11-0471 (RER)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T -,&t - 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:
11-00000471
Property Address:
80273 VIA PESSARO
APN:
772-550-053- - -
Application description:
REMODEL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
10000
Applicant:
Architect or Engineer:
PIP
------------------
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.
Licens Class: B Licensee No.: 506667
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 (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.).
(_ 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. , BAP.C. for this reason
Date:
Owner:
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:
LQPERMIT
Owner:
SANDRA FISHER
80273 VIA PES'SARO
LA QUINTA, CA 92253
Contractor:
CLARK JR, JACK L.
51220 AVENIDA CARRANZA
LA QUINTA, CA 92253
(760)564-3511
Lic. No.: 506667
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
D: / \ Di[T: 6,4 11
`' " 2611
CITY OF .Ae: J'INTR
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 EXEMPT Policy Number EXEMPT
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 1 sho d become subject to the workers' compensation provisions of Section
3700 of the Labor C d , II shall
forthwith om�pl/yyw�it�h/those provisions.
/Date:�y-z�-6j plicant: 4L4iL �"�'-"-[-u+
WARNING: FA RE 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 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 build; onstruction, and hereby authorize representatives
of�fiis/county to enter up the above-mentioned prope fo inspection purp s.
Date: 1�'r 2 ` ignature (Applicant or Agentl: "' L ��Q
a
Application Number . . . . . 11-00000471
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 117.00 Plan Check Fee
76.05
Issue Date . . . . Valuation . . .
. 10000
Expiration Date . . 12/24/11
Qty Unit Charge Per
Extension
BASE FEE
45.00
8.00 9.0000 THOU BLDG 2,001-25,000
--=-------------------------------------------------------------------------
72.00
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . . 15.75 Plan Check Fee
3.94
Issue Date . . . . Valuation . . .
. 0
Expiration Date 12/24/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
.75
-----------------------------7--------------------------------------=-------
Special Notes and Comments
ADD 2 FIXED TEMPERED GLASS WINDOWS IN
EXISTING OPENINGS. ADD 2 CASEMENT
TEMPERED GLASS WINDOWS ABOVE NEW PONY
WALL IN EXISTING OPENINGS. INSTALL NEW
DOOR & PULL FLOOR PLUG THROUGH WALL.
NOTE: ALL IN UNCONDITIONED SPACE. 2010
CODES.
--------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
-------------
1.00
ENERGY REVIEW FEE
7.61
Fee summary Charged Paid Credited-
----------------- ---------- ---------- ---------- ----------
Due
Permit Fee Total 132.75 .00 .00
132.75
Plan Check Total 79.99 .00 .00
79.99
Other Fee Total 8.61 .00 .00
8.61
Grand Total 221.35 .00 .00
221.35
LQPERMIT
I
Bin #
City of La Quinta
Building 8T 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: 'Q v2 %A.
P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone
Address:
Project Description:
City, ST, Zip:
%2sS GrJiivOOG�� /N C :<� �iiY o �/vi
Telephone:
"'vr.{:�;:::�:{y�vz:J:�rr,••�
� 7
State Lic. # : CityLia #•:
Arch., Engr., Designer:
Re
GP.a�LL J E i iiY�
Address:
City., ST, Zip:
0,e 54 - /l&7a—
Telephone:
::6'v is •ti:j:•::; vi��'J��r•jr L 4 J:'
S:it<Li�•{:fri7�JJiJ �\.:r:i{f:C
•Y•�i ra'{i�:.i4{Jv':�{Y<6:jiEp:::..;•�
y. L
J;::::>.":;.,..•.."::.�::L•l:x�%:>a:�,:::sJ»s;{;>k.
