12-0519 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Lr—f2-00000519 `r
Property Address:
' 51770 AVENIDA VELASCO
APN:
773-174-001-1 -000000-
Application description: PLUMBING
Property Zoning:
COVE RESIDENTIAL
Application valuation:
2000
Applicant:
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT.
Owner:
CORONEL ISMAEL
53945 AVENIDA
LA QUINTA, CA
Contractor:
Owner '
CARRAN
92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/09/12
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 contractors) licensed
pursuant to the Contractors' State License Law.). '
(_ ) I am exempt under Sec. this reaso"� �y
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: r • /
LQPERMIT
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is heieby 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'ariy 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 �tthe a ve infortion is cortx. agree to comply with all
city and county ordinances and state laws relatingng onstrud on, and h reby a horize representatives
of th' county to enter upon the above-mentioned pfo 'nspecti n purpose .
Date.G-`Z — (7- Sig ure (Applicant or Agent):
------------------------ Tr -I/ % .Y�oar
------------------
---------------------------------------------------------------------------------
----------------------------LICENSED
LICENSEDCONTRACTOR'S DECLARATION
_
WORKER'S COMPENSATION DECLARATION -
I hereby affirm under penalty of perjury.that I 'am licensed under provisions of Chapter 9 (commencing 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 -
insurance 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 (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
this p ' is issued, I shall not employ any
certify that, in the performance of the work ftthrker
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner. so as t become subjwo ars' ompensation 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 ould be me subject t ' co ensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labo C e, I sh I forthwith cth t ose rovisions.
that he or she is exempttherefrom 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).:
I�LI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
e: !!& -y - \'a Applicant: -
,,
Y the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
WARNING: FAILU E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply toanowner 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 ($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 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 contractors) licensed
pursuant to the Contractors' State License Law.). '
(_ ) I am exempt under Sec. this reaso"� �y
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: r • /
LQPERMIT
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is heieby 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'ariy 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 �tthe a ve infortion is cortx. agree to comply with all
city and county ordinances and state laws relatingng onstrud on, and h reby a horize representatives
of th' county to enter upon the above-mentioned pfo 'nspecti n purpose .
Date.G-`Z — (7- Sig ure (Applicant or Agent):
Application Number 12-00000519
, Permit PLUMBING SEWER
Additional desc
Permit Fee' . . 30.00
Plan Check Fee
_
.00'
s - Issue Date
'
Valuation
2000 `
Expiration Date ". 11/05/12
Qty. Unit Charge Per'
Extension
BASE FEE
30.00
----------------- -------------------
Notes and Comments
r. SEPTIC ABANDON, SEWER CONNECT. 2010
CODES,.
------------------------------------------------------------------------
Other _- Fees . . . . BLDG STDS ADMIN'(SB1473)
1.00
Fee summary, Charged Paid
Credited
Due
Permit Fee Total 30.00
.00 :00
30.00
Plan Check Total. ..00
.00 .00
.00
Other Fee Total 1.00
.00 .00
1.00
Grand Total 31.00
.00 .00
31.00•
�' LQPERMIT
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OVMEW S PACKAGE
(7'60) 777-70.12
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
P TAW -1 EER'EX QVaaD
Dear Property Owner
An. application for a buildingt has been submitted in yo name listing yomelf as the builder of the .property
-impr�svements specified at % 7 70 ji/oe �i►�
Ve are providing you with an Owner -Builder Ackno*iedgment-and- Information Verification Fonrn to make you awm of your
.responsibilities and possible risk you may incur by hawing thispermit-issued in -your our name as the
Owns -,Builder. We will not issue a building permit until yomhave read, initiated your undavtaading of ea&provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute tbis•:-notice
unless You, the property owner, obtain the prior approval of the permitting authority.
Read and maiat eack statenrentha4iw w signi, fy you
or verify this information.
f I. understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder"
building permit that erroneously implies that the property owner is providing his. or her own labor and material perseii. 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.
�2. I understand building permits are not required to be signed by property owners unless. they are responsible for the
construction and are not hiring a Licensed Contractor to assume this responsibility.
3. I understand as an "Owner -Builder" I am the responsible.party of record ori 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 her name instead of my
own.
4 I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value-
of
alueof my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
6. I. understand if I am considered an "employer" under state and federal law, I 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 me to serious fniancial
risk.'
understand under California Contractors' StateLicense 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, I may be held liable for any
financial or personal. ieo.aries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
f-
9. I understand I may obtain more information regarding my obligations as an "employee" from the Internal Rownue
Service, the United States Small Business Administration, the California Department of Benefit Paymeeits, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLR) 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
party legally and financially responsible fox proposed construction activity at the following address:
f
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applic�able- laws and requirements that govern Owner-Ruilders as well at employers.
12. I agree to notify the issuer of this form immediately of any additions, deletions, or ebsugos today of the informatioh 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 lieense die Contractors' State License Board may may be unable to ass tt 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 uWiaanstd Contractor or employee of that individual or firm is Owed wbile wOd dng
on your property, you may be held Idaiile for damages. If you obtain a permit as Owner -Budder and wish to hire Contfaetors,
you will be r€spowible for verifying vAmffier of not those Contractors are propedy licensed and ibce sWs of their workers'
compensation instuanee cove"Ce.
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 issuWg; dw.perm*L lVote: A copy of di�- propergF owner's. ddver.'sAtersse, forma notackad 3 or
other verification acceptab to the agn is req to _ reaerated when tke p cmrit is i w verify the property
owner's signature. '
Signature of property owner Date: S - �-
v
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 AC
LNT TO ACT ON PROPERTY OWNER'S B HALY
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
-the fallowing persons) to act as my ageags) to apply for, sign, and file the documents necenary to obtain ari 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 perjurythat 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 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 owner's signature..
Property Owner's Signature: Date:
MAY. -09-2012 WED,10:05'AM DESERT CONCEPTS
Workspace Webmail ::.Print
FAX No... 760 200 9007 'P• 001
Pa'g'e.l of 1
Perin# I aloe® Window
Subject: 51-770 Ave. Velasco, La Qulnta]
From: Carol Pfannkuche <CPfannkuche@cvwd.org>.
• L
Dat®: ' Wed, May 09, 201210:04 am
To: "'ish@coronelentcom"• <Ish@coronelent.com> 1
Attach: Image001.png
�RE: 51770 AVENIDA VELASCO, LA QUINTA
• THE SANITATION CAPACITY CHARGE WA5 PAID ON 6-30
.2003 MCR#96657'
• • THE SEWER LATERAL IS 49` SOUTH OF THE NORTHERLY'..
MANHOLE' ;
o THE SEWER MANHOLE 15 7.8' DEEP
PLEASE CALL.IF-YOU HAVE ANY QUESTIONS
Thank you, ;
Cato) Pfanakwhe i
Development Services Technician =
Phone: (760) 398-2661 ext. 3521
Fax (760) 568-1788' '
... ............
From: ish@coronelent.com [mailto:ish@coronelent.com]
Sent: Wednesday,.May 09, 2012 9:46 AM,
To: Carol Pfannkuche -
R .
Subject: [FWD: 51-770 Ave. Velasco, La Quints]
-------- Original Message--------
Subject,'51-770 Ave., Velasco, La Quints
From: <ish@coronelent:com> ' -
Date: Wed, May 09, 2012 9:44 am
To: c�roi@cvwd.org
Copyright ® 2003-2012. All rights reserved•' ,
http://emai117.secureserVer.net/view�-Pl'int Multi.pllp?uidArray=5221INBOX&aEmjPart=O 5/9/2012
r