10-0204 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
,7A5p_li6_ati&'n_ Nilirnlie;7. 10-00000204
(Property Address: 46615 CAMEO PALMS DR
APN: 643-181-006-43 -2117
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2250
c&ty/. 4 4 Q"
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
VOSSLER ERNIE
46615 CAMEO PALMS DRIVE
LA QUINTA, CA 92253
---Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/15/10
ID
JUN 2 9 2010
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LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 fcommencing 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.
Date: Contractor:
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
OWNER -BUILDER DECLARATION
carrier and policy number are,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier Policy Number
following reason JSec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
.1 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
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3 7 0 of the Labor Code, I shal fo Wit complywitDithose provisions
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
'permit
/late:,,,
any applicant for a subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
Applicant:
1, 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
WAR G.. F 'LURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the
DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 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.).
I I am exempt under Sec. , B.&P.C. for this reas n
Vlate:
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 JSec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
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.
I . 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 representati s
Da:hi pon the above-mentioned property foor i5spe ti urposes.
e'- iunature (Applicant or Agent):
Application Number . . . . . 10-00000204
------ Structure Information 30INCH PARAPET AT EXISTING PATIO COVER -----
Other struct info . . . . . CODE EDITION 2007CBC
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT INV FEE
Additional desc
Permit Fee . . . . 108.00 Plan Check
Fee
35.10
Issue Date . . . . Valuation
. . .
. 2250
Ex 12/12/10
,piration Date . .
Qty Unit Charge Per
Extension
BASE FEE
90.00
1 -. 00 18. 0000 -THOU -BLDG 2, 001-25, 000
'18." 00
----------------------------------------- 7 ----------------------------------
Special Notes and Comments
30INCH PARAPET AT EXISTING PATIO COVER
-FACADE/VB/RES-3/CLASS A -FR [ENGINEERED)
2007 CALIFORNIA BUILDING CODE.
***INVESTIGATION FEE ASSESSED PER 2007
CALIFORNIA BUILDING CODE APPENDIX
CHAPTER 1 §108.4 FOR WORK COMMENCING
BEFORE PERMIT ISSUANCE***
CODE CASE: 10-0628 [JMI
June 15, 2010 10:56:38 AM AORTEGA
------------------------------------------ 7 ---------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN -(SB1473)
1.00
STRONG MOTION (SMI)
- RES
.50
Fee summary Charged Paid Credited
---------- ---------- ----------
----------
Due
-----------------
Permit Fee Total 108.00 .00
.00
108.00
Plan Check Total 35.10 .00
.00
35.10
Other Fee Total 1.50 .00
.00
1.50
Grand Total 144.60 .00
.00
144.60
LQPERMIT
Din #
40
City of La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
t> -- aLrIA
Project Address: Owner 7sNn,.
A. P. Number: Address: 4-6 -6 f
Legal Description: 17 'City, ST, Zip: A
6�
Contracto e Telephone:
F1
Address: Project Description:
City, ST, Zip: OZ7-u 9 ek,
Telephone:
. . . . . . . . . . . . . . . . . . . . ..... .......
A.
State Lic. # City Lic. #,
Aj1EjFrr-, Designer: �Z>t5T
10AY 2010
Address: -7 7-6 ?,Z t!5W�,iTPI e-1
City., ST, Zip: v-%-v)r (.a
J*
X AJ J
Telephone: -7 71476 Z,6 -Z Constructio Type: Occupancy:
n
R.
State Lic. Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: P:�:v Sq. Ft.:
# Stori es:
# Units:
Telephone# of Contact Person: 7,5-5�6 Estimated Value of Project: - 015�1
* z 7 -
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Reqld
Rec!d
TRACKING PERMIT FEES
A
Plan Sets
Plan Check submitted 'Ji 1) Item
Amount
Structural CaIcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Cates.
Called Contact Person Plan Check Balance.
Tide 24 CaIcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2" Review, ready for co 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 correctionstissue Developer Impact Fee
Planning Approval
Called Contact Person I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
FTotal
Permit Fees
�11-51quo- P&P -(-M 1we
A?,
I
Comments: Structural content is approvable.
