10-0210 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 4 ___1Q-000.00210_..
Property Address:
44310 WILLOW CIR •
APN:
604-092-020-58 -22982 -
Application description:
WALL/FENCE
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2300
Applicant: / Architect or En r.
- �IGI�GV
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012,
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/16/10
Owner:
DAVID &KELLY DEGEARE
44310 WILLOW CIRCLE
LA QUINTA, CA 92253
-------------- ------ -- - --
i Dwa
Contractor: vi 1 / N
Owner
C1 y P °-A�::ifIRTA
----------------
-
-----------------------------------------------------
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 maintain a certificate of consent to self•insurefor 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.
bate: Contractor: _ 1 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 -
1 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 -
any 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-)• -
( CSI, 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 I am exempt under Sec. B.iAP.C: for this reaso -
17
r _
�_Date:- 3-0 b -tut .OjOwner:-`�--1
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty ofperjury 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
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(/s/pall ���visions.
Date:�G 19pplicant:_
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 ($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 followingissuance 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 l have read this application and state that the above information is cor Pt. I !epjjo comply with all
city and county ordinances and state laws relating to building construction an y riz epresentatives
of this county to enter upon the above-mentioned property inspec ' o S.
_Date: &-2036gna-"- ture (Applicant _-or Agent):
Application Number 10-00000210
Permit• ELECT - ADD/ALT/REM
Additional desc .
Permit Fee •16.50 Plan Check :Fee
4.13'
Issue Date Valuation
0.
Expiration Date .: 9/12/10-
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 .7500 PER, ELEC`DEVICE/FIXTURE 1ST 20
1.50
Permit . . ,WALL/FENCE PERMIT
Additional�desc .
Permit Fee . . . . 54.00 Plan Check Fee :
.00
Issue Date . . . Valuation . . .
. 2300
Expiration Date 9/12/10
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
92 L.F. 516' COURTYARD WALL INCLUDES 12
COLUMNS, 2 SCONCE LIGHTS AT WOOD &
WROUGHT IRON GATE. 2007 CODES
-----------------_---------------------------------------------
Other Fees . . . . ... . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged, Paid Credited
----------
Due
----------- ------
Permit Fee Total 70.50 .00 .00
70.50
Plan*Check Total 4.13 .00 .00
4.13
Other Fee Total 1.00" .00 .00
1.00
Grand Total 75.63 .00 .00
75.63
LQPERMIT ..
-
q.l ! Y "r UA V U LN I a
BUILDING AND SAFETY DEPARTMENT °
GARDEN WALL STANDARD •
6" C.M.U.
m 1350psi. Fy= 40000psi
04-0 24 Vert O CL
f4 O 32" Ho.:
ALTERNATE .
3" CLEAR BENDS
0 HORIZ. AS SHOww, T L o
1 ' 6 6- C.M.U.
13
SOpsi, Fy>< 4000Opsi
/4 O 24' Vert O CL
/4 O 32' Horiz
r GARDEN WALL
Scale: 3/8- _ 1'-0'
7_1L.
6' C.M.U.
fm- 135Ops,. Fy- 400009si 3" CLEAR
/4 O 24" Vert O CL
#4 O 32' Moriz f♦ HORIZ. AS SHOWN T
lo
,.
r rr
OPTIONAL
10-lr/t6" S GARDEN WALL
Score 3/8' 1'-0'•
TE
3" CLEAR
• V MORIZ AS SHOWN T -
C' CMu
`.-�• Int
1350os, rr. 4Dpoops•
. .. I• O 24' ve•t • Cl
/4 6 32' Horn - I
S GARDEN WALL —�
Score: 3/8" - 1'-0- pot10HeL
I30-L&p
6" C.4.U. `
i'me 1350psi. Fy- 40000psi -
/4 O 24- Vert Q CL .
/4 O 32 HOriI - � - 3 CLE AR -
I4 mmz As sHorr*I T
ol
_r r
OP TION AL
10-„/16 30"LAp GARDEN WALL
_ ALTERNATE
3 CLEAR SENDS
.J4 NORIZ. AS SHOWN T -
I
2'- 3-
4 GARDEN WALL'
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPER Y OWNER'S PACKAGE
(7'60) 777-7012
FAX (760) 777-7011
Disclosures bpi Forms for Owner -Builders Applying for Construction Permits
MANT1 K-01WE Tn PROPERlv QWE�i1FR
Dear Property Owner.
Anapplication for a building permit has been submitted in your name listing yourself as the builder of the .property
improvements specified at
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
MWOUSibilities and possible risk you may incur by having dds-permit.issu0d 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 the permitting authority.
Oz's . .- z. � Err AND'YEUFLCATI�ON OF nFd�' aN
f3W TTONS. Read artd kitial each statemew below to signify you uradlerstan&or verify dais Mfonnasion.
`Q6 " 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. Party.
A2. I understand building permits are not inquired 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.partyof 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 Iter name instead of my
own.
PB4. 1 understand Contractors are required by law to be Licensed and bonded in California and to list their license numbers on
permits and contracts.
J)D 5. I 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.
6. 1 understand if I am considered an "employer" under state and federal law, 1 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
7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residentia
structures cannot .legally build them with the .intent to offer them for sale, unless all work is performed by. license(
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performs
under contract with a licensed general building Contractor.
n8. 1 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. Wj. ries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
_p 9. I understand I may obtain more information regarding my obligations as an "employer" from the interud ROWnuo
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 (CSLB) at 1-
800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
-4010. 1 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:
1 L I gree that, as the party legally and financially responsible for this proposed constriction activity, 1 will abide by all
applicable liws and requiremetits that govern Owner -Builders as well as employes.
12.1 agree to notify the issuer of this form immediately of any additions; deletions, or cringes to say of the informsfion I
ave 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 6naMW loss
You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be i vivil court. It is also
important for you to understand that if art unlic onsed Contractor or employee of that individual or firm is injured while wnching
on your Property,' You may be ltetd Balite for damages. If you obtain a permit as Owner -Builder and wiser. to hire Contractors,
you will be responsbic for verifying whether or not those Contractors are properly licensed and the status of their woticers'
compensation inguranve 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 issq. .*e,per=tL NotF: A copy of the property owner's diiver.'s fo+rrr nota Arrq or
other verification acceptable to the Furey is required be .relented when the permit is issua� to verify the property
owner's signature.
Signature of property owner Date: �' r� C71le
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.
AUTHORIZATIEON M AGENT TO ACTON PROPERTY OWNER'S -HALF
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 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 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:
Bin #
Qty of La Qunnta
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 #
1
Project Address: 3 ` D W T 46 wi C, 2
Owner's Name: �GE
A. P. Number:
Address: V f `✓lGG��C /�
Legal Description: �� _
Contractor:Telephone:
Address:
City, ST, Zip:
Project Descr iption:
City, ST, Zip:
Telephone:
__M
a r.::> :i'ti;'i4'.kt`.r:.
kw'£>s`:"'>'•`<":;>4Fx.t..i;::;it
t 1t
r r.
State Lic. # :
City Lic. #:
bt/
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic. #:
{ •,.... s 1..:'��c
,"••.a:%: >»><.,:r:rF:
02ti 4l�{i;>+�i:'Yfi::Y''i'^{f;4'.y9>��',a•'
;; ?- r;;•v
ConstructionT e: r Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
Units:
Telephone # of Contact Person:
Estimated Value of Project:�®o®
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
tad Review, ready for correctionslissue
` Electrical
Subcontactor List
Called Contact Person
jl Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees