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14-0572 (SPIN)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 14-00000572 Property Address: 53380 AVENIDA RAMIREZ APN: 774=082-007-18 -000000- Application description: SPECIAL INSPECTION Property Zoning: COVE RESIDENTIAL Application valuation: 0 Applicant: Architect or Engineer: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury tha m licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of thl B "ss and Professionals Code, and my License is in full force and effect. Lic n a License No.: AV Dat 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 - th i or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by y a plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 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.). 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 Law.). am exempt under Sec. , B.&P.C: for this reason MS`S-/S/ Date: Owner: 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.I. Lender's Name: _ Lender's Address: LQPE%MIT Owner: SCOTT SIENKIEWICH 53380 •AVEN'IDA RAMIREZ LA QUINTA, CA 92253 (253)266-8438 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/05/14 ----------------------------------------------- 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 _ 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 Code,1 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 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 a Ae to camp ith all city and county ordinances and state laws relating to building c struction, and by au ize.repr ematives of this _ y to enter upon the e -mentioned property fo i pection p Date: �J �� �"� Signature (Applicant or Agent Application Number . . . . . 14-00000572 Permit SPECIAL INSPECTION Additional desc . . Permit Fee . . . . 71.50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date 11/01/14 Qty Unit Charge Per Extension 1.00 71.5000 EA MISC SPECIAL INSPECTION 71.50 ------------- -------------------------------------------------------------- Speciai Notes and Comments SPECIAL INSPECTION - SPECIAL INSPECTION TO CASE #14-0622 [KM]. 2013 CALIFORNIA BUILDING CODES. Fee summary Charged Paid Credited ---------------------------------------- Due ----------------- Permit Fee Total 71.50 .00 .00 71.50 Plan Check Total .00 .00 .00 .00 Grand Total 71.50 .00 .00 71.50 LQPERMIT i Bin # City Of La Quinta Building 8i• Safetybivision P.O. Box 1504, 78495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit �17 Project Address: .1 33 � — � Owner's Name:/ A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Telephone 52 O266 — jS7 Address: Project Description: S�rs4/w (���� TO City, ST, Zip: �`t • aDZ'Z ElL.A'v► r— . Telephone: - State Lic. # : City Lie. #: Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ?. Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: Sq. Ft.: #Stories: # Units: Telephone # of Contact. Person: Estimated Value of Project: APPLICANT: DO NOT'WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING P3RMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Bal: nce Title 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 HOUSE:- '"' Review, ready for correctionshssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. . Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees b RECORD/NG REQUESTED BY AND WHEN RECORDED MAIL TO: Veronica J. Montecino, City Clerk CITY OF LA QUANTA ,P.O: Box 1504 . La Quinta, Ca. 92247-1504 Exempt Recording Fees per Govemment Code Sections 6103 and 27383 NOTICE OFSUBSTANDARD- BUILDING AND/OR PROPERTY Notice is hereby given to.all persons, pursuant to the provisions of the La Quinta Municipal Code, as adopted by Title11 of the La Quinta Municipal Code that the property describedbelow has been in:-Pected and found to be substandard as defined in Chapter 11.72 of the above code and the owner of record lave been or will be notified. Violations consist of: LQMC 11.72.030 (N) Public Nuisance — Property Out of Harmony LQMC .11.72.030(R) Public Nuisance — Landscape Maintenaice LQMC 11.72.030(D) Public Nuisance —Broken Windows, Doors, and Gates LQMC 11'.72.030.(W) Public Nuisance - Motor Vehicle Parts LQMC 9.50.090 (P -A 1) .. Irrigation System LQMC 9.50.090.(A-12) 'Maintained Landscaping This' document will be expunged .only when the City Building Official finds that the public nuisance has been abated and either that such abatement has been accomplished -at no cost to the City or that any such costs have been repaid to the City or that such costs have been placed upon the tax rolls as a specialassessment pursuant to the Government Code. Detailed information regarding this Declaration, Code Violations, or any costs or fees that must be paid the City, may be obtained by contacting the Building 8 Safety Department, Code Compliance Division LEGAL DESCRIPTION LOT 18 IN BLOCK 224, SANTA CARMELITAAT VALE LA QUINTA, UNIT NO.21, AS PER MAP ON FILE 1N. .BOOK 20, PAGE 22 OF MAPS,. RECORDS OF RIVERSIDE COUNTY, CALIFORNIA - Owners of Record: . Lori Hare -Clark - Area: 020-020 Situs: 53380 Avenida Ramirez APN #: 774-082007 By: DATE: June 14, 2011 - City of a Quinta George Munoz, Code Compliance_ Officer NOTICE OF SUBSTANDARD: BUILDING OR PROPERTY 53380 Avenida Ramirez Exempt" Recording Fees per. Government' Code Sections 6103 and 27383 State of California City. of La Quinta County of Riverside On June 14, 2011, before me, Pam Nieto, Notary Public personally appeared George Munoz, who proved tome on the basis of satisfactory evidence, to be the person whose name is subscribed to within said instrumentand acknowledged to be that he/she executed the same in his/her authorized capacity, and that by his/her signature en the instrument the person or the entity upon behalf of which the person acted, executed the. instrument. -I certify under PENALTY OF PERJURY under the IaWs of the State of California that the foregoing paragraph is true and correct: WITNESS my hand and official seas ' PAR1ELk MM �+ Con616110 111$34806 Notary Publk • CANfoWa '.L It ;�-- • ' Riveatde CouMlr . L : Signature:. M comm. Expires May 2, 2015 . Notary Public . :. PAMEUI NIE ' Commission i 19306 Notary Public • Catifemia a Rivaaide County : ME Comm. Elres Ma 2.201