Construction Type: Occupancy:
State Lic. #:
Project a circle one New Add'n Alter Repair>r.,4"s•>.;Y�s,,z•<;:J:..:J;s�:.c,•.J.�k
J type � )� Demo
Name of Contact Person:LXXpw e �d'VS 7
Sq. Ft.:
#Stories:
# Units:
Telephone # of 'ontfact Pe on:� ,� p �e"� -jo 9,g
Estimated Value of Project: /64bcn CA15
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
2i1 Review, ready for correctionsfissue
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
School Fees
Total Permit Fees
So
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDIN:, & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Cons{ruction Permits
[11TP0T,_ JVTt NOTICPEuTy OWNED
Dear Property Owner.
An. application for a building permit has been submitted in your name listing yourself es the builder of the property
improvements specified at ' l,2 Z o%
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as &-,
Owner -Builder. We will not issue a building permit until you have read, initialed your unierstanding 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.
0M7q 'S ACHI"WLEDGMENT AND VERMCATWN OF N
DfRECTTONS: Read and initial each statement below to signify you understand or verify this Kormation.
I. 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. 1, 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 ma -1 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-
tV-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..
eg( _3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that f 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. l 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 my construction is at least five hundred dollars ($500), including labor and materials, i may be considered an "employee'
under state and federal law.
CjL6. 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 financial
risk.
t_7. I understand under California Contractors' 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 licensee
subcontractors and the number of structures does not exceed four within any calendar -ear, or all of the work is performer
under contract with a licensed general building Contractor.
if
_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
financial or personal iDjuries 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
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.
C10. 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 rtonsibte for proposed construction activity at the following address:
i
I. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner -Builders as well as employers.
4 12. 1 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 cowt. 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 property 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 issnitig; &e.perm kL Note: A copy of the property owner's driver's License; form n0t6u*adon; or
other verification acceptable to the agency is required to be presented when the permit is issued to verify the property
owner's signature.
Signature of property owner c�,,) fes, i Date:/jam ('77–
Note:
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 1 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):
Project Location or Address:
Name of ?kuthorized Agent: �%,e,,� QErJ�a 40c,5 417 �,b ep Tel No "
Address of Authorized Agent: Q5`– � � �� � � 2R4 3
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:(1, l J� �/ Date: — d j
26'-3'
CITY OF LA QUINTA
e'er' �'� �'�• 5 OIL BUILDING & SAFETY DEPT.
2'-0' .5'-a ,•-�• 6• 9•-p• APPROVED
FOR CONSTRUCTION
2'-O' 5'-10' 7'-3' 11-9'
C DATE J-:---! 1 By
I -T 1( 9 j F,;
ME
r--- ----- -----
I
I
I
1
4 41 ,•-o•
N
ZP
1
ll»
4 A
.4-4).
CHIP AND SANDRA FISHER
80 273 VIA PESSARO
LA QUINTA, CA. 92253
760 777 7224
0 sa(5ndra.fisher(@cox.net
I _ _ _ _ cell 208 4812998
8'-4' 6'-4'
82T i
9'-0' CL*G
CARPET'
o _
SE i0
t
/-4- i'-4' y SLOPE
4' 2�-II' g•
2'-8' I_ I. 5'
1
I �
,I
1
1
I .
I
I
I
61 1 L
;o
May 5, 2011
To: City of La Quinta, Building and Safety Division
Re: Fisher Residence, 80 273 Via Pessaro, Lot 43, The Hideaway
We are submitting the attached drawings for permitting to enclose a small
covered deck on the second floor of our home.
1. & 2. Install fixed tempered glass at the courtyard facing opening
and at an opening overlooking the roof.
3. & 4. Install operable tempered glass windows above a new pony
wall on the Front and Right elevations. a
5. Install a door to this area.
I
All windows and doors to match existing doors and windows, green
aluminum clad wood, manufactured by Sierra Pacific and installed I
per manufacturers installation requirements and as existing doors
and windows. Windows to be a minimum of 6" recessed in existing
frame. Reinstall the iron railing in front of the new pony walls so 1
that the exteriors elevation would remain unchanged in any way
other than the glass windows. The glass will be tempered as
required by the City of La Quinta. This will be a non -conditioned
space.
t
1
�— -------------------
I
I