11-0114 (BLCK)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: -x-11-00000114
Property_ Address: 54575 AVENIDA HERRERA
APN: 774-282-015-4 -000000-
Application description: WALL/FENCE
Property Zoning: COVE RESIDENTIAL
Application valuation: 4500
Applicant: Architect or Engineer:
el -11-1 - P [ V -\-
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 70001 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 ($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 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 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, 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
I—) I am exempt under Sec. , Bj}&P.C. for this reason
CONSTRUCTION LEN04G 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:
DIWAKER RAMAN
17612 MAPES AVENUE
CERRITOS, CA 90703
---------------------r�-� _
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 2/01/11
�D
Contractor: FEB 01 2011
Owner
crry of {.A QUINT
------sCE DEPT
uaA?
WORKER'S COMPENSATION DECLARATION
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 become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provisions.
Date:. pplic.nt:
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 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 190 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 d state laws relating to builging construction, and hereby authorize resematives
offtthi/s �-ountyy to enter u the above-mentioned prop. for inspection purposes.
a15 te: 2--/– Signature (Applicant or Agent):
Application Number . . . . . 11-00000114
PermitWALL/FENCE PERMIT
Additional desc .
Permit Fee 72.00 Plan Check Fee
.00
Issue Date . . . . - Valuation
4500
Expiration Date . .. 7/31/11
Qty Unit Charge Per
Extension.
BASE FEE
45.00
3.00 9.0000 THOU BLDG 2,001-25,000
27.00
--------------------------------------------------------------------'--------
Special Notes and Comments
180 L.F. 6' SIDEYARD WALLS (2) CITY
STANDARD, 2010 CODES, PER,KK
----------------------------------------------------------------------------
Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
------- ---------- ----------
Permit Fee Total .00 .00
72.00
_72.00'
Plan Check Total .00 .00 .00
.00.
Other Fee Total 1.00 .00 .00
1.00
Grand Total 73.00 .00 .00
73.00
LQPERMIT
Taf 4 4 Q191444i
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(7 60) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
WEVE 'ANT! NOTICE TO PROPERTY 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._ (t j�i �te�s A_q,,w*_Aa (a 14 ('{l
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 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.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand orverify this information.
J20-1. 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. L. 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.
J2. 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.
3. I understand as an "Owner -Builder" I am the responsible party of 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 her name instead of my
own.
06-4. I 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 "employer"
under state and federal law.
.Ag^_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
risk.
7. 1 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 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. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
rf nancial or personal. injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
–4 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.cslb.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:
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.
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 ith any financil loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
important for you to understand that if an unlicensed Contiactor 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 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 issuing: the permit. Note: A copy of the property 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.
Signature of property owner �— Date: /Z
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 asmy 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 1luthorized 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.
n / u Zor
Property Owner's Signature: �`�O^P"- ��– Date: _ (� /
Diwakar Raman
7o Whom It May Concern:
Hi,
17612 Mapes Ave
Cerritos, Ca 90703
I recently purchased a property in La Quinta, Ca (Address is 54575 Avenida Herrera, La Quinta, Ca). As
part of many renovations to this house I am planning on building a block wall on both sides of the
property as per the city code. As I currently reside in Los Angeles, I am unable to come in person to
obtain the necessary permits for the job before we proceed. I have asked Mr. Francisco Corona to
represent me for the same. Mr Corona is representing me and I hereby authorize him to work with the
city to obtain the necessary permits on my behalf.
I have also enclosed a copy of the title for the house. Please feel free to contact me in one of the
numbers below in case it is needed.
I appreciate your time and the guidance in this matter.
Regards,
�•,..� /��,� ����/orf
Diwakar Raman
f' RECORDING REQUESTED BY:
Lar/yers Title Company
AND WHEN RECORDED MAIL TO:
Mr. Diwakar Raman
17612 Mapes Avenue
Cerritos. CA 90703
Title Order No.: 310322343
DOC # 2090-0625551
12/30/2010 10:22A Fee:15.00
Page 1 of 1 Doc T Tax Paid
Recorded in official Records
County of Riverside
Larry W. Ward
Assessor, County Clerk & Recorder
Illlll llllill lllli lli llilll lllll Illlll lil llili Illi Illi
PAC
DA i ,,lsC I LONG -„ i
' i /� i. < F I 42G ?CCR I P" 'Li: ;, a` �✓ % CLiQ
t
'Y �Ut il5
Escrow No.: 003171 -AP •.., ._ _
GRANT DEED
i
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $77.00
[X] computed on full value of property conveyed, or
( ] computed on full value less value of liens or encumbrances remaining at time of sale.
[ ]t;Unineorporated area [X] City of La Quinta AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged
Fargo Bank, NA
hereby GRANT(s) to:
Diwakar Raman, a Married Man, as his sole and separate property
the real property in the City of La Quinta, County of Riverside, State of California, described as:
Lots 3 and 4 in Block 305, of Santa Carmelita at Vale La Quinta, Unit #28, in the City of La Quinta, in the County
of Riverside, State of California, as per Map recorded in Book 19 Pages 59 and 60 of Maps, in the Office of the
County Recorder of said County..
Also Known as: 54575 Avenida Herrera, La Quinta; CA 92253
AP#: 774-282-015-2
DATED: December 27, 2010
STATE OF CALIFORNIA
COUNTY OF San
On !
before me: --�-- ——--_. --
a Notary Public in and for said State personally appeared
James Tyler er and BriAnn Hailey
who proved to me on the basis of satisfactory evidence to be
the person(s) whose name(s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s)
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State
of California. that the'foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Wells Fargo Bank, NA
By.
James Tyler, Sr. REO Sales Manager
By:
BriAnn Hailey, REO Sales Representative
I: IC 0. CASA$
r Ctit;t. Y °735173
C�'r5i4 ...
;TR
Signature (Seal)
MAIL TAX STATEMENTS TO PARTY SHOWN BELOW; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE:
I
Bin #
Qty of is Quinta
Building 8L Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # V\P.O.
\
\
Project Address: 57457 5 WG P
Owner's Name: W p )LA R A""I"rV
A. P. Number:
Address: 1-1612- MAKS 6\
Legal Description:
City, ST, Zip: I TVS CA 90-703
Contractor:
Telephone:
Address:
Project Description:
City, ST, Zip:
& u t L 0 NL t))C.):=- .1i O LL R
Telephone:
^} .:r ... rx< •tea.:
<>: - .:a .' ::"� :
14 i 1 OF 0 K
State Lie. # :
City Lie.
W ? t_r)CG C Kai I o.0
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
% ` r " >. V , > na
......
Construction Type: Occupancy:
State Lie. #:
Project acircle one New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKUVG
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.
Pians picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
a
2°" 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.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees