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0212-181 (GRES)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 Business and Professionals Code, and my License is in full force.and effect. License # Lic. Class Exp. Date Date Signature of Contractor i.. . 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 offeredfor sale (Sec. 7044, Business & Professionals Code). I, as owner of the property,�am exclusively contracting with licensed contractors to construct the project (Sed'7044, Business &%Professionals Code). 13 O I amoexemptJunder Sections B&P.C. i t this rrelason Date �%/rte°} ' ., Signature of Owner'Ki/, "�! 4 1 11h#1,d.1_✓' r 1131 f WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: () I have and will maintain a7certificate 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. (This 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�topthe workers' compensationprovisions of, Section 3700 of the Labor .Cocle,di.91jall fort:•'?hwith comply w�,1 1ith,those pr v dons - Date:. h //a . Applicant / %17 r eJ/,�e i Warning: Failure'io 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 •:t 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. -scertify that I have read this application and state thaYl a above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authofize representatives of this City to enter upon the above-mentioned property for ins ection puoses j Signature (Owner/Agent) / �s�' �:( /� f Ratel, PERMIT# ' BUILDING%.PFRMIT;; . r L �` DATE VALk'TION` LOT TRACT JOB SITE ` . APN. ADDRESS :.2A ColA�fti� OWNER CONTRACTOR / DESIGNER / EN (NEER 44_2,95 VM CORONAl: O T.rA Cw7V''.INaTA: CA 92W 03TA USE OF PERMIT C:iARAGY OR CARHC1.1'T 3 ' t,1t�7.'�.CHtp13 Cf`�,lu�t;SY X33 �.N.i�t�l'f;:i"f'dC3,i1.'I'ICS•1�' frff.�' �g,4'3?35�� �E?� 2�3�7 U1=1ITNAM DMPOS't'R.ATI -000, §301,41 POWWOW ��.i�.:C V WITHOUT 1%J1LL�SPf61 ��:1tMt't': �� .�. .✓ � ••,... MAY 14 1003 . CI OF LA OUItiTA a • INANCE DEPT. EYY pp++��-���• ++�88.�p�v�p .�,��Lww*GL .*�yy p� n�i y r 7 py . rlAnd:'.J:dAl'RSr➢r 1:101V6 OF .. O UJ..,Y13.�4�i�..i=O fir/ t FEMWIFF2 SUMMARY PLAN CHEM ITER3,03-QQQ­40'"41,8 3t�,SD t; ONSTKLIC'CION FEE x 01-(100.41 awooi3 00.00 E -LOC ',MrAf FEF~ 101 -OW -420-000 $23,23 S?'I�O�+if� �,�ta'£tO1t1 1�;�' R.T:SiS� 1 Q9 �•%�0-�k �. -QilQ A.65 s ORA13I1• O W- 101.000.4.44.OV) g% 1flA Tt'fY'1KSTlQrts`k'.f0h 17d?k: 101.000.423-000 a9ti.€tEi L,.j1L'd:1`.4 k.`' YAT, Wl.ffrfR-V i:'LL`✓J.T ifSC8gldqq.��l'�Ll'}gqfti��'•'1../ �C��dyyA'•.,, , (W��Slt/7r .4 1 L g TOTAL P MIJ Yrys DUE 14 ow 411). 4 # RECEIPT DATE BY 1 w r DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap _ _ F.A.U. Framing _ ,p Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation r 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 S .r Lateral Pool Cover Sewer ,onnection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring 1-703 Low Voltage Wiring s Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: its 'Bin # : Of 1r, - r City La Quints Building 8r Safety Division 1%Permii # P.O. Box 1504, 78-495 Calle Tampi o - La Quints CA 92253 -'(760) 777-7012 t t Buildin PermitA li g , pp cation and -Tracking Sheet. Y' Project Address: S t� Q /� Wrier's Name:'.' WL /UFSS A. P. Number: �� t • - Address: I T V/ Co,� Legal Description: Cita. ST. Zip:' A, A_ Clo1a S 3 , Contractor: U QL elephone: Address: A t�4�'� / S— CU Project Description: AJ Cr Ck Zip _ he Telephone: P ho ne: :::::...... a State Lic. # Cit,: � Lic. #: Arch.. Engr.. Designer` t a Addres > - o u N p S: , r 1 ' City. ST, Zip: 9� I r - I TelP e hone: Con • st ructi on v T .P e. - Occ u p anc�•: • �. Std[e Lic. #• xx P • ro e ct t, e ci rcl .I ( e one : ' New . P ) . .�dd'n Alter Repair • Demo: Name of Contact Person:J r/"1 S . Sq. Ft.': K Stories: # Units: Telephone # of Contact Person:Coo_ W Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal 'Req'd Recd - _ TRACKING PERMIT FEES y i Z Plan Sets Plan Check submitted fo .Item Amount s Structural Calcs.,; Reviewed, ready for corrections � ��_ . Plan Cbeck Deposit Truss Calcs. Called Contact Person I� Plan CF.eck Balance e Title 24 Calcs. ° '.( Plans picked up Construction o t Flood plain plan Plans resu _ ed w Mechanical Grading plan end Re%�iew, readv correct' s i e �Z4 Z% Eleciric-3l O • Subcontactor List Called Contact Person - Z1 Plumbing. Grant Deed Plans picked up • � S.11.1. o � H.O.A. Approval ` Plans resubmitted • Grading! 9 IN HOUSE:- adv'for correct' s/issue ' •_! /(o Developer Impact Fee Planning Approval_ Called Contact Person /li A.I.P.P. +� Pub -Wks. Appr . Date of permit issue 71 t INV School Fees ;_dA R CIA t Total Perunit Fees 3Acki6 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. For your protection you should be aware that as "Owner/ Builder" you are the responsible psrty 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 subco-ttract, 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 employerand 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 Rev --,nue 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 performi_ig 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.922 (760) 777-70 /% FA�: ( 7 -701. , �/ O //J,,IA OV9gR'S SIGNATURE/ ATE ,. PROPERTY ADDRESS PERMIT NUMBER(s) rt /�/¢L��� 'p:) CITY OF LA QUINTA SUB -CONTRA, TOR LI T JOB ADDRESS�T—o��Jr`�G(, (.v7W�Lufi'!