14-0317 (BLCK)P.O.- BOX 1504' _
78-495 CALLE TAMPICO
LA QUINTA,' CALIFORNIA 92253
Application Number: 14-00000317
.Property Address: 78940 SONESTA WY
APN: 604-151-028-39 -23269 -
Application description: WALL/FENCE
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 1500
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
ANDREW SCORTEANU
1 78940 SONESTA WAY LA QUINTA; CA 92253
(760) 668-2900
MAR 2.
Contractor:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/25/14,
Applicant: Architect or Engineer: Cp1'Y CSF LA QIlI, Owner
E13dMCiE DEPT
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensedWsand
sions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Profe my License is in full force and effect.
'License Class:o.:
Do L_ r. Contracto
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
a y a licant for permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
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
twoimprove forthe 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.).
) 1 am exempt under Sec. , B.&P.C. for this reason
. Z
Date: S- 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...).
Lender's Name: /
0 1 1
Lender's Address
LQPERMIT
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, I'!sf�)IJI will mply with those provisions.
bate: J z / 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 (5100,000). 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 shalldefend, 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 cou y toe ter upon the above-mentioned property f�o�inspec n•purposes.
Date: , * ` Xignature (Applicant or Agent): _
Application Number . . .
14-00000317
Permit WALL/FENCE
PERMIT 2013
Additional desc .
Permit Fee . . . . 47.19
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 1500
Expiration Date 9/21/14
Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC
WALL, FIRST 100 LF
47.19
Special Notes and Comments
90LF OF 6' WOOD FENCE AT NORTH.SIDE
OF
YARD (INSIDE PROPERTY LINE) AND
(1) GATE
AT SOUTH SIDE OF PROPERTY. 2013
CALIFORNIA BUILDING CODES.
-----------------------------,-----------------------------------------------
Other Fees . . . . . . . . ..
BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, WALLS
60.06
Fee summary Charged
Paid Credited
Due
Permit Fee Total 47.19
.00 .00
47.19
Plan Check Total .00
.00 .00
.00
Other Fee Total 61.06
.00 .00
61.06
Grand Total 108.25
.00 .00
108.25
LQPERMIT
Iain #
City of La Quinta
Building &r Safety Division
P.O.. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
14 l
Project Address:
Owner's Name: �Yel v M,
A. P. Number:
Address: 9q L-10 Say •1-44 Wa
Legal Description:
City, ST, Zip: ( Qk 11 1 7� e/a'WS-3
Contractor:
Tele hone: 0 —
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Address:
Project Description:
City, ST, Zip:
I
I Y15h, GTPi S .( de -
Telephone:
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State Lic. # : City Lic. #;
Arch., Engr., Designer:
1 _.
I Y) 5 (l• el
Address:..
r " n -�o pardeC
City., ST, Zip:
Telephone:
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Construction Ty e: Occupancy:
Project
Proja circle one): New Add'n Alter Repair Demo
J hP ) P
State Lic.
Name of Contact Person:
Sq. Ft.:
#Stories:
#Units:
Telephone #,of Contact Person:
q
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 Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
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 correctionslssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees.
Total Permit Fees
• < •. • - .fes ` . ' 1. - ♦ ' r t t• F .+. ! - _ ; _ •, _ ..
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CITY-OFlJa QUINTA
Bl1iLB,'NG & $A-F_ElY DEPT.
• i �, APPROVE®: - --
y" FOR CONSTRUCTION
DAT ' BY f' / , r•
_ _ � _ .. � y" - .• _ - ,_ ., a .,, r —..1 �lAA�11JJ 1MA1/'11 L�•1/�1AA7 .
ot,"
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504 Bu . iLDING & SAFETY DEPARTMENT
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
PROPERTY, OWNER'S PACKAGE
(760) 717-701.2
FAX (760) 777-7011
Ditclosures & Form's for Owner -Builders Applying for Construction Permits
1AVQATAAV:N0_110E TO PRO OWNER
- U E R. TV
Dear'Property Owner.
Azi.6pplicationlbra buildin permit -has beensubmittedin your asthe ,builder of the .property
iwpFGv6rnmts specified at q0 - 3o Yip Yi
We are pi;oviding yowwath an Owner -Builder Acknowledgment-a6d IfifdrinationNerificationForret to make you awawof your
respowibilitiesand possible risk you may incur by haiving diis-per6it-isswd1h. your66 -
name as
Owner=Builiter. We Will not issuea buRding-permit untit,you-havei-ead; initialed your. "derstioding of each -provision,
signed, and returned this form to us at our official address -indicated. An agent of the owner cannot execute this - noti-e
unless you, the property owner, obtain the prior approval of the permitting authority.
DIRECUONS. Readandinitial each statement below 6 mgntfy
iyou'i6ider:s� iii verifyth4s i;�or?netion.'
I understand a frequent practice of unlicensed persons is to have the property owner obtainan "Ow ner-Buil&e'b �1-
Iding.Perrnit that erroneously implies that the property owner is providing his or her own laborana material personally. 1, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed perzon
and his or her employees while working on my property. My homeowner's insurance may not . provide coverage - for these
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 -
OW -7 2.1 understand building permits are not required to be signed by property owner's unless they are responsible forthe
construction and are not hiring 3, licensed Contractor to assume this respoz?sibility..
Olin '3 .understand
as. an "Owner -.Builder'' I am the. responsible party of.recordoa the. permiL.1 understand that I may pretect
from potential financial risk by'hiring a licensed Contractor and having the permit filed in his e rlir nam instead of my
own.
4. 1 understand Contractors are required by law to be licensed and bonded in California and tolist their license numbers on
permits and contracts.
p
fr_5.1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the totalralue'
of my construction is at least five hundred dollars ($500), including labor and materials, I may be -considered an "employer"
unr state and federal law.
I understand if I am considered
an "employee' under state-, and federal taw, I must register with the state and federal
,tovernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemplo)ment
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 single-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 the work is performed
under contract with 'a licensed general building Contractor.
8. I understand as an Owner -Builder if I sell the property for which this permit is issued, Itmay be held liable, for any
financial or personal. Wjuries sustainedby any subsequent owner(s) that result from any latent construction defects in the
woriomanship or materials.
k9. I understand I may obtain more information regarding my obligations as an "employer" from the internal ILevenue
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 (CSL B) at 1-
800-321-CSLB (2752) or www.csib.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
p legally d financ'�1ty �nsible for proposed cons c activity at the following address:
- - $ SOn_s4c, - --- z..(, a -
l 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
ap licable laws and requirements that govem Owner-Builderi as well as employers.
12. I agree to notify the issuer of this fora 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 lic=w,. the Contractors' State License Board may be unable to
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 wilicensed 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 whWw or not those Contractors are properly licensed and the status of tkw workers'
compensation insurance coverage.
Before it building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issaiag,the..per=JL Nota: A copy of *e -property owner's driver'stfoerrsej fa+m irk or
other verification acceptable do the agency is required to be presented when the permit is roved to va* the property
owner's signature.
Z
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, I hereby authorize
the following person(s) to act as my agents) to�apply for, sign, and Ede'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
information and certify its accuracy. Note:'A copy ofthe 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.
Property Owner's Signature: Date: