13-0137 (BLCK)P.O. BOX 1504 T 41Y`4 4 a" VOICE (760) 7�7-7012
79-495 CALLE TAMPICO., FAX (760) 777-7011
EA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/08113
Application Number: 13-00000137 Owner:
Property Address: 51770 AVENIDA VELASCO STEVEN LIU
APN: 773-174-001-1 —000000— 1822A ROUTE 66 #433
Application description: WALL/FENCE. LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL (626)37871075
Application valuation: 3000 D 4
Contractor:
Applicant: Architect or Engineer: Owner 08
2013
CITYOFI-A Ully
F1 NCE ep.
---------- ---------------------------------------------------------------------------------------
LICENSED CONTRACTOR'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 rneintain a certificate of consent to self -in sure 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 Nurnber
following reason (Sec. 7031.5. Business and Professions Code: Any city or county that requires a permit to, I certify that, in the performance of the work for which this permit is issued, I shall not employ any
connct,faIterS:,mp ove, 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,
p�e .a nL 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
Li f;njeo.,aw 1�,Sh=g lcommencing with Section 70001 of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I shall forthwith comply with those provisions.
tt� she pt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
a pplicant for a permit subjects the applicant to a civil penalty of,not more than five hundred dollars ($500).: Date: 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 ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License La�v 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 ($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 completio�, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.). APPLICANT ACKNOWLEDGEMENT
1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044 Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
prope�y who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1 . Each person upon whose behalf this application is made, 'each person at whose request and for
pursuant to the Contractors' State whose benefit work is performed under or pursuant to any permit issued as a result of this application,
,.�ic.e�nse
I am exam und r Sec. I e 0 son 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.
IrID 2. Any permit issued as a result of this app lication becomes n ull 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
'_�51�.UCI.O �DWG � GEN'CY permit to cancellation.
I h reby aff rm und r penalty of perjury that there is a construction lending agency for th . a performance of the I certify that I have read this application and, state that the above infor tion is correct. I agree to comply with all
oova
t
I , to i, i on, and here a representatives
work for which this permit is issued (Sec. 3097, Civ. C.). city rd coup olglances and state laws relating to building con
is coun
er
of t upon the above-mentioned property for 0
Lender's Name:
Foam 3�atdre (Applicant or Agent):
Lender's Address:
LQPERMIT
Application Number 13-00000131
Permit . . . . . . ELEC-MISCELLANEOUS
Additional desc
Permit Fee .. . . . . 15-.75 Plan Check Fee
-3.94
Issue Date Valuation . . .
. 0
Expiration Date �8/07/13
Qty Unit Charge Per
Extension
BASE.'FEE
15.00
1.0d .7500 PER ELEC DEVICE/FIXTURE IST 20
------------------- ------------------- ---------------------------------------
.75-
Permit . . . . . WALL/FENCE PERMIT
'Additional desc
Permit -Fee . . . . 54.00, Plan Check'Fee
.00
Issue Date . . . . Valuation . . .
. 3000
Expiration Date 8/07/13
Qty Unit Charge Per
Extension
BASE FEE
45.00
1.00 9.0000 THOU, BLDG 2,001-25,000
9.00.
-----------
----------------- ---------------- ------- ----------------------
'Special Notes and Comments
70 LINEAR FT., 6 FT HIGH GARDEN WALL
(PER ORCO BLOCK STANDARD) WITH (4)
12i -X1211 COLUMNS, (2) UNDERGROUND CONDUIT
LINES TO FRONT COLUMNS FOR (2)DECORATIVE
LIGHTS. 2010 CODES.
7 ------------------ -------------------------------------------
Other Fees . . . . . . . . . BLDG,STDS ADMIN (SB1473)
-------
1.00
Fee summary Charged Paid- Credited
------ ---------- -----
Due
------------------ ----------
Permi Fee Total 69.75 .00 .00
7
69.75
Plan Check Total- 3.94 .00 .00
3.94
Other Fee Total .1.00, .00 .00
1_00
Grand Total 74.69 .�00 .00
74.69
LQPERMIT
isin ff
Permit #
/-� ---/-37
Project Address:
— 5-
A. P. Number:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subconfactor List
Grant Deed
ILO.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
Tsch-ol �Zs
QtY Of La Quinta
Building &, Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
:L):]= I/.- I fA. ( 0 n ki),vner's Name: �, el�— V - ) e - I ,
City Lic. #:
Construction Type:
Occupancy: fjoAx—&
Project t)'pe (circle one): New Add'n After Repair Demo
Sq. Ft.: 10 # Stories: # Units:
................. Estimated Value of Project: 12,40612,
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING
Plan Check submitted
Reviewed. ready for corrections
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready (or corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
3,4 Review, ready for corrections/issue
Called Contact Person
Date Of permit issue
PERMIT FEES
Item Amount
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
Grading
Developer Impact Fee
A. 1. P. P.
Total Permit Fees
Contractor:
Address:
CitY. ST, Zip:
Telephone:
State Lic. #
Arch., Fngr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:
Telephone # of Contact Person:
# Submittal
Plan Sets
Structural Calcs.
Truss Calcs.
Title 24 Calcs.
