09-0724 (PAT)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
09-00000724
Property Address:
53835 AVENIDA DIAZ
APN:
774-151-034-4 -000000-
Application description:
PATIO COVER - RESIDENTIAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
13593
Applicant: Architect or Engineer
0"ve . .010,
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: 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 ISec. 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(& 1 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.).
(_ 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 am exempt under Sec. , B.&P.C. for this reason
xDate��– �LZI — I V - Owner:
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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/20/10
Owner:
RODRIGUEZ JESUS
53835 AVENIDA D
4
LA QUINTA, CA
MAY 0 2010
Contractor:
Owner
0n'OFI
------------------
WORKER'S COMPENSATION DECLARATION
1 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 becom, subject 76`wikers' compensation provisions of Section
3700) of the Labor Code, all or
'thwcompl ith those provisions.
Date: �V Applicant:
WARNING: FAILURE TO SECURE WOR ERS' COMPENSAT N COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 agree to comply with all
city and county ordinances and state laws relating to building nstr ction, and hereby authorize representatives
of this county to enter upon the above-mentioned property f sp tion purposes.
ate: 2f%-1 Signature (Applicant or Agentl:
Application Number . . . . . 09-00000724
Permit . . . PATIO COVER PERMIT
Additional desc . .
Permit Fee . . . . 153.00 Plan Check
Fee
99.45
Issue Date . . . . Valuation
. . .
. 13593
Expiration Date ... 11/16/10
Qty Unit Charge Per
Extension
BASE FEE
45.00
12.00 9.0000 THOU BLDG 2.,001-25,000
108.00
----------------------------------------------------------------------------
Special Notes and Comments
1,022SF PATIO COVER AT SIDE
--" PROPERTY/VB/ACCESSORY/CLASS 'A=FR
[CONVENTIONAL/CITY SPEC] THIS PERMIT
DOES NOT INCLUDE MECHANICAL, ELECTRICAL
OR PLUMBING INSTALLATIONS. 2007
CALIFORNIA BUILDING CODES.
May 20, 2010 9:27:31 AM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 153.00 .00
.00
153.00
Plan Check Total 99.45 .00
.00
99.45
Other Fee Total 1.00 .00.
.00
1.00
Grand Total 253.45 .00
.00
253.45
f
LQPERMIT
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t
Bin} V
Qty of La Quinta '
Building 8I Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
(�' 1
Project Address: c5 3 Awl fin.- (PtZ
Owner's Name: s 2oor)£?
A. P. Number: 274— . U 3+
Address: 5357;,S VENI (,Ar Q 2
Legal Description: UOT 4- 06 O(1 033
City, ST, Zip: (� t7l►J Ila
Contractor
Telephone: •. ;;.`:.:ti::>' :>;::<>r::::'::<>;"'
�%s:fs%^•,:'>.:?>.;c•:;w��;: ;;
Address:
Project Description: NF -U) CA"/zt1,kD 11b
'{Y� Qi;.. 1. may. �R3J A,ti«w•.i� +ti, ..1 4':,� 4.�.:�Ji�li�.k^ 4c " 1
v"Sk ``-� •.w'" _.��: ' y v., r .i': .� ir!'d y`p 'J
Telephone:
,:=Jzst;;`:::�.'•>�>:` df��.n>;,�;»
r ..::'�� .�• -•.-'� ' 's ":'.' -
State Lic. # :
City Lic. #;
Arch., Engr., Designer:
Address: 3 (q -K CAU( �Lr
City., ST, Zip: " H- 00i -0O PA0 S, CA �IrZ2�1v
Telephone: -760 2!! L. S l .? >? :: ;::>: ; ;::::;::::«;.::;.;{.:::�..
State Lic. #: :<>>'.r'>«>:l::<ft;>:.s;•:E;
Cons pfon;Type: . y r Occupan(T 1.
