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12-1197 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T4&t aF4w ` Application Number: 12-00001197 Property Address: 53060 AVENIDA RAMIREZ APN: 774-052-063-22 -000000- Application description: WALL/FENCE Property Zoning: -, COVE RESIDENTIAL AuullcdLIUll VdIUaiiUll. 1250 Applicant: . Architect or Engineer: �1i� til �N BUILDING & SAFETY 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 Professionals Code, and my License is in full force and effect. License Class: License No.: Date: Contractor: OWNER -BUILDER DECLARATION I 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 ($500)•: (_ 1 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 he or she did not build or improve for the purpose of sale.). (_ 1 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 contractor(s) licensed pursuant to the Contractors' State License Lew.). ' (_) I am exempt under Sec. , B.&P.C. for this reason \Date: ��' -/ / ��, Owner: r/ 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 Owner: RON JOE JACQUES 53060 AVENIDA RAMIREZ LA QUINTA, CA 92253 ---------------- Contractor: I� Owner I VOICE (760) 77 70-i�," FAX (760) 777- INSPECTIONS (760) 777-7153 Date: 10/09/12 OCT o 9. 2012 lU. OF (A QUINTA 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 Policy Number yI 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 Co , I shall ith comply with those provisions. Date: %0'-r•�i�Applicant: .i• WARNING: FAILURE TO SECU ORKERS OMP ATION 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 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 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 county to enter upon the above-mentioned propertyr nsp do rposes. Date: %0�---Signature (Applicant or Agentl: C LQPERMIT Application Number, 12-00001197 Permit WALL/FENCE PERMIT, Additional desc . Permit Fee 31.00 Plan Check Fee .00 Issue Date '. Valuation 1250 Expiration Date 4/07/13 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 2.0000 HND BLDG 501-2,000 16.00 ---------------------------------------------------------------------------- Special Notes and Comments REAR WOOD FENCE REPLACEMENT 516" X 50 L.F. BASE CONCRETE, WOOD FRAME, COVER ON BOTH SIDES. -----------------_------------------------- - Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) - 1.00 Fee summary Charged Paid Credited Due Permit Fee Total 31.00 00 .00 31.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 32.00 .00 .00 32.00 P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 BUILDING SAFETY DEPARTMENT 78-495 CALLE.TAMPICO (760)777-7012 LA Qt!INTA, CALIFORNIA 92253 FAX .(760) 777-701 1 Considering Becoming an Owner -Builder? Important information you need to know BEFORE pulling your permit! The term "Owner -Builder" can mean three different thins: "Owner as Worker", "Owner as Contractor". or "Owner as Employer" Understand each has Benefits or Risk, and it is possible to combine them! Hiring a California Licensed Contractor means you do not personally perform any of the conswcton work, thepermit is not taken out in your name, you are not personally responsible for the construction and you are not an Owner -Builder. 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 worker injury; Benefit/Risk: Highest Benefits and the Least amount of Risk 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, workmanship, and completion of the job. You benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully. Benefit/Risk: Possible Benefit'with Low Financial Risk Owner -as -Contractor is a type of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in yow name and you hire California licensed sub -contractors' to perform portions of the construction work. WARNI M1 : The benefit of protection provided by law when you hire only. California licensed sub -contractors can turn to ...enous financial risk if you hue unlicensed contractors to perform'any of the work. Benefit/Risk: Possible Benefit and Sie ifcant Financial Risk Owner -as -Employer is a type of Owner -Builder where you pay any unlicensed individual to perforn any construction work valued at more than $500.00, the permit is taken out in your name and you are personally responsible for the 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 tares or provide workers compensation insurance for each worker. Benefit/Risk: Possible Benefit with Significant Financial Risl� a P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 BUILDING SAFETY DEPARTMENT 78-495 CALLE.TAMPICO (760)777-7012 LA Qt!INTA, CALIFORNIA 92253 FAX .(760) 777-701 1 Considering Becoming an Owner -Builder? Important information you need to know BEFORE pulling your permit! The term "Owner -Builder" can mean three different thins: "Owner as Worker", "Owner as Contractor". or "Owner as Employer" Understand each has Benefits or Risk, and it is possible to combine them! Hiring a California Licensed Contractor means you do not personally perform any of the conswcton work, thepermit is not taken out in your name, you are not personally responsible for the construction and you are not an Owner -Builder. 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 worker injury; Benefit/Risk: Highest Benefits and the Least amount of Risk 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, workmanship, and completion of the job. You benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully. Benefit/Risk: Possible Benefit'with Low Financial Risk Owner -as -Contractor is a type of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in yow name and you hire California licensed sub -contractors' to perform portions of the construction work. WARNI M1 : The benefit of protection provided by law when you hire only. California licensed sub -contractors can turn to ...enous financial risk if you hue unlicensed contractors to perform'any of the work. Benefit/Risk: Possible Benefit and Sie ifcant Financial Risk Owner -as -Employer is a type of Owner -Builder where you pay any unlicensed individual to perforn any construction work valued at more than $500.00, the permit is taken out in your name and you are personally responsible for the 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 tares or provide workers compensation insurance for each worker. Benefit/Risk: Possible Benefit with Significant Financial Risl� (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 1 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 filed 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 a head 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 3: 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 8. 1 understand as an Owner -Builder if 1 sell the property for which this permit is issued, i may be held liable for any 1dcial or personal. sustained b an subsequent owner(s).that result from an latent construction defects in the P � Y .: Y �1 Y . workmanship or materials. I understand 1 may obtain more information regarding my obligations as an "employer" from the Inter�al Revenue �/tekce, the United States Small Business Administration, the California Department of Benefit Pa.+meots, and the California Division of Industrial Accidents.:1 also understand.l may contact the California Contractors' State Lecense Board (CSLB) at I- 800-321-CSLB_(2752) or www.cslb.ca.gov for more information about licensed contractors. 0. 1 am aware ofand consent to an Owner -Builder building permit.applied for in my name, and understand that I am the party legally and financially able .`for proposed construction activity at the following address: O�P7�`� itYVI�IRCCZ: i A .L•ir - -- #I: I agree that, as the party legally and financially responsible for .this proposed. construction activity,.l will abide by all alica ble Paws and requirements that govern Owner -Builders as well as employers. 12. 1 agree to notify the issuer of this form immediately of any additions; deletions, or changesto any of the information I a 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.assiEtyou 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 :vrorking on your property; you may be held liable for damages. If you obtain a permit. as Owner -Builder and wish to hire.Contraetors, 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 isnaft. the. permit. Note: A copy of the property owner's driver's ikense# faun' netanitmstian; or other verification acceptable to the ageincy is. required to be presented when the, permit is issued to. verify the. property owner's signature. 'Signature of property owner 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, l hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. , ,,,, ,, , ,q,�, Scope of Construction Project (or Description of Work): �- 1w""`."' Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No -7X17 o v 1 declare under penalty of perjury that 1 am the propert ownarider for the address listed above aI personally. filled out -the above information and certify its accuracy. Note: A copy of the wner's driver's license, form notarL-ation, or other verification acceptable to the agency is required- tobe p� enyd w en the permit is issued to verify the property owner's signature - Property • MR/2% i�j . 0 P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IWOK -IY(r iVOTICF 10 PROPERTY OWNER Dear Property Owner. An. application for a building permit has been sub 'tied ' name listing ye If the builder of the property improvements specified at S3_,GniL�L Q/yL�e Z� We are.p�oviding you with an Owner -guilder Acl,-- gment-and Information Verification orm 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 yewhave 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- OVYM,FVS ACI N WI;EpE 4ENTAND VERIFICATION OP MORNA flIN D1RECUOIVS. Read and initial each statement-be#Wyle signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" ding 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 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. c�2. I understand building permits are not required to be signed by property owners unless they are responsible for the truction and are not hiring a licensed Contractor to assume this responsibility - A&3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. 1 understand that 1 may protect self from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my . own. a4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on e lts and contracts. 05. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value 0f y 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 -employee' under state and federal law, i must register with the state and federal 446 - eminent, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." 1 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 single-family residential ctures 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. -� 4CA-) cc, id CITY OF LA QUINTA BUILDING & SAFETY DEPT. - APPROVE® . FOR QO STRUCT ZA pct � �� �,• �Z� j .3 DAT BY . ' # City. of La Quinta Blrtidirlg 8t Safety Division Permit # P.O. Box 1504,78-495 Calte Tampico fj [a.Quinta, CA 92253 -:(760) 777-7012 Building Permit' Application and Tracking Sheet Project Address: _G? "Vf. /�eL Owner's Name:. — A P. Number. Address:- EJ— 3��hiAe PAmj' e zi i Legal Description: i City, ST, Zip: a Ul Cao. Ci � S �Contractor: Telephone: 77- iS MO a says Address: Project Description: City, ST, Zip: to fr j Telephone: ;ME � State Lie. # : City Lie'. M. Arch., Engr., Designer. i Address: City., ST, Zip: Telephone: 1 Construction type: . Occupancy: State Lic. #: ; w�� y..� Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Kc&� Sq. Ft.: #Stories: #Units: Telephone # of Contact Person: , w O O P 7. �7 © (� Estimated Value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERMIT FEES - Plan Sets Plan Check submitted Item Amount Structural Cales Reviewed, ready for corrections Plan Check Depcsit. . Truss Caics. Called Contact Person Pian Check Bala -act Title 24 Calcs. Plans picked up Construction' Elood lain plan -Plans-resubmitted —-Mecharilcal - --- Grading plan 2� Review, ready for correctionvissue Electrical " — -- -Subeoutactor List - --- - -- -- Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resabmitted Grading IN HOUSE: -Developer Review; ready for corrections/issue Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr ' Date of permit issue School Fees Total Permit F -es