10-1408 (BLCK)P.O. BOX 1504 Qum& VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT. INSPECTIONS (760) 777-7153
BUILDING PERMIT
Dater 12/27/10
Application Number: r1-0-00001408 v Owner.
Property Address: 52493 AVENIDA VILLA SIPE & SCHOPF RESIDENCE
APN: 773-273-023-11- -000000-. 52493 AVENIDA VILLA
Application description: WALL/FENCE LA QUINTA, CA 92253
Property Zoning: COVE RESIDENTIAL (541)477-0800
Application valuation: 1075
+ Contractor,'` ''� n u 1f '
Applicant:
/� A Architect or Engineer: Owner �U I j+J
�,�%/C`� „' � ��`� _• irC IC�Gs�� Y , ,M1 • � � �i � rr ; 1 r. i � -.,J
` 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 (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 ($5001.:
(_) 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 orimprovement 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 ISec. '
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 contractorls) licensed
pursuant to the Contractors' State License Law.).
1 _ 1 I am exempt under Sec. B.&P.C. for this reason
Date! Owne
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 -
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 .
ce carrier and policy number are: TT
Carrier -- -a�V �----- - - -_ -- Policy Number d A 3'7 If �� V�
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 SPrtinn
�.:33Y7,100 of the Labor Code, I shall forthwith comp with those provisions.
-Date:- 1 - �APPligant
ho 'Ay
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND -
DOLLARS 1$100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
y,. 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 tothework being
- - 'performed under or following issuance of this permit.• t
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 construction, and hereby authorize representatives
of -this county to enter upon the above-mentioned properR for inspection purposes./%
Date:" 2 i nature (Applicant or A� t :
Application Number . . . . . 10-00001408
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee . . 27.00 Plan Check Fee
.00
Issue Date . . . Valuation . ...
1075
Expiration Date 6/25/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
6.00 2.0000 HND BLDG 501-2,000
12.00
---------
Special Notes and Comments
43 IN FT X 6 FT HT GARDEN COURTYARD -
OURTYARDENCLOSE
ENCLOSE BLOCK WALL PER ORCO STANDARDS
AND APPROVED PLANS,PER G.B.
----------------
Other Fees -. . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee luminary Charged Paid Credited
Due
Permit Fee Total 27.00 .00 .00
27.00
Plan Check Total .00 .00 .00
.00
Other Fee Total 1.00 .00 .00
1.00
Grand Total 28.00-. .00 .00
28.00
LQPERMIT
-
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING &c SAFETY DEPARTMENT
PROPERTY O"ER'S PACKAGE
(760) 777-70.12
FAX (760) 777.-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IPORUAT! NOTICE TO MOM
RTY 4WATEtt
Dear Property Owner
An. application for a building permit has been submitted is your name listing yourself as the builder of the .property
impFovements Spec at 45 3 A Venida .billa- 0 LftQVIA1rf1 & q
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 he
Owner -Builder. We will not issue a building permit until you,have read, initialed your understanding of ea&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.
OV WS Af1Q!QV ;EJ)(;MNT AND'WREWATION`OF II A
DI CTWIVS: head and initial eachstatement beloiv"to`sigidfy you understand`or'verify this information.
1. 1 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 persbuaft. 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 understand building permits are not required to be signed by property ownersunless 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. party of record ori the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having.the permit ailed in his or her name instead -of my _
4. I understand Contractors are required by law to be licensed and bonded in Califorria and to list their license numbers on
permits and contracts.
. 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.
4&/6. 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
7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
s" ctures 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."
4F
LV& I understand as an Owner -Builder if I sell the roe for which this I may be held liable for an
property rtY per is issued, y Y
financial or personal. 4.udes sustained by any subsequent owner(s) that result from any latent construction defects in the
orkmanship or materials.
4�6- 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. [.also understand I may contact the California Contractors' State License Board (CS LB) at I-
40-321-CSLB (2752) or www.cs[b.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
party legally and financially responsible for proposed construction activity at the following address:
11. I agree that, as the 1 all and finauciall resp' for this m osed construction activi I will abide b all
FAY.. Y Y P P P' h', Y
licable liws and requirements that govern Owner -Builders as well at employers.
Zve
12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or, changes to day of the information I
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 finanOhll loss
you may sustain as a result of a complaint Your only remedy against unlicensed Contractors may be, inicivil court. It is; also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while wod dng
on your property; you- may be held liable for damages. If 'you obtain a permit as Owner -Builder and wish to hire Contractors,
You wilt 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 issulttg; Me.pernAt. Note; A copy of dw property owner,$ djJver!s ftcettse; form noWdwdvn� or
other verification acceptable to the agency required to be presented when the permit is issued to verify the Pioperty
owner's sisnature.
Signature of property owner
- # Date: l t Z
-10
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 KHALF
Excluding the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize
the following person(s) to act as, my ageat(s) to apply for, sign, and file the documents necessary to obtain art Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of ?kuthoriaed Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjurythat 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:
SAFECO INSURANCE COMPANY OF ILLINOIS
2800 W. Higgins Road, Suite 1100, Hoffman Estates, Illinois 60195 (A stock insurance company.)
QUALITY -PLUS HOMEOWNERS POLICY DECLARATIONS
J INSURED: POLICY NUMBER: OA3710507
STEPHANIE SCHOPF POLICY PERIOD FROM: MAY 28 2010
`CHRISTOPHER SIPE AT: 12:01 A.M.
410 S OREGON ST TO: MAY 28 2011
JACKSONVILLE OR 97530-9349
AGENT:
CALIFORNIA INS'SPECIALISTS
RESIDENCE PREMISES: PO BOX 15206
52493 AVENIDA VILLA SANTA ANA CA 92735-0206
LA QUINTA CA 92253-5213
TELEPHONE.::;C&C-0)T 2'31_-46519
Your new policy is effective May 28, 2010.
-'THIS POLICY DOES NOT.PROVIDE EARTHQUAKE COVERAGE.
-.The limit of liability for this structure (Coverage A) is based on an estimate of
the cost to rebuild your home, including an approximate cost for labor and
materials in your area, and specific information that you have provided about your
home.
SECTION I - PROPERTY COVERAGES S
A - Dwelling 170,000 $ 686.00
B - Other Structures 17,000
C - Personal Property 85.000 -27.00
D - Loss of Use 24 MOWAS .
S'ECTLON�II -- LIABIL`ITY��COVERAGES2 37.00
E r_
- Pesona - Liabislfty (:eacr
ha.occurence) 5:O.Or,�0:0:0;.
Fes-, -=.Med .ca!lv.,Payments. C'each7 person)• 1,000
INCLUDED COVERAGES Included
Building Ordinance or Law Coverage
Included in limit applicable to Coverage A
Full Value on Personal Property Included
Extended Dwelling Coverage Amount 85,000. Included
Private Residence Employees Included .
Workers Compensation - Occasional
Of
AMV M- L011
Section I N/A S 11000
<:'=:. .
96 . Q .
You may pay your premium in full or in installments. There is no installment fee if
you pay in'f.ull. There is a fee for each installment. If more than one policy is
billed on the installment bill, only the highest fee is charged. The fee is:
$0.00 per installment for recurring automatic deduction LEFT)
$0.00 per installment for recurring credit card or debit card
$2.00 per installment for all other payment methods
CHO-6000/EP 9/06, CHO-6033/EP. 2/00, CHO-6133/CAEP 1/05, CHO-6260/CAEP 6/99
ORIGINAL
CH0� MWEP 9/06 Page 1 of 1 OATS PREPARED MAY 31 2010
G1' , i
Bin #
City of La Quinta
Building a Safety Division
P.O. Box 1504, 78-495 Calle Tampico '.
La Qulnta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
i
Project Address: ��,(�93 lgveh%da t%IIGL.
Owner's Name: 61X, Chr1:)1yAer i hve
A. P. Number: q73 -�2 73 -OZ3
Address: 52493 AVeniaa 11,14
Legal Description: Exyi%i "��� CC.ifQCL/{Q
City, ST, Zip:ZZ53
Contractor: 0
Address:
Telephone:x'¢/-4%7 0pio
Project Description: G,40p6A1 GJ�L
City, ST, Zip:
Telephone:/0-
State Lic. # : City Lia M.
Arch., Engr., Designer.
41 w at
y
Address:
City, ST, Zip:
If17A:1�17.
Telephone:
State Lic. #:
Name of Contact Person:
Construction Type: Occupancy:
Projecttype (circle one): New P_dd'n Alter Repair Demo
Sq. Ft:
#Stories: #Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Recd
TRACKING
PERMTr FEES
Plan Sets
Plan Cheek submitted
Item Amount
Structural Cates.
Reviewed,.ready for corrections
Plan Cbeck Deposit
Truss Cales:
Called Contact Person
Plan Check Balance
Title 24 Cake-
Plans picked up
COaSC'lletiOO '
Flood plain plan
Plans resubmitted
Mechsn[al
Grading plan
2'! Review; ready [or correctionsilissue
Electrical
Subeontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L
H.O.A.' Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
. Developer Impact Fee
Planning Approval
Called Contact Person
A.U.P.
Pub. Wks. Appr
Date of permit Woe
School Fees
Total Permit Fees
�4-Y . ...
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f
OF78.105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 - (619) 564.2246
April 25,-1989
Ms. Teresa Rowland
106 East Washington, Suite 200
Colton, California 92324
SUBJECT:ORDER NO. R-78810-1, LOTS 10 AND 11, BLOCK .1101
Dear Ms. Rowland:
Based upon the following facts, it has been determined that-,
Lots 10 and 11 of Block 101, Santa Carmelita at Vale La Quinta
can be sold as two separate lots.
Facts:
1. Lot 10 has a home constructed on site. This home was.
finaled by the County Building Department on June 9, 1982.
2.. Lot 11 has an,older home constructed on site. This home
was brought up to code on January 22; 1981.
3. A single grant deed identifies both lots.
4. Record of a lot merger cannot be found.
5. Existing 50 x 100 foot, lots are permitted to have a
single family home.
6. Two homes on one lot is a violation of current zoning
regulations.
Should you have any questions regarding this,matter, please do.
not hesitate to call.
Very truly yours.,.
erry Her
Planning and Development Director
JH/ad
AD/LTRJH.026
MAILING ADDRESS P.O. BOX 1604 LA QUINTA; CALIFORNIA 92253
v
j ) JOB f Q eD PE7A-
/
/ SHEET NO. / OF / p
/ CALCULATED BY 8/LG TAFT DATE
iPN. 32 x}39®
CHECKED BY �AV DATE
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