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10-1067 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00001067 Property Address: 47775 WIND SPIRIT DR APN: 623-520-012- - Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 1257 c&ht °F 4 Q" Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 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).: (_) 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.). (_ I 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 _ I I am exempt under Sec. , B.&P.C. for tis reason rq Date: V —1FDq00 Owner: CON#TRUCTION 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 ISec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT Owner: SOWELL AVA F T 47775 WIND SPI LAQUINTA,CA -------------- -- Contractor: Owner 9 23 D VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/14/10 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 hernt snhjerr to the wnrkrrs' r,.rmponsation provisions of Section 3700 of the Labor Ple, I sha f forthwith compWwit)gthose pro vi ons. Date: Applicant: iAV2 'I 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 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. 1 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 conspvflction, and hereby auth7ilze representatives of this county to enter upon the above-mentioned prope for in ecftion purposes. pate: I�k� IO Signature (Applicant or Agent): Application Number . . . . 10-00001067 Permit . . . WALL/FENCE PERMIT Additional desc . Permit Fee . . . . 31.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1257 Expiration Date 4/12/11 Qty Unit Charge Per Extension BASE FEE 15.00 8.00 2.0000 HND BLDG 501-2,000 16.00 ---------------------------------------------------------------------------- Special Notes and Comments BLOCK WALLS - 27LF Q 5'-4"H/17LF (CURVED) @ 4'H/6LF (4' AT SCREEN WALL AND 2' AT SIDE PROPERTY LINE) @ 61H AND 21X4' BOXED COLUMN @ 5'-10"H [CITY STANDARD] ***THIS PERMIT DOES NOT INCLUDE ELECTRICAL OR PLUMBING INSTALLATIONS*** October 14, 2010 5:05:11 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ----------------------------------------=---------------- Due Permit Fee Total 31.00 .00 .00 31.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 32.00 .00 .00 32.00 LQPERMIT 1 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 OW ! NOWE TO FROEERMY 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 w 9ZZ53 We are .providing you with an Owner -Builder Acknowledgment and Information Verification Fort. to make you aware of your responsibilities and possible risk you may incur by having thispermit•issuted in your name as the Owner -Builder. We trill not issue a building. permit until you•4ave read, initialed your understanding of each'ptovision, 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. 0VWS ACKNOWLEDGMENT AND-VEMWATION OF INEORMAMN IJM TIONS: Bead and irritiat eachstatement below to signify you understand or-ver(fy this information. . • 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" wilding permit that erroneously implies that the property owner is providing hisor her own labor and material pemnally. 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 derstand building permits are not required to be signed by property owners unless they are responsible for the nstructiuonn 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 on the permit. I understand that I may protect self from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4.1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on emrits and contracts. @5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value MLIY construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 6. [understand if I am considered an "employer" under state and federal law, I must register with the state and federal overnment, 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 jlctT nderstand under California Contractors' State License Law, an Owner -Builder who builds single-family residential ures1 ucannot .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. 4uries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue ervice, 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 I,B) at I- 0-321-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 legally and financially responsible . for; proposed construction activity at the following address: t11. I agree that,. as the party legally and financially responsible for this proposed construction activity,.t will abide by all plicable laws and requirements that govern Owner -Builders as well as employers. 12. 1 agree to notify the issuer of this form immediately of any additions; deletions, or changes to day of the information I ve 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,. rhe 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'eivil court. It is_ also important for you to. understand that if an unlicensed Contractor or employee of that individual or firm is injured while worlring 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 whetter or not those Contractors are property licensed and the status of their workers' compensation insuranee 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 the..permit. Note: A copy of tfce property owner's d%iver'slketase� form notadcadeN or other verification acceptable to the agency is required to be presented when the permit is inuedi to verify the property owner's signature. ' 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 file the documents necessary to obtain an Owner -Builder Permit for my project. ����� Scope of Construction Project (or Description of Work): bI1�[[,, I 08-n5fYLl4`(no Project Location or Address: Name of Authorized Agent: T6 �,r , Tel No ](,p Address of Authorized Agent: 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 drivers license, form notarization, or other verification acceptable. to the agency is required to b presented whe the permit is issued to verify the property owner's signature.. Property Owner's Signature: Date: fd �� �V Din # Ow Of ,a 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 # Project Address: 5 CJ' 2703 Owner's Name: A. P. Number: Address: y-7715`ti�4-`�p Legal Description: Contractor: Owylec 61L(1& -r City, ST, Zip: L(�Il�l I ZZ5 Telephone: :: f•,fn. Address: Project Description: City, ST, Zip: GN7it pr P)(Wrl Telephone: P .'{ti mss < ur !% G1� 1� Fhff'�O1 llt�y1D�Ni' State Lic. # : City Lic. Arch., Engr., DesigneriN�#!-4p Address:; y .1` W117b. PPV -4 W+ "- vtol 4i City, ST, Zip: ?•'i# D Y kY1 VOW/V0100, 041W Telephone: t' K State Lic. #: s}� • :,.�o?I"r}::: ri,::?..:, "� ..••c;�S?�/�;:'x"^zi�. Name of Contact Person:('Toe 4cj4mo-n Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stoo�ries::��,�,,.,, # Units: Telephone # of Contact Person: �� - (p -2 !�� c . % MI; Estimated Value of Proie'fC�(/i Lam APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Rec'd TRACIONG PERMIT FEES Plan Sets Plan Check submitted �� , Item Amount Structural Cales. Reviewed, ready for corrections flan Check Deposit Truss Cales. Called Contact Person lan Check Balance Title 24 Cales. Plans picked up Construction 1S.4 9,1 L-0 Flood plain plan Plans resubmitted echanlcai �.. Grading plan 2i° 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 corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue S , 0 School Fees Total Permit Fees t0 I.�Sw` do f 41 j4 Jul Lot Oiiona1SNOO WO-A T � e CI3AOaddV 1d3a.J11.3JtfS 19 JNI `/ •�•f t/1N1 O dl 69 RIDQEGiA T VN y .� PLAN 1A10 .� PE=8'7.7 01 .70 RIDGEGATE 'I `` Ip6 4>• . PIAN 2C FF•58.1 j - 'PE•57•.6 .y �� cr _, : _ �4 e� �/ V4 U181; ' .�o �� •mow Nu — :► < _ ,O� j 40 Y 1 ,4u . 7TH K 4 J l r,