permit. I understand ftt t may prote iffrotn tential � .' . 3'� Po financial risk by hirurg a licensed Contractor.and having the permit filed in his or her name inst+omd of in own. 4. I understand Contractors are required by taw to be licensed and bonded in California and to list their Brew numbers J�iats and.contracts. I understand if I eaMploy or otherwise engage any persons, other than California licensed Contractors, and the total vi om�y. construction is at least five hundred dollars i " ($500), mck(du(g labor and matenals, I may be considered an emplo'. under state and federal law. 6. 1 understand if I am considered an,!employer" ov �l Y'� under state an+d �deral taw,'l must register with the staff. and fa t, vs�thhold pay(nt1 taxes, provide worla s' compensation disability insurance, and contribute to un amploy, compensation for each "employee." i al risk so understand, my failure to abide by these laws may subject me to serious Fina 7. I understand under California Contractors' StateLicense Law an Owner -Builder who builds single-family msid tures cannot legally build. them with the .intent to, offer them for sale, unless all work is performed by tic subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is perf under contract with a licensed general building Contractor. t8. I understand as an Owner -Builder if I sell the property for which this perunt is issued,.1 may be held liable for any . cial•or personalir(juries tuafafined by.any subsequent" owaer(s) that result from any latent construction defects in the workmanstup.or materirik ... I understand I may obtain.more information regarding my obligations as an "employee' -1-4.1 froth the fuRetml iFenu® Service, the United States Small Busiams Administration, the California Department of Benefit Payments, and California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSM at 1- 800-321-CSLB (2752) or www.cslb.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 pW legally and financially responsible for proposed construction activity at the following address: Iagree that, as the Party legally and futamially responsible for this proposed construction activity, l will abide by all IpLpl le laws and requirements that govern O-Buildets as well as employers. 12.1 agree to notify the issuer of this fmm immediately of any aidideuns, dddiom, of obis AMY of thin b"nation I rovided on this form.. Licensed contractors are regulated by laws designed to protect the public. It you► 00mmct with someone who does not have a twease, the Canuaators' State Lioeasc Board maybe uoabie to tit you wib any dntuaaiaI loss You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors malt bo inv" collet. It is also important for you to tatdatasand that if oat Mawased Cbuttac for W tvloyee of that individual or &M is try Wad Whik wodang on your Property; you may be Acid li for dwAgm If you obtaina permit as Ownw-Budder and Wi* to. biro CAo*tots, � will be � fer valrying v or not those Ganem are pmpe* and the status of droll Workrss' codon insux;awe coverage. Before a building permit cera be kmed, dds form must be completed and signed by the propertp owt►er and retained to the agency respondble for i and ft 4wVer=tL Note: A calf of dc:: ptwguty oW,rer's dWvcrVJ4w9Vqfi4M XOWOR6114 Of other ver#ka Ubn aWqiA*k to dna ap ncy is e+eg Ire pr+asead when tla0 pVMt& is Lusted to t w MvpEeM owner's skmature . Signatim of property owner Date Note: 77se following Authorization Form is required to be completed by the property owner catty when daaignatin an agent of the property owner to appy fora construction permit for the Owner -Builder- . &U-MgItI77 ADON OF AGENT TO ACT ON ]PROUR'k� t�@VN SIMMALF B Excluding -the Notice to Property Owner, the execution of which I understand is my personal twPORSibAWY, I "Y aumm the folkwina pervou(s) to act as my Wat(tt) to Vply for, sign, and file the documents aeocssezy to obuin. an Owm-Buildt Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: _ Tel No Addrew of Authorized Agent: I declare under penalty of perjurythat I am the property owner for the address listed above and I personally filled our the information and certify its accuracy. Note: A copy of the owner's driver's license, f wm notarization, or other v V"tio, 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: 101-02A% CITY OF LA QUINTA BUILDING & SAFETY DEPT APPROVED FOR CONSTRUCTION DATE "Y -Q—, kd A*W &4"M 05 0.444 4p - 6 -.- Wo 47-1 u rig- A.�,G>LA:ZE. w 1 rw 4 x 4' p°` 5 oz1=•a)e4G tn o ®s im CrJ, �i►.yo�u Wo 47-1 u rig- A.�,G>LA:ZE. w 1 rw 4 x 4' p°` 5 oz1=•a)e4G CITY OF LA QUINTA BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION t c I.DATE BY O p ,• b n ,O �O 1 Z° 1 J Ids .� {l `Y�y�� � n r `"'e �� ���h �.!.�'�;I 'A��lf`'•� ,�a+�N h���..,�; C ��'S'fa �' I �t ,: ajR'f % � -.'. �,"Y` � `. - "''�r.��yl' �,L SK/P�Ie4r�}5 1.L�j �'w"r '•F iY�u.�� �. ail'.r j�SCyy �.�lr,.t:�`fi'����.�. i� .�::1'.. - �.�•�• 900 �/ ta. '- ,, l MR,, IAt1i ,71 h Y Pte,n gy�+��i� -011. tide' ;' 4'Fy=Y•iCK.YL`r. t:Sn .�'> Li°Tl.:a� 6