BPAT2016-0016Z 1.
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BPAT2016-0016
Property Address: 52320 AVENIDA RAMIREZ
APN:• 773262004
Application Description: VALDEZ / PATIO
Property Zoning:
Application Valuation: $450.00-
Applicant:
450.00
Applicant:
JOSE VALDEZ
52320 AVENIDA RAMIREZ
LA QUINTA, CA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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:140528101254115165
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 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
permit subjects the applicant to a civil penalty of not more than five hundred dollars
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
h or she did not build or improve for the purpose of sale.).
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
th C ntractors' State License Law.).
am exempt under Sec. _ . B.&P.C. for this reason
Date: �( `� Owner-
CONSTRUCTION
wnerCONSTRUCTION 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:
Owner:
JOSE W
ACE (760 ,
FAX -t760),;'
P'INSPACTICIP1(7,60);L!l,o
-`-ITY1--0_F_LAU NTAi
OMft� l INffYDEVEI nPAAPhITnci
52320 AVENIDA RAMIREZ
LA QUINTA, CA 92.- 53
Contractor:
JOSE VALDEZ
52320 AVENIDA RAMIREZ
LA QUINTA, CA 92253
(760)771-3027
Llc. No.::CONV:140528101254115165
016
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' conpensation 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 Number: _
I, certify that in the performance of Me 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 37D0 of the Labor Code, I shall forthwith
comply with those provisions.
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'N SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the 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 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 applicaboh 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 sta:e 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 representat:ves of this city to enter upon the
above-mentioned property for inspection purposes.
-
Date: Signature -(Applicant cr-Age
FINANCIAL INFORMATION.
s DESCRIPTIONS 3, ACCOUNT QTY AMOUNTS z+ PAID
, ,PAID_DATE
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $1.00 4/21/16
PAID:BY
'YMETHOD ' RECEIPT #, # ¢ — CLTD BY
.,
• , , s ,CHECK - x
JOSE VALDEZ
CASH R14968. RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00
ESCRIPTION
� ACCOUNT �'` `
` QTY
i• AMOUNTPAID
s;
s s z.
r�
PAID DATE
1, _
,?
x
,
PATIO COVER, STD, OPEN
101-0000-42404
0
$97.17
.$97.17
4/21/16
Y PAID BYE,
METHOD e ' ;
RECEIPT #
;•F CHECK #
CLTD BYE
f> r'*•`f - of
JOSE VALDEZ
CASH
R14968
RSE
DESCRIPTIONQ
:ACCOUNT,'
QTY@ANIOUNT�
'',PAID
PAID.DATEF
PATIO COVER, STD, OPEN PC
101-0000-42600
0
$95.72
$95.72
4/21/16
'�
PAID BYE r x
4", �METkIOD
y't
x t
`RECEIPT #
} CHECK #
CLTD BY
JOSE VALDEZ
CASH
R14968
RSE
Total Paid for PATIO COVER/ COVERED PORCH/ LATTICE: $192.89 $192.89 t
-ACCOUNT.,rQTY''
AMOUNTS -:4
PAID
AID. DATE!
_ -
SMI - RESIDENTIAL
101-0000-20308
0
$0.50
$0.50
4/21/16
PAID BY'Le
METHOD k i f.
RECEI(?T #
}CHECK #
CLTD BY
�_.
is
JOSE VALDEZ
CASH
R14968
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.50 $0.50
TOTALS:•
Description: VALDEZ / PATIO
• • •
Type: PATIO COVER
Subtype:. CITY STANDARD/PRE-
Status: APPROVED
Applied: 3/31/2016 RSE
ON •DATE T COMPLETION DATE:
' " ' vACT16N.
ENGINEERED - OPEN
.CHRONOLOGY
Approved: 4/20/2016 JJO
Parcel No: 773262004 Site Address: 52320 AVENIDA RAMIREZ LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA
VALE LA QUINTA Block: 82
Lot: 19
Issued:
UNIT 10
3/31/2016
Lot Sq Ft: 0 R'
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $450.00
Occupancy Type:
Construction Type:
Expired:.
No. Buildings: 0
No. Stories: 0
No. Unites: 0
Details: ADD NEW PATIO COVER AT ENTRY PER CONV. LIGHT FRAMED CONSTRUCTION 602 CRC CODES.
.. , ,:: ADDITION -.�_"
.-
AL SITES
.'
20 µ
Printed: Thursday, April 21, 2016 4:16:16 PM 1 of 3
- SYSTBti1S t
• • •
TYPE
STAFF NAMES
ON •DATE T COMPLETION DATE:
' " ' vACT16N.
"NOTES
.CHRONOLOGY
$�
PLAN CHECK SUBMITTAL
RAMSES SEVILLA
3/31/2016
3/31/2016
RECEIVED
-
CALLED ANGEL TO INFORM HIM THE PLANS ARE READY FOR
TELEPHONE CALL
JIM JOHNSON
4/7/2016
4/7/2016
CORRECTIONS
CALLED ANGEL GERERDO TO INFORM HI THE PLANS ARE
TELEPHONE CALL
JIM JOHNSON
4/20/2016
4/20/2016
READY TO ISSUE
CONDITIONS
CONTACTS
,rte. � a.F �. -
7. �p p.: •" "' S i va..'w^e._
NAME:TYPE 'NAME °. ADDRESSI A CITY STATES ZIP PHONE FAX # EMAIL tt }
,�
+.
APPLICANT
JOSE VALDEZ
52320 AVENIDA
'LA QUINTA CA
92253 (760)771-3027
RAMIREZ
Printed: Thursday, April 21, 2016 4:16:16 PM 1 of 3
- SYSTBti1S t
Printed: Thursday, April 21, 2016 4:16:16 PM 2 of 3'
' srsrcnns
CONTACTS
NAME TYPE NAME'
ADDRE551'
CITY '� STATE ZIP
PHONE ' FAX EMAIL '<
.
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RM;;•. . E...c,Ay .\, ! K R5 cn
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CONTRACTOR
JOSE VALDEZ
52320. AVENIDA
LA OUINTA CA
92253
(760)771-3027
RAMIREZ
OWNER
JOSE VALDEZ
52320 AVENIDA
LA QUINTA CA
92253
(760)771-3027
RAMIREZ
FINANCIAL
INFORMATION
r
,
"Y.. .�.. � ° a....j gym:{
s
.
DESCRIPTION,;
¢
��� �s XCOUNT =� ,�:.QTY
w MP Iya� w
,,.AMOUNT � A b
P I i41 IP
A 0 D E RECE T#
" H K # ,., M TH £. .w ICLTD'..
-CHE E .OD PA D BY vii
<,
s.
BSAS SB1473 FEE
101-0000-20306 0
$1,00
$1.00
4/21/16
R14968
CASH JOSE VALDEZ
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$1.00
BSA:
PATIO COVER, STD,
101-0000-42404
0
$97.17
$97.17
4/21/16
R14968
CASH
JOSE VALDEZ
RSE
OPEN
PATIO COVER, STD,
101-0000-42600
0
$95.72
$95.72
4/21/16
R14968
CASH
JOSE VALDEZ
RSE
.OPEN PC
Total Paid for PATIO COVER / COVERED PORCH /LATTICE:'
$192.89
$192.89
SMI • RESIDENTIAL
101-0000-20308
0
$0.50
$0.50
4/21/16
R14968
CASH
JOSE VALDEZ
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI:
$0.50
$0.50
$194.39
$194.39
INSPECTIONS
PARENT PROJECTS
' RETURNED -
'r
REVIEWS
;: 'STATUS`" REMARKS
r
REVIEW TYPE'.
REVIEWER ; SENT DATE' DUE DATE
-
,h
DATE
r s NOTES
*.,
•
1ST BLDG NS (2 WK)
JIM JOHNSON
3/31/2016 4/7/2016 4/7/2016
REVISIONS REQUIRED
2ND BLDG NS (1
JIM JOHNSON
4/13/2016 4/20/2016
4/20/2016
APPROVED
WK)
Printed: Thursday, April 21, 2016 4:16:16 PM 2 of 3'
' srsrcnns
7
BOND
ATTACHMENTS
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;'::i"v"Y ... -... rn...... . .::� ed"�'F �... p � v.::. ...?Ac")' .. q 'P�,A. a^'"� .'.^^� "'Alf,
Attachment T. e: � DESCRIPTION " PATHNAME °SU,BDIR '-ETRAKIT',9NABLED:
.:.C.REATED • - ;E„ ,OWNER _. A .
52-320 AVENIDA
52-320 AVENIDA
DOG
4/7/2016
JIM JOHNSON
,
0
RAMIREZ.docx
RAMIREZ.docx
RESPON ESE TO
RESPONESE TO
DOC
4/20/2016
JIM JOHNSON'
CORRECTIONS
CORRECTIONS
0
BRES2016-0016.pdf
BRES2016-0016.pdf
2016-02-0311.00.50
2016-02-0311.00.50
IMAGE
4/4/2016
KEVIN MEREDITH
o
HDR.jpg
HDR:jpg
IMAGE
4/4/2016
KEVIN MEREDITH.
2016-03-04 10.19.52.jpg
2016-03-0410.19.52.jpg
0
Bin #
City of La Quinta
Building 8t Safety Division
Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
b 1 b Building Permit Application and Tracking Sheet
Permit #78-495
Zd�
Project Address: 2 —300 tioer Rqt-,• (R—Gz
.0 Name:
A. P. Number:
Address:/
�-32 lot r
Legal Description:
City, ST, Zip: yl �' 2 Z S 7
Contractor:
T ele hone• 2
P O
Address: S 2 -32p
Project Description:
City, ST, Zip: 225 '3
//���
{�t/nno.
Telephone: 2
D
.
State Lic. # :
City Lie.
Arch., Engr., Designer:
Address: PV
City., ST, Zip:
Telephone:
.
Construction T Occu acc
Type: P Y:
State Lic. #
Project type a cit w (circle one • New Add'n Le
A r ReA air Demo
_ 0....... TZ--.....
Name of Contact Person: A)rJ (�V
Sq. Ft.: ' 2
# Stories:
# Units:
Telephone # of Contact Person:%(� —1 6 2z
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan'Sets
Plan 'Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Depos#
Truss Cates.
Called Contact Person
Plan Check Balance
Titte 24 Calcs.
Plans picked up'
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN IiOUSE:-
'"! 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,
.ti
Total Permit Fees
z
P.D. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Constructi.:)n Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the bLilder of the property
improvements specified at
We are providing you with an Owner -Builder Acknowledgment and Information Verification 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 you have read, initialed your understanding 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:
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this informatior..
:JV L I understand a frequent practice of unlicensed persons is to have the property owner obtair. an "Owner -Builder"
building permit that erroneously implies that the property. owner is providing his or her own labor and material personally. I, as
an Owner -Builder, maybe 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.
r
2. I. understand building permits are not required to be signed by property owners unless they aze responsible for the
construction and are•not hiring a licensed Contractor to assume this responsibility.
J"J 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or hei 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
permits and contracts.
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)i including labor and materials, I may be considered an ".employer"
under state and federal law.
-I'V 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance; and contrib-ite to unemployment
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 sirgle-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 tle work is performed
under contract with a.licensed general building Contractor.
�J 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 cons miction defects in the
,workmanship or materials.
9. I understand.I may obtain more information regarding my obligations as an "employer" frorr_ 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-
80/0-321-CSLB (2752) or www.cslb-ca.gov.for more information about licensed contractors.
V 10. I 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:_
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 as.well as employers.
V 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 eo verify the property
owner's signature.
Signature of property own` L��!1 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 ACTON PROPERTY OWNER'S BEFALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibilitj, I hereby authorize
the following person(s) 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):0V.14- 17o
Project Location or Address: 2— 20
Name of Authorized Agent:
Tel No.
Address of Authorized Agent:
I declare under penaltyof 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 oiler verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owners signature.
Property Owner's Signature:: Dater