0012-177 (AR)LICENSED CONTRACTOR 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 Busiriess and
Professionals Code, and my License is in full force and effect.
License # ' Lic. Class Exp. Date
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
(, 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors" to construct the project (Sec. 7044, Business & Professionals
Code).
() I'amfexe pt under Section B&P.C. for this reason
y
Date �ii "' f`�Signature of Owner�_'0a%t.(J VA .A&I
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 & policy no. are:
Carrier Policy No.
(Thi section-need.not be completed if the permit valuation is for $100.00 or less).
( 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, Ishall forthwi h comply with those prow Ions.. T
Date: i (^^v 'L? Applican ha.�..l,r. t1 1 w0 il�
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $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.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject ' to the conditions and restrictions set forth on his
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 applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers,. agents and employees.
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 State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent)\ ^ &Lkd. -7�--�k�Q.a�&' Date Pl'4�1 7�
BUILDING PERMIT PERMIT#
DATEVALUATION LOT �� �1` r 7'O TRACT
Js� 0� • �i#1� i 8 - li��
JOB SITE t
APN
ADDRESS •
1-616 AVENIDA1.HMMIRA.
OWNER
CONTRACTOR / DESIGNER / ENGINEER
3~ NAC` HO COMMAS
O VINF l3CTT-l.1 ER
51.616AVMAYIOW A
LAQCJii�T`-A C& 92253
USE OF PERMIT
GI1~Iv"1 RAL%3UMMOr
110 '13Y ROOM ADDITION (Ib3i:'I TND H3P..;VR0O*M &ADD ;t,+ 0W'YA STAd.'G) AS
PF,R APPFIOVE y PLAN'S ONLY
VA,VATION Vw,Do LZ
ERMNUa1RD COM OF 001.1-MU(°:d7CON
C"• )N!",TRUC'r ION "X, 1..01-000-4.18-000 $61180
ME:Cl3.hNIC,ALYRe 101-000-1.1.000 SM00
I;i l�f.'`l' IC'•Ai. Stlrib.'. .101 47 -'n�Q I�,BI1
WLi MAIN40 FEE;., sn'00
S'i RONO MOTION ft%. • PtUS.ID 1411-000-241-1000
, fALHWIRUI;10.9fiXDT� _CXC:F7D
$179.45
^ O�LEMS I"hRE PAM PTI'. ,
$0.00
lb yop
J
% TAL P14NI YY"S Dom: ROW
P�
� � v 9
•
RECEIPT y
DATE
d �
BY
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms 8 Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap -mC S
F.A.U.
Framing $-, p Gj�
Insulation D
Compressor a
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final - -
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
OWNER/BUILDER INFORMATION
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.
a.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing"their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law' to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of variuus trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may",be financial risks for you,if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small -Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is'iniended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by propertyowners unless they are performing their own work
personally. w
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814. r`
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours, /(!/,;fr+
i z
CITY OF LAQUINTAF/L Al
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico /r
La QuintaCA;9?253`�
(760) 777:7012`"
FAX (760) 777-7011.pFa
�
11 1A XAl fi,�a 1t
OWNER'S SIGNATURE/ DATE
PROPERTY ADDRESS
a
PERMIT NUMBER(s)
Additions of less than 1,000 square feet meet the
requirements of package D for the applicable
clirnate zone with the following exceptions: walls
meet only the mandatory insulation level of R-13
in a wood frame; glass area is limited to the
percentage allowed by the' package plus any
glass removed because of the addition.
Additions of 1,000 square feet or more meet all of
the requirements of package D.
Dual -Glazed Skylights and Dual -Glazed
Greenhouse Windows
Dual -glazed skylights or dual -glazed greenhouse
windows are treated as though they have the U -
value required for prescriptive compliance.
Dual -glazed skylights and dual -glazed
greenhouse windows should be included - in
compliance calculations as a fenestration product
with a U -value equivalent to the Package D
requirement for the appropriate climate zone (or
0.75 for additions of less than 500 square feet).
Table 74: Prescriptive Compliance of Additions -
Summary of Section 152(a)1 Requirements of the Standards
1. This approach does not allow credit for glass removed. Compliance with the requirements for
additions of less than 500 square feet is allowed, in which case credit for glazing removed is allowed.
2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory
requirements.
3. "Heavy P .ass" and "Light Mass" walls may meet the Package D requirements for mass wall insulation
instead of R-13 (see Chapter 3).
4. For addition and alteration compliance only, dual -glazed greenhouse windows and dual -glazed
skylights are assumed to meet this requirement.
5. The Package D fenestration area plus the area of any glazing removed because of the addition.
6. All applicable mandatory measures must be met (see Chapter 2).
7. No electric resistance space heating may be installed.
Additions and Alterations July 11, 11999 7-7
Q
> 500 but
COMPONENT
< 100 ft2(1) .
< 500 ftz
<1000 ftz
>1;000 ftz
Insulation
Ceiling
R-19
Package
Package
Package
Wa113
R-13.
R-13
R-13
Package
Floor
Mandatorys _
Package
Package
Package
Fenestration
Max. U -Value°
0.75
0.75
Package
Package
% of CFA
< 50 ftz
Pkg. + Removeds
Pkg. + Removed'
Package
Shading
N/A
Package
Package
Package
Space Heating'
Mandatory6
Package
Package
Package
& Cooling
(No electric)
(No electric)
(No electric)
(No electric)
Water Heating6
Replacement
N/A
N/A
N/A
N/A
Increase
See Table 7-2
See Table 7-2
See Table 7-2
See Table 7-2
1. This approach does not allow credit for glass removed. Compliance with the requirements for
additions of less than 500 square feet is allowed, in which case credit for glazing removed is allowed.
2. Meet the component prescriptive requirement for Package D (see Chapter 3) and all mandatory
requirements.
3. "Heavy P .ass" and "Light Mass" walls may meet the Package D requirements for mass wall insulation
instead of R-13 (see Chapter 3).
4. For addition and alteration compliance only, dual -glazed greenhouse windows and dual -glazed
skylights are assumed to meet this requirement.
5. The Package D fenestration area plus the area of any glazing removed because of the addition.
6. All applicable mandatory measures must be met (see Chapter 2).
7. No electric resistance space heating may be installed.
Additions and Alterations July 11, 11999 7-7
Q
TABLE NO. 1-Z15
ALTERNATIVE COMPONENT PACKAGES
" . FOR CLIMATE ZONE 15
LEGEND: NR = Not Required; NA = Not Applicable; REQ = Required; MIN = Minimum
SEE NOTES FOLLOWING TABLE NO. I -Z16
342 July 1, 1999 Residential Manual
PACKAGE]
COMPONENT ''
A
B
C
D
BUILDIN IVVELOPE
Insulation Minimums2
Ceiling
R30
R38
R49
R38
Wood Frame Walls
R19.
R19
R29
R21
"Heavy Mass" Walls
(R5.5)
(R4.5)
NA
(R4.76)
"Light Mass" Walls
[R7.0]
[R6.0]
NA
NA
Below Grade Walls
NA
NA
NA
RO
Slab Floor Perimeter
R7
R7
R7
NR
Raised Floors
R19
R19
R21
R19
Concrete Raised Floors
NA
NA
NA
R4
GLAZING
Maximum U-value3
0.65
a65
0.40
0.65
Maximum Total Area
NR
16%
16%
16%
Maximum Total Nonsouth Facing Area
9.6%
NR
NR
NR
Minimum South Facing Area
6.4%
NR
NR
NR
SOLAR HEAT GAIN COEFFICIENT4 .
South Facing Glazing
0.15
0.15
0.40
0.40
West Facing Glazing
0.15
0.15
0.40
0.40 C
East Facing Glazing
NR
NR
0.40
0.40
North Facing Glazing
NR
NR
NR
NR '
THERMAL MASS5
REQ
NR
REQ
NR
INFILTRATION CONTROL
Continuous Barrier
NR
REQ
NR
NR
Air -to -Air Heat Exchanger
NR
REQ
NR
NR
SPACE HEATING SYSTEM6
Electric Rsistant Allowed
NO
NO
YES7
NO
If Gas, AFUE =
78%
78%
78%
MIN
If Heat Pump,
Split System HSPF8 =
6.8
.68
6.8
MIN
Single Package System HSPF =
6.6
6.6
6.6
MIN
SPACE COOLING SYSTEM
IJSplit System A/C, SEER .=
10.0
10.0
10.0
MIN
If Single Package A/C, SEERS =
9.7
9.7
9.7
MIN
DOMESTIC RATER HEATING TYPE
System must meet budget, see
ANY
ANY
ANY9
ANY
151(b)1 and 15](1) (9)
LEGEND: NR = Not Required; NA = Not Applicable; REQ = Required; MIN = Minimum
SEE NOTES FOLLOWING TABLE NO. I -Z16
342 July 1, 1999 Residential Manual
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 1 of 2) CF -1R
Project Title
Project Address
Documentation Author
Telephone
..
Compliance Method (Package or Computer) Climate Zone
GENERAL INFORMATION
Building Permit li
Plan Check / Date
Field Check / Date
Enforcement Agency Use Only
Total Conditioned Floor Area ft Average Ceiling Height:
Conditioned Slab Floor Area ft2
Building Type: Single Family Addition
(check one or more) Multi -Family Existing -Plus -Addition
Front Orientation: North / South / East / West / All Orientations
(input front orientation in degrees from True North and circle one)
Number of Stories
Number of Dwelling Units:
Floor Construction Type: Slab/Raised Floor (circle one or both)
BUILDING SHELL INSULATION
M,
Component Frame Type- Cavity Sheathing Total R- Assembly
Type wd = wood Insulation Insulation Value' U -Value'
stl = steel R -Value R -Value
Location/Comments
(attic, garage, typical, etc.)
Wall �.
Standard
Wall
Standard
Roof p
Standard
Roof
Standard
Floor
Standard
Standard
Floor
Standard
Slab Edge
Standard
FENESTRATION
Shading Devices
Fenestration Orien-
#/Type/Pos. tation
Area Fenestration Fenestration Interior Exterior Overhangs
(ft) U -Value SHGC Shading Shading Att. /Fins
Att.'
Front
Standard
Front
Standard
Left
Standard
Left
Standard
Rear
Rear
Standard
Standard
Right
Standard
Right
Standard
Skylight
Standard
Skylight
Standard
' For prescriptive compliance, Total R -Value and Assembly U -Value are not required for a wood -framed wall that meets
cavity R -value insulation requirement for the Prescriptive Package.
' For prescriptive compliance, there are no credits for any interior shading except the default or"Standard" drapery. These
default. interior shading devices (draperies) need not be installed for compliance purposes.
July 1, 1999 . O.
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 2 of 2) CF -1R'
Project l isle
HVAC SYSTEINIS
Note: Input h\dnanic c^:n! t:::' !w,}i.,;rc d.r.:! tn:drt \-,;..; +
�,'� 11i�;trjl,JllJt1
Heating Equipment Minimum Iype and
Type (fumace. heat Efficiencv 1.oca?ion
Date
e•. I>: _ . I Ie:.:in,_ Load
Duct or Heat Pump
Pip int-, Thermostat Configuration
pump. ct_.) (AFIIL or I1S1'f) (ducts. attic. ete.) R-ValttC T% pe (split or package)
Cooling Equipment
Minimus)) ---
Duct
Heat Pump
Type (air conditioner.
Efftciericv
Lnc::tion
Duct Thermostat Configuration
heat pump. evap. cooling)
(Srl'It)
(attic. etc.)
'R -Value Type (split or.package)
WATER HEATING SYSTEMS
Energy' External
Rated, Tank Factor or Tank
Water Heater Distribution Number Input VAV Capacity Recovery Standby' Insulation
Type Type in S\•stcnr (.r 13nt°hr) (gallon.! Efficiency Loss (°o) R -Value
1. For small gas storage water heaters (rated inputs of fes: than or equal to 75.0NI Itttr/hr). cleciric rebistance. and heat pump water heaters. list Energy
Factor. For large gac stotagc water heaters (rated input of grentct than 7:.11110 Htu ht). list Rated Input. Recovery Efficiency and Standby toss.
CFor instantaneous gas water hcatcn. list rated input and recover\ efficiencies.
SPECIAL FEATURES anti MODELING ASSUMPTIONS (Add extra sheets if necessary)
including Thermal Mass (thermal mass t\;I):, co\ering, thickness. and description)
COMPLIANCE STATEMENT
This certificate of compliance lists ow buildinc fcatutc: and perlorntarce specifications needed to comply with Title 24. Paris 1 and 6 of
the California C o& of Regulations. and the adnrinkirativc regulations to implement them. This certificate has been signed by the
individual wilh overall design responsibilit\. WVhen this certificate of compliance is submitted for a single building plan to be built in
multiple orientations. any shading feature that is \ari;c! is indi aged in th:• Spccial Features / Remarks section.
Designer or Owner (her Businessand Prolessions Code)
Name:
Title'Firm: _
Address:
Telephone: .
Lic. P:
(signature)
Enforcement Agency
Name:
Title.
Agency:
�. Telephone:
(signature / stannp)
(da!:)
Docomentatioh Author
Namc:/✓�r2—
'I tlloTinn:
Icicphone. 7/el3L13—g2-10¢'
Isi ma rr) (da c)
JalN. 1, 1999
Notice:
Document Cannot Be Duplicated
Date 1/2/01
No. 21432
owner NameHerachio Contreras
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
No. 51-616 Street Avenida Herrera
City La Quinta
Tract # BLK52 Lot # 18
Type of Development Residential Addition
Comments
APN # 773-133-007
Jurisdiction La Quinta
zip 92253
Permit # 0012-177
Log #
Study Area
Square Footage 120
is an extension of bedroom & shower stall.
No. of Units 1
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It
has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: .
Residential Addition 500 Sq Feet or Less
EXEMPT
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of
0.00 X 120 or $ 0.00 the property listed above and that bui0ing
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By N/A - Maria Soledad Contreras Telephone
Name on the check
v
By Dr. Doris Wilson �'
Superintendent
Fee collected /exem ted by Annette Barlow Exempt $0.00
/ _ o Check N6. N/A
Signature
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
ollect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDING REQUESTED BY
M/M CONTRERAS
AND WHEN RECORDED MAIL TO
Name
Street MR. & MRS. CONTRERAS
Address 51616 AVENIDA HERRERA
City, State
Zip Code LA QUINTA, CA. 92253
FILENO. 00 221027
DOC N 2000-418610
10/24/2000 08:008 Fee:6.00
Page 1 of 1
Recorded In Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 8 Recorder
1111111111111111111111111111111111111111111111111111111
M
$
U
PAGE
SIZE
DA
PCOR
NOCOR
SMF
MISC.
J.
A
R
L
COPY
LONG
I REFUND
NCHG
HUSBAND AND WIFE AS DECLARED OWNERS
We, HERACLIO CONTRERAS and MARIA S. CONTRERAS
do hereby certify and declare as follows:
Itp
We are married to each other. We hereby claim as a homestead and make ourselves declared homesteaded owners of, the premises
located in the City of LA QUINTA
County of 1�VER.S ISE State of California, commonly known as
51 61 6- AVENIDA HERRERA, LA .,T IN A, GA.
and more particularly described as follows:
LOT 18 OF BLOCK 52, IN BOOK 18, PAGE 63 OF MAPS.
We are the declared homestead owners of the above declared homestead. We own tee title interest in the above declared homestead:
The above declared homestead is our principal dwelling , and we are currently residing on that declared homestead.
:)l with dependents. ❑ declared owner(s) are over 65 years of age. ❑ declared owner(s) are disabled.
The facts stated in this Declaration are true as of our personal knowledge.
Dated: _A [Lr 11 G T 2 8 P-0 0
HiRACLIO CONTRERAS
MARIA`S. CONTRERAS
STATE OF CALIFORNIA
COUNTY OF RIVERSIDE
On this 5Th of October , 20 , before me, ENEIDA CEDENO (here Insert name and title of the
officer), personally appeared HERAMO CONTRERAS AND MARIA S NT S personally known to
be (or proved to me on the basis of satisfactory evidence) to be the persons) whose name(s) is/are subscribed to be within instrument and'
acknowledged to at he/sheAhey exeucted the same in his/hai/their authorized capacity(ies), and that his/hernheir signature(s) on the instrument
the person(s r t n ty upon behalf of which the person(s) acted, executecltlle ......
ra ENEIDA CEDEII
WITNES y h d _ ``i'j Commis ion # 1241976 z
�..
,Ir�r� Notary Fublic �- Californla $
Signatur (Seal) z : - Riversid.. County
Copyright T.C.. . ev. ti/84 MyCcm rn.t5:p5�Dac15,2M3 , TCP -6
OWNER / BUILDER INFORMATION
Dear Property Owner:
An application for a building permii has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "Owner/ Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection:
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations including State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Adminstration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/ Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAK,(760) 777-7011 q
4 Akln) 401�n
OWNER'S SIGNATURE/DATE
PROPERTY ADDRESS
it
PERMIT NUMBER(s) ,