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08-1343 (RR)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application description Property Zoning: Application valuation: Applicant: 08-00001343 51825 AVENIDA RAMIREZ 773-165-016-4 -000000- RE-ROOF COVE RESIDENTIAL 4000 Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: VASQUEZ LUPE 51825 AVENIDA LA QUINTA, CA (760)564-4841 Contractor: Owner RAMI 922,9 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 8/06/08 ------------------------------------------------------------------------------------ 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. D� ate:wV _ „�ContractorF: - - _ I have and will maintain workers' compensation insurance, as required by Section 3700.of the Labor /Vy Ry Code, for the performance of the work for which this permit'is• issued. My workers' compensation OWNER -BUILDER DECLARATION insurance cairiei 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 .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 1 and agree that, if 1 should.become subject to the workers' compensation provisions of Section License taw (Chapter 9, (commencing wit4 Section 7600) of Division 3 of the Business and Professions Code) or \ 3700 of the Labor Code, I shall forthwith comply with those pWvisions. that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by �anyp1pp,licant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars -15500): as"owner of the property, oriny 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, anq�who does the work'himself or herself through his or her own employees, provided.that the improvements are nobintended or offered for sale. If, however, the building or improvement is sold within orie 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.) (_ 1 1, 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.). 1 1 I am exempt under Sec. B.&P.C. for this reason —�� 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 WARN114G: FAILURE TO SECURE WORKERS' COMPENSATION COVJEAAGE 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 fora 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 �^d state that the above information is correct. I agree to comply with all city and county ordinances and state laves relating to building construction, and hereby authorize representatives of this county,to egter upon the above- entioned propeyOy for inspectionku,rg ses. /y / Application Number . . . . . 08-00001343 Permit . . . RE -ROOF Additional desc . Permit Fee . . . . 30.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/02/09 Qty Unit Charge Per Extension BASE FEE 30.00 ---------------------------------------------------------------------------- Special Notes and Comments REMOVING EXISTING ONE LAYER OF HOT MOPPED ROOFING MATERIALS / ADDING ONE PLY TORCH DOWN ROOFING Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total .00 .00 .00 .00 Grand Total 30.00 .00 .00 30.00 LQPERMIT r 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA,; 92253 TELEPHONE.(760) 777-7012 FAX•(760):777-7011 OWNER/BUIL'DER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.' For your protection you shouldbe aware that as "Owner/Builder" you are the responsible party of record on such a permit. Building permits are not required to be.signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than'yourself, you may protect yourself from possible liability if that person applies; for.the proper permit. in -his or her name. Contractors are required. by law. to be licensed and, bonded by the State of California and to have a business license from the City or County.•They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your:benefit-and protection: . If,you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $20000 or more for -,the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the State and Federal. Government as an employer and you are subject to several obligations; include State and Federal -income tax withholding, federal' social security taxes, worker's compensation insurance, *disability insurance costs and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information .about yourobligations under Federal Law,- contact the Internal Revenue Service (and, if you wish, the 1; J.S. Small'Business Administration). For 'more -specific information about your obligations under -State Law, contact the Department of Benefit Payments and the Division ofIndustrial Accidents. If. the structure' is intended for sale,, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,'without'a licensed contractor'or subcontractor, only under limited conditions. A frequent practice of:unlicensed persons professing to be contractors,°is :to secure an "Owner/Builder" building permit, erroneously implying that the property:owner'•is providing'•'his or her own, labor and material personally. Building permits are: not -required to be signed 1iy property owners unless they are performing their own work personally. Information about licensed,:contractors maybe obtained by contacting the Contractors' State License Board in your community or at 1020 N. Street; Sacramento,. California 95814. Please complete and return the enclosed owner -builder verification'form so that we can confirm that you are aware of these matters. The building'permit will not be' issued until the verification is returned. Very truly yours, CITY OF LA QUINTA 's DEPT. OF BUILDING AND SAFETY 78-495A Calle Tampico La Quinta, CA 92253 (760) 777-7012 FAX: (760) 777-7011 O E S SIGNATU A E' s 0"901 LJ LJ -,AJI gym, �E2 PROPERTY ADDRESS PERMIT NUMBER(S) Bin # City of :La •Quin a Building at Safety Division P.O Box 1'504,: 78.495 Calle TampicoP La Quina ta, CA 92253 - (760).,777-7012 Building_:Per t Application and'Tracking Sheet it # Project Address: 1 ZS Owner s Name: LUe-v19wr A. P. Number: .Address:.. S6?V M: I'd Legal Description:City, Contractor: 19 ST, Zip: L,4G!V l A/ f;q- ! as 3 Telephone; J ;� - yg ell r " Address: Project Description: °ems _ I✓ e S n City, ST, zip: t Telephone: �5R - .. ' 'City Lic. o o �r A,9LS State Lic. # : Arch", Engr., Designer: U l Address: City, ST, Zip: Telephone: State Lic. #: Name of Contact Person: Construction Type: 0 °,GYMS Occu anc P y: _,project type (circle one): , New Add'n Alter Repair Demo Sq. Ft.:. a # Stories: P Funits: Telephone # of Contact Person: Estimated Value of Project: t7 DO po APPLICANT: DO NOT WRITE BELOW.THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets -Plaq Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit . Truss Calcs. Called Contact Person Plan Check Balance Energy Cales. Plans picked,up Construction Flood plain plan 'Plans resubmitted Mechanical Grading plan2"d Review, ready for corn"ectionsfissue Electrical SubcontactorList Called Contact Person. Plumbing Grant Deed Plans picked up, S.M.I. H.O.A. Approval Plans resubmitted "' Grading IN HOUSE:- ''" Iteview ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees