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BPLB2016-0083y VOICE (760) 777-7125 78-495 CALLE TAMP, ICO ; D -92253 FAX (760) 777-7011 LA QUINTA, CALIFORNIA COMMUNITY DEVELOPMENT DEPARTMENT INSPECTI NS (760) 777-7153 BUILDING PERMIT 1;; 6/2/2019 ac Application Number; BPLB2016-0083 Owner: a Property Address: 52523 AVENIDA RAMIREZ STEVE PFANNKUCHE C=am' �� p APN: 773291025 52523 AVENIDA RAMIREZ !i— z Application Description: PFANNKUCHE RESIDENCE / SEWER HOOK UP LA QUINTA, CA 92253 .--I C3 Property Zoning: Nc7 S o Application Valuation: $1,000.00 Qt O o � U Applicant: Contractor: z STEVE PFANNKUCHE OWNER / BUILDER 52523 AVENIDA RAMIREZ LA QUINTA, CA 92253 U LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: License No.: 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 ($5 ).- s 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 not build or improve for the purpose of sale.). s'owner of the property, am exclusively contracting with licensed contractors ` t corfstruct 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 ors' State License Law.). exempt under Sec. B.&P.C. for this reason &te:-(%�2— 6 Owner_. ! •�d.� .Gr yr ��!%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 Lender's Llc. No.: 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 :)f 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 perfornance.of the work for which this permit is issued. rkers' compensation insurance carrier and polity number are: Carrier: icy Number: certify that in the performance of tae work for which this permit is issued, I shall not employ any person in any manner so a3 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 comply with those provisions. o. Date: �Z —1 Applicant:`12/,GFs-1 �(%C 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 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 performcd 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 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-mentioned property for inspection purposes. Date: Signature (Applicant or Agent) FINANCIAL INFORMATION. 4n:DESCRIPTIONM y- ACCOUNTS -rQTYAMOUNT F `.PAID A PAI D.DATE' BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 �e PAID aMETHOD��°RECEIPT#�`�'�` CHECK# �'� CLT.D BY% r } Total Paid for BUILDING. STANDARDS ADMINISTRATION BSA: $1.00 $0.00 = P �•DESCRIPTION ", k .t tom. ,» x < ACCOUNT i' QN w, AMOUNTm _ PAID PAID DATEx PERMIT ISSUANCE 101-0000-42404 0 `$91.85 $0.00 PAID BY , -,`� Y z ' .` ✓METHOD :° RECEIPT L # °CHEEK #k CLTD BYE*' Total Paid for PERMIT ISSUANCE: $91.85 $0.00 Y ,DESCRIPTION r-x� „., ,< s ACCOUNT= ?, QTY AMOUNT „ °yPA'ID PAID=DATE';' BUILDING SEWER 101-0000-42401 0 .$12.09 $0.00 PAID. BY x� { �IFT# CHCK CLTD BY.>', ` �DE56RIPTION .� y FYI rhW;rACCOUNT� : QTY �gMOUNT� .'i.�.r `PAID Y'PAID`DATE' BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 PAID BY � :,w x F3 w METHOD "Vv v x ` RECEIPT#.�,4 a `- CHECK # `s CLTD - - Total Paid for PLUMBING FEES: $24.18 $0.00 TOTALS:00 Description: PFANNKUCHE RESIDENCE / SEWER HOOK UP 77 Type: PLUMBING Subtype: Status: UNDER REVIEW Applied: 6/2/2016 MFA " Approved: 6/2/2016 MFA Parcel No: 773291025 Site Address: 52523 AVENIDA RAMIREZ LA QUINTA,CA,92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 154 Lot: 1 Issued: UNIT 16 < Ni4METYP.E � NAMES :. - 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 APPLICANT Details: SEWER HOOK UP AND SEPTIC ABANDONMENT PER 2013 CALIFORNIA BUILDING CODE STEVE PFANNKUCHE FINANCIAL INFORMATION Printed: Thursday, June 02, 2016 4:29:19 PM 1 of 2 r CBFWSYSTEMS 77 CONDITIONS CONTACTS < Ni4METYP.E � NAMES :. - e A- DRESSl. "CITY ESTATE - •: ZIP. '. 1 X> MAIL «- n,. e :: .... v • >., �.,„,s .<er°PHONE,�';IFAE` s ..- x_. .. APPLICANT STEVE PFANNKUCHE 52523 AVENIDA LA QUINTA CA 92253 (760)989-5597 RAMIREZ CONTRACTOR OWNER / BUILDER (760)989-5597 OWNER STEVE PFANNKUCHE 52523 AVENIDA LA QUINTA CA 92253 (760)989-5597 ' RAMIREZ FINANCIAL INFORMATION Printed: Thursday, June 02, 2016 4:29:19 PM 1 of 2 r CBFWSYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID; • PAID DATE RECEIPT# CHECK# a METHOD PAID BY CLTD" :x. BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 BUILDING SEWER PC • 101-0000-42600 0 $12.09 $0.00 Total Paid for PLUMBING FEES: $24.18 $0:00 INSPECT IC s PARENT PRO I, REVIEW TYPE I `REVIEWER " I SENT DATEf I DUE DATE I .'R DATEED I STATUS' I REMARKS I s NOTES Printed: Thursday, June 02, 2016 4:29:19 PM 2 of SYS rEiNS 1 09 Bin # City of La Quinta .. Building 8i Safety Division - . 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application, and Tracking Sheet Permit #= Project Address: ' r ,�vL l`i� -owner's Name: �G A. P. Number: dress: 5 5 2 de awl Ve -z— Legal Description:=City, ST, Zip: t] [ 2 S^ Contractor. eleP hon e. Address: xBoject Description: City, .ST, Zip: D D A - TelTelephone: Po . h State Lie. # : City Lie. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: hone: n tru -Cos c t' � n Type: o Occc ane P Y: to e S t Lie. #: Project type (circle one): . New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: # Stories: Units: Telephone Telephone # of Contact Person: so&timated Value of Project: / APPLICANT: DO NOT WRITE. BELOW THIS LINE # Submittal Req'd Rec'd TRACKING 9ERMIT FEES Plan Sets Plan Check submitted' Item Amount Structural Calcs.. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Baiance Title 24 Calcs. Plans. picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd 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 HOUSE.- '"! Review, ready for corrections/.issue Developer Im fact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees 0 .NA`TCOACHELLA VALLEY WATER DISTRICT Q�5i7R� t P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 6/1/2016 SUBJECT: SANTA CARMELITA, 52523 AVENIDA RAMIREZ, LA QUINTA, LOT 1, LID 684546 ** SCC ONLY** STEPHEN PFANNKUCHE Project: 16-7228 52523 AVENIDA RAMIREZ Project Date: 6/1/2016 Amount Due: $4,851.00 LA QUINTA, CA 92253 GEO: 06-06-12-1 Planner: RUBEN MONTIEL TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK SUBJECT:SANTA CARMELITA, 52523 AVENIDA RAMIREZ, LA QUINTA, LOT 1, LID 684546 " SCC ONLY** . w COACHELLA VALLEY WATER DISTRICT r,,* P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel l 1.00 FF SCC -COLLECTION $2,415:00 $2,415.00 1.00 FJ SCC -TREATMENT $2,436.001 $2,436.00 $4,851.00 PAID $Z'�- c Development Services Department JUN' 0-1 2016 = , ,Coachella Valley Water District 75-515 Hovley Lane East Palm Desert, CA 92211 ti SUBJECT:SANTA CARMELITA, 52523 AVENIDA RAMIREZ, LA QUINTA, LOT 1, LID 684546 " SCC ONLY** . w COACHELLA VALLEY WATER DISTRICT r,,* P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel l Tw�p 4 4., QW&M P.D. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7.012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An applicationfor a building peffi it has been. submitted in your name listing yourself as the bailder of .the property improvements specified at a Y; r��E iii 7 We are providing you with an -0 wner-Builder Acknowledgment and Information Verification Form to nmke 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 understand: ng 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 signer you understand or verify this information. _4I 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, may be held liable and -subject to serious financial risk for any injuries sustained b} an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not proviie 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. understand building permits are not required to be signed by property owners unless they are responsible for the constriction and are not hiring a licensed Contractor to assume this responsibility. -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 hr name instead of my own. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits.and contracts. - �I understand if I employ or otherwise engage any persons, other than California licensed Contractors and the to6 tal value of my construction is at least frve.hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law.. Z4K I understand if I am considered an "employer" under state and federal law, 1 -must register with the state and federal. government, 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 one to.senous financial risk. 7. I understand under California Contractors' State License Law, an -Owner -Builder who build 7 - s single.family residential strictures 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. 0understand 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. ='I understand I may obtain more information regarding my, obligations as an "employer" from the Internal Revenue eice, 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.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 party Dally: and finan ially res onsible or proposed construction activity at the following address: S Z 5` Z 7 ver, �� , f✓� `z L 4 ��?�114 Gl 2 -z 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all a plicable laws and requirements that govern Owner -Builders asmell as employers. 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. _ Signature of property owner Date: f' — 2 -- Note: The following Authorization Form is required lobe 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 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): 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 informmmatiori 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 be presented when the permit is issued to verify the property owners signature. Property Owner's Signature: Date: CITY OF LA QUINTA SUB-CONTRACTOR LIST JOB ADDRESS _3 14Veo,XJi,_ ) evm,✓,_-2PERMIT NUMBEP1` ""((-'L-i2E'3OWNER -BUILDER � � --N�• �� --� This form shall be posted on the job with the Building Inspection Card- at all times in a conspicuous place. Only person$ appearing on this list or their employees are authorized to work on"this job. Any changes to this list must be approved by the Building Division prior to commencement of work. • Failure to comply will result in,a stoppage of work and/or the voidance. of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. t Trarin / ('lacc�firation _ ...._ ..................................................State Contractor Contractor..s.Lic :<.:;:.:::::..;:.:::•;:.;:;:.;:..:::::::::.;;:;.;::;:.::.;:.:.;:.;:.;;.;;.;;.:;.;:.;:.Workers ..........................................:.:::...::::::::: <: .Come ion Insu .a . .. nsat ..::.::.:..:.:..........:..::......:...p...................:..................................... rt Business.. Y:..............................:......... rCompany Name Clas 'fi aU ExP Date Cairier Name PolicY Number•onLicenseNumbei Exp. Date License Number Exp. Date . A C-81 (xxxxxx) xx xx/x e. . State Fund CalCoriP) FormatVariese. xx/xx xz1B x xxx) xx xx xx )x X. <EA RT H W O.>:.;:.:;;.;!:.;;;:.;:.;:.;;!:.>:.;;:.:.;:.;;:.; ' t 11 ••� /"T �J Gl � ✓ � T g_ Q , 0 1 1 � Gxi =5 ><>< >> STRUCT STEEL {C I:.;..:;, MA..:....... R..::L1.: c. t >L'ATHP:LAS.T .:R.: .:::::.::::1::.::. w ROOF:.:?::..::w�. SHEET IVIET IL (C;>;;_;>;;:;, 21 LNSU:LATLO:f�[ SEWAG DISP [C 42: C .R.NETS.:I::::::..1 N G (C.1.. T. X. LAND:S`C'AR.ING`(C 27)