,
Project a circle one): e Add n Alter Repair Demo
Name of Contact Person: R 1 O 6v
Sq. Ft.: l
# Stories: '
# Units?
Telephone # of Contact Person:
Estimated Value of Project: q oo0 -` -
,
' APPLICANT: DO NOT WRITE. BELOW THIS LINA ,.•;,, .
#.
Submittal
Req'd
Recd
TRACKING
PERMIT FEES •., , ,
Plan Sets
Plan Check submitted
ItemAmount ~
le�
Calcs.
.Structural
Reviewed, ready for corrections
tt
Pla�3 Check Deposit I-Ak 46
Truss Cales.
Called Contact Person
Plan Check Balance .
Title 24 Calcs.
Plans picked up 1� Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2nd Review, ready correctio /issue Electrical
Subcontactor List
Called Contact Pe $ Plumbing
Grant Deed
Pians picked up. 1�►�Aa16kjo S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'"' Reyiew, ready f orrectio issue Developer Impact Fee
Planning Approval
Called Contact Person I� ?� A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
1�
Total Per ' ees
i r"4�A�
1015 l: 2 V� 10 X21 - NS
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.P.O. Box 1504
LA QUINTA, CALIFORNIA -92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner=Builders Applying for Construction Permits
IMPO TANT! NOTICE TO PROPERTY OWNER
Dear Property Owner.
An. application for a building permit has been submitted .in your. name listing yourself as the builder of the property
�
improvements specified at 3 -� 7 S A -X) e,, 4. Q ,A-. b ; lF -Z ems- Q C ,„dl r_► .C4 .
We are .providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you awate of your
responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a buildingpermit 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 the permitting authority.
OWNER'S ACIM-W- EDGMENT AND 'VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.' .
1. 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 personally. 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 propety.
"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.
I understand as an "Owner -Builder" I am the responsible.party of record on 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.
1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
VVI understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars' ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
ot;. /1 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 financial
risk.
understand under California Cont actors' 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.
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. injuries sustained" by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
.1 `AKI understand I may obtain more information regarding my obligations as an "employer' from the Internal Revenue
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 (CS -LB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
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 for proposed construction activity at the . following address:
agree that, as the party. legally and financially responsible for this proposed construction activity,.i will abide by all
a�ppllii(cabt6 laws and requirements that govern Owner-Builders'as well as employers.
a / Tl. I agree to notify the issuer of this. form 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 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 issuing. t -he permit. Note: A copy of the property owner's deiver's 1kensei form notarization, or
other verification acceptable to the agency Ys� a to . e .presented when the permit is issued to verify the property
owner's signature -
Signature
nature_ /
Signature of property owner
Date: S - ,
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 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
"k-
I.- -
*
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 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:
April 6, 2010
i
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247=1504 ,
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Mr. Ricardo Aguilar
R.C. Group, Incorporated
31475 Calle Helene
Thousand Palms, CA 92276
F I L -E
BUILDING & SAFETY DEPARTMENT,
(760) 777-7012
FAX (760) 777-7011
RE: Building Permit Extension Request — 53835 Avenida Diaz (Rodriguez).
Dear Mr. Aguilar:
-- --- —l�h-ave-reviewed_ ° our -letter dated Janna 26-20°10—re uestin a=time= extenvsiom- --- - -�
Y rY � - q ` g
for the plan review of the residential covered patio addition proposed for
construction at the above address under Building Permit #09-0724. Our records
indicate the following status on this project.
Plan review status:
Original application date: 07/10/2009
180 -day expiration date: 01/06/2010
90 -day extension date: 04/06/2010
90 -day extension date: 07/06/2010
Under the. provisions of 2007 California Building Code (CBC), Appendix Chapter
1, Section 105.3.2, application extensions.are limited to 90 days.. Your request
is hereby granted.
Please be advised that unless a building permit for this project is issued on or
before Tuesday, July 6, 2010, your "application will expire automatically.
Yours truly,
Greg Butler
Building & Safety Manager
7 ,
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gr: 53.135 AVOW Dt*t
JAN 2\6 2010