Th is Mate ri a I S e n t f o r
Your Files
Your Review
El Checking
Other: M
By: John W. Thompson
Rancho Mirage Office: 0 (760) 834-8860
Other E]
Z Per Your Request
E] Approval
E] At the request of:
71-780 San Jacinto Dr. Ste. E2, Ranch.o Mirage,. Ca. 92270 pK (760� 834-8860 fax (760) 834-8861
Letter of Transmittal
To:
City of La Quinta Today's Date: 6-10-10
78-495 Calle Tampico City Due Date: 6-11-10
La Quinta, CA 92253 Project Address: 46-615 Cameo Palms
Attn:
Phillip Plan Check #: 10-204
Submittal: El 1st El 4 th
1Z 2 nd El 5 th
El 3 rd 171 Other:
We are forwarding: By Messenger El By Mail (Fed Ex or UPS)
F1 Your Pickup
Includes: # Of Descriptions: Includes: # Of
Descriptions:
Copies: Copies:
171
Structural Plans 1
Revised Structural Plans
Fl
Struct. Calcs 1
Revised Struct. Calcs
El
Truss Calculations El
Revised Truss Calcs
El
Soils Report El
Revised Soils Report
Structural Comment List El
Approved Structural Plans
1 Redlined Structural Plans El
Approved Structural Calcs
1 Redlined Structural Calcs El
Approved Truss Calcs
El
Redlined Truss Calcs El
Approved Soils Report
171
Redlined Soils Reports El
Other:
Comments: Structural content is approvable.
Th is Mate ri a I S e n t f o r
Your Files
Your Review
El Checking
Other: M
By: John W. Thompson
Rancho Mirage Office: 0 (760) 834-8860
Other E]
Z Per Your Request
E] Approval
E] At the request of:
CITY-OFLAQUINTkSUB-CONTR&C OR LIST
S M, 1556,E
JOB ADDRES �!Mew 9-alMS 3VERMIT NUMBER * 10-,ae4 OWNEFL le, * BUILDER -
][his form �hall be posted on the job with the Building lnsoection'Card- at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to worl
on this job.. Any -changes to this list 'Must be approved by the Building, Division prior to comme . ncement of work. Failure to comply will result in a stoppage of work and/or the voidanc(
of building permit. For each applicable trade, all information requ sted below must be completed by apklicant. "On File" is not an acceptabld response.
Trade I Classification :Cor
.#3
Cdntractor, *.:,. ".!I A
. ... . Matt.Oonuii6t Lic
CERAMIC TIUE (C-54)
CABINETS M-6)
FEAPING (CA3)
L
LANDSCAPING JC�-27)
POOL (C-53)
C � 1 .1
Company Name
Classification
License Number
Exp. Date
Carrier Name
Poricy Number
Exp. Date
License Number
Exp, Date
(e.g. A. B, C-8)
(xxxxxx)
ixx/xxixx)
(e.g. State Fund, CalComp)
(Format Varies)
(xxlxxlxx)
fxxxx)
(xxlxxlxx)
tARTHWOM (PA 21
-30
FRAMING'AC-5)
A,
STWCT ...T.
P�.UMBING'(C-36j'
45
LATH ".-$TER.(C�35)
DRYWALL (C-9)...:'.
-HYAC (C-;0
ELE TRICAL
C
RQQRNG
:6HEIFUMETAL I
IFLOqPJNG 19-1,
-GLAZING (047i�.:::,
INSULATIOW(C4V
sEWAdtDisp; .-41),.:'
CERAMIC TIUE (C-54)
CABINETS M-6)
FEAPING (CA3)
L
LANDSCAPING JC�-27)
POOL (C-53)
C � 1 .1
P.O. BOX 1504
LA QUINTA,' CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAvETY DEPARTMENT
PROPERTY OWNER'S PACKAGIE'i
(7-6-0) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner-BuRders Applying for Construction Permits
WNUAly L�l KoncEmo mum ovaqm
Dear Property Owner.
b f
Aii. application for a building be�p submitted yourw4f as 72
permit has
improvements specified at
Wv are providing yoi Owner-Bui Atknow6igmeni and Inibrantion-Verill 9 =make yymm avim of your
msponsibilities; and possibte risk.
You may mcur by having dds, permit owed W,your name as he.