Flood plain plan
Grading plan
Subconfactor List
Grant Deed
ILO.A. Approval
IN HOUSE: -
Planning Approval
Pub. Wks. Appr
Tsch-ol �Zs
QtY Of La Quinta
Building &, Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
:L):]= I/.- I fA. ( 0 n ki),vner's Name: �, el�— V - ) e - I ,
City Lic. #:
Construction Type:
Occupancy: fjoAx—&
Project t)'pe (circle one): New Add'n After Repair Demo
Sq. Ft.: 10 # Stories: # Units:
................. Estimated Value of Project: 12,40612,
APPLICANT: DO NOT WRITE BELOW THIS LINE
Rec'd TRACKING
Plan Check submitted
Reviewed. ready for corrections
Called Contact Person
Plans picked up
Plans resubmitted
Review, ready (or corrections/issue
Called Contact Person
Plans picked up
Plans resubmitted
3,4 Review, ready for corrections/issue
Called Contact Person
Date Of permit issue
PERMIT FEES
Item Amount
Plan Check Deposit
Plan Check Balance
Construction
Mechanical
Electrical
Plumbing
Grading
Developer Impact Fee
A. 1. P. P.
Total Permit Fees
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CITY OF LA QUINT/k
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BUILDING & SAFETY D. T.
APPROV
FGR GGAI CTION
DATE
By
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P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Bu1ILDIN,G & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
Considering Becoming an Owner -Builder?
Important information you need to know BEFORE pulling your permit!
The term "Owner -Builder" can mean three different things:
"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 construction work, the permit 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 financiail
'risk due to worker injury.
Benefit/Risk:, Highest Benefits and the Least amount of Risk
Owner -as- Worker is a type of Owneri-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
your name and you hire California licensed sub -contractors to perform portions of the construction work. WARNING: The benefit of
protection provided by law when you hire only California licensed sub -contractors can turn to, serious financial risk if you hire
unlicensed contractors to perform. any of the work.
BenefitfRisk: Possible Benefit and SiFnificant Financial Risk
Owner -as -Employer is a type of Owner -Builder where you pay any unlicensed individual to perform any construction work valued at
m , ore than $500.00, the permit is taken out in your name and you are personally responsible for their 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 taxes or pro.vide workers compensation insurance for each worker.
Benefit/Risk: Possible Benefit with Sienificant Financial Risk
1W
(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
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 uOwne.r-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 ,
1.0b
Tdf 4 4 a"
P.O. Box 1504.
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
1. BUILDING &
TROPERTYOWNEWS- PACKAGE
SAFETY DEPARTMEINT
(760) 777-701�
FAX'(760) 777-701'1
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application -for a building permit ha een sub in 0 pme listing yours9lf as P91bbuildde; of the,property
improvements specifiedat 28 A I. 1 '74 A k� C45 C -,d 4,t 6�4 q >-2! D
'Ruilder'Ackno�wleTjiii�nt and Information Veri to : ware
We are providing you with an Owner fi t i A e �youa of ybur I
responsibilities andpossible risk you may incur by having this permit+issued in your name as the
Owner -Builder. We will not issue a building permit until you have 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 th� permitting authority.
Read and initial each statement below to signi)� you understand or veri)� this information.
1. 1 understana a frequent practice of unlicensed persons is to have the property . owner obtain an "Owner -Builder"
0"g permit that erroneously implies that the property owner is providing his or,her own labor and material personally. 1, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
anffs or her employees while working on my property. My homeowner's insurance may not provide coverage for those
up Tes. I am willfully acting as an Owner -Builder and am aware of the lin-dts of my insurance coverage for injuries to, workers,
91rfny property.
I understand building permits are not required to be signed by property owners unless they are responsible for the
-tion and are not hiring a licensed Contractor to assume this responsibility.
- I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
f from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
s and contracts.
I understand if I employ or otherwise engage any persons, other than California licersed Contractors, and the total value
construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employee'
m I
ate and federal law.
—4 1 derst if I am considered an "employer" under state and federal law, I must register with the state and federal
wit
n :d d
g v ent 0, payroll taxes; provide workers' compensation disability insurance, and contribute to unemployment
c- _X__ '
omp nsation . for each "employee." Falso understand my failure,to abide by these laws may subject me to serious financial
risk.
- L-Nl understand under California Contractors' State License Law, an Owner-Bu'ilder who builds single-family residential
s��cVes 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. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
manshiv or materials.
9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
�ce, the United States Small Business Administration, the California Department of Benefit Payments, and the California
N" n of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at I-
I-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
legally and fina
;W�11 addrgs:
a_& , Zonsible or proposed constructioq activity at the follo,
L01 ;�A )-IdO
%_,# I w`7
1. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
able laws and requirements that govern Owner -Builders as well as employers.
_aV2. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
ha rovided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
sopeet who does not have a license, the Contractors' State License Board may be unable to assist'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 unlicensed 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 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 issuninvIL ecr ml�. �ote: A copy of th e property o wner 's driver's license, form notarization, o r
,o
np
ed
other verification acceptable i req e to be presented when the -permit is issued to v ify the property
owner's signature.
Signature of property o Date:
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.
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 agent(s) to apply for, sign, and file 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 peiJury 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 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:
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