/ PERMIT.NUMBER OWNERBUILDER h This form shall be posted on the job with the Building Inspection Card at all times in a cou nsoicous Ip ace, Only p rsons appearing on this list or their employees are authorized to work N on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance a of building permit. For each applicable trade, all information requested below must be completed b n a licant "On File" is t 1,1l y pp not Trade /Classification Contractor aaccep a e response. State Con>taetofs License, WorkErs Compensatitin Insurance City Business license -,Company Name Classification (e.g. A. B, C-8) License Number Exp. Date (xxxxxx) (xx/xxlxxl Carrier Name Policy Number (e.g. State Fund, CalComp) (Format Varles) Exp. Date lxxlxx/xx) 'License Number Exp, Date (xxxx) Ixxlxxlxx) EARTHWORK (C-12) , CONCRETE IC -8) C' p O �p // Of ' —6v, I/2. 7 0S-5 FRAMING (C-5) ` STRUCT.:STEEL (C-51) MASONRY (C-291 PLUMBING IC -361 5) LATH, PLASTER (C-36HY WALL (C-91 HVAC IC -20) 'ELECTRICAL (C-10). ROOFING. I C-39) i r O SHEET METAL (C-43) FLOORING (C-1'5) r GLAZING IC -171 INSULATION (C-2) : SEWAGE'Di&. PAINTING oERAIMIC, TtLE:IC-54) , FENDING (C=?13}` iLAiYI�SCAM' G (C-271: POAL IC -531 FROM :KATHY.WERNESS FAX NO. :7603455530 May. 09 20043 10:13AM P3 ' C 0 . J 1 'KATHY WERNESS 44-295 Via Coronado - LaQuinta, CA.92253 760-345--5530 -. 760-413-2846 Mr. Serifin Rubi 82357 Mountain View Avenue Indio,.California 922:01 This letter will serve as confirmation that I wish to employ you as my contractor to constuct a free-standing garage at -the above referenced property. Since,,you, were the Superindent- at the site I purchased my home last year, I feel confident that you know what you are doing, and feel the quality of construction will be- <consistant with'the rest of my home. The free standing garage will be approximately 15'x20' as per the plans submitted to the City of LaQuinta for their approval, and follow guidelin-as as required.', As we verbally agreed, your rate will be $25.00 per , hour with.a maximum labor charge of.$6,000, and I will, ,pay for all building materials, that we will.order thru Y Home Depot -or other sources as necessary. (i.e: roofing materials,,' stucco materials, etc. Construction will 'start upon approval by the City of LaQuinta and you estimate approximately.two months to construct:the garage. The plans have been submitted to the City for approval, :signed off by.the architect and now awaiting a Workman's. Compensation Policy to employ you on ray .behalf. Your signature below will allow me to submit and proceed with any other necessary approvals the City might have prior to construction. ' Thank you, Kathy.Werness, Homeowner _approval by Serifin Rubi, P. O . Box 1504 t,. 78-495 CALLE TAMPICO G (76.0) 77777000 04 J LA QUINTA, CALIFORNIA 92253 'FAX (760) 777-7101 FINAL NOTICE OF VIOLATION 7/2/2003 • �. Kathy q,OVerness ;:,� • 44295 -Via -Coronado La-Quinta; TCA_92253 RE: VIOLATIONS OF THE LA QUINTA MUNICIPAL CODE AT 44295 Via Coronado (APN 604-211-017), LA QUINTA, CA. On 11/14/2002, you were notified by this office that you were in violation of the City's Municipal Code. Our records indicate that you were made aware of the nature of yoar, violation, the action necessary to correct the violation, and that you were given ample time to remedy the violation. Another inspection was made of the subject property on 7/2/2003: That inspection revealed that the necessary corrective action had not been taken. This letter will serve as notice that if the violation is not corrected before July 16, 2003 an administrative citation will be'issued or a notice to appear in court to seek compliance. if -you have any questions concerning this matter, you should contact the undersigned immediately at (760) 777-7021, Monday thew Friday, between the hours of. 8:00 a.m. an 00 m:. Sin rely, J c •e isuraca, Code Compliance Officer •- KATHY WERNESS 44295 V.IA:CORO.NAD LaQUINTA, CA. 92253 Home Phone 760-345-5530 April 04, 2003 Jackie Misuraca RE: Case # 7673 City of LaQuinta 78-495 Calle Tampico LaQuinta, CA 92253 Dear Jackie You should have received a fax from Judy Handy, Handy & Parker Insurance Agency in Riverside verifying that sheds processing the Workman's Comp policy for me on the construction of the garage at my home. I wanted to bring the completed plans back to your office because today, April 4th, is my only day off and I want- to get this handled. Judy said she would keep you updated on the stated of the Policy and Binder. One of the other issues in the "Red Line" remarks was you wanted a letter from the Homeowner's Association. The home owners at the Santiago tract have never implemented an association or had any meet--ngs since I have owned the property, in September, 