Owner -Budder. We Will not law a building -permit. until you have read', hildaW your. undersWiding Of eath; PMAS1011,
signed, and returned this form to us at -our official address indlca�t7e& An agent of the owner cannot execute diismotice
unless you, the property owner, obtain the prior approval of the, pernutting authority-
0NWW-S.AC1Q4QWLE0CMWW AND YEAMAJIMN 46F HWMU.WN�
DfiWCYWNS Read wW mutal each statemew betaw rw signify you w&do3tand or vero dw informa"m
und�rsisztd - a 5requed't pracbc'e of ;iahceeasad persons is to have the property owner obtain an "Ov, ner-Builder"
building permit that erroneously implies that the property owner is providing his or her own labor and material Pmmak, 1, as
an Owner -Builder, may be held liable and subjecA to serious financial risk for any injuries sustained by an unlicensed person
and his or her employm while worhng on my property.'my homeowner,s insurance may not provide coveMe for those
injuries. I am willMy acting as an Owner -Budder and am aware of the limits of my insurmce-coveragc for injuries to workers
on my property -
Z2. I understand building permits are not required to be signed by property Owners unless they are responsible for the
construction and are not liking a licensed ContracAor to assume this responsibility.
"I understand as an "Own responsible party of rmord on the permit. I understand t I may protect
er-Buildee' I am the
myself from potential fimmcial risk by hiring a licensed Contractor and having the permit filed in his or her name instmd of my
own.
"4. understand Contractors are required by law to be licensed and bonded in California and to list their license numbers On
permits and contracts.
V15. 1 understand if I employ or.otherwise engage any persons, other than California licensed Contractors, and the total valul
of my construction is -at least five -hundred. dollars ($500), including labor and materials, I may be considered an "employer'
tm�,d"erte and federal taw.
6. 1 understand if I am considered an ,employee, under state and federal taw, i must register with the state and feder
,government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployme
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financi
risk
�71 understand under California Contractors' S . tate License Law, an Owner -Budder who builds single-family residew
structures cannot legally build them with the intent'to -offer them for sale, unless all work is performed by licew
subcontractors and the number of structures does not exceed four within any calendar year, or all Of the work is Perf0m
under contract with a licensed general building Contractor.
L/8. I understand as an Owner -Builder if I sell the property for which this permi ssued,
t is i I maybe held a for any
Or PMWILRI. 4uries sustaked by.any subsequent owneF(s) that result from any latent construction Mocts, in the
worlananship or materials.
Jz6"'iunderstand I may obtain more information regarding my obligations as an "employee' from the Inte1*21 R"euU10
Service, the United States Small Business Administration, the California Department of Benefit PaymeM. and tht CalifDrilia
Division of I�dustrial Accidents. I also understand I may contact the California Contractors' state Ucense Board (CSL13) at I-
V7('0-' SLB (2752) or www.c*sIb.c&gov for more information about licensed contractors.
0' I am aware of and consent to an Own . er-Builder building permit applied for mi my name understand that I am the
party legally and the following address:
__V I agme that, as the party legally and finaxicially responsible for this proposed construction activity, I will abide by all
applicable liws and requirements that govern Owder-Builders as well ag employers.
12
agree to notify the issuer of this form immediately of any additiens� deletions, or cba%w w *ny of die infornmion I
have provided on this form Licensed contractors are regulated by taws designed to protect the public. if you contract with
Somean C who do" not have a, Imense.. the Contractors, State lAcense Board my be unable to assM you with any finaMW loss
you may sustain as a result of a complaint Your only remedy against unlicensed Contractors way be in -civil cGUIL It is also
iMPOrtaUt for You tounderstand that -if amutiliconsod Contrwtor of employce of that in�lojrfirm is 00W wWe w0d1ing
on Your Proper%'You may be Wit h" &r damages. If you obtain a permit as'owner-Builft and wish to hire Conuvolors,
You wdl bC' MWOMI& for verififing wtedm or not those Contractom are propedy licensed and dre sMM Of dMir wo&ew
COMFCCISati011 infUrIMe 00venge.
Before a building permit can be issued, this form must be completed and siVed by the properq oymer and returned tO
the agency responsible for kwuhM 9ka.Vw=kL NoW .4 copy of (Ite-pvVerty o�vtw`s di*,w-%LAWmv,
, Jam ""*0*14 Or
other verifkadon accepabk to die agatey is reqwlrod to be prmeryeif when dke pemde is immi to vO* the PmPeTtY
owner's signature. If 11,
Signature of propurty owner
M
Note: Thefollowing Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to applyfor a construction permitfor the Owner -Builder.
AUTHORUATION OF AGENT TO ACT ON PROPERTY OWN
UR!SAF—KHAI�F
Excluding the Notice to Property Owner, the exemtion of which I understand. is my personal responsibility, I htmbY auth�
the following person(s) to act as my agelit(s) to apply for, sign, and file the documents necmary to obtain m Owau-B"Ader
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 he abo'
information and ceifify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other ver�ftcafion
acceptable to the agency is requiredlo. be presiutted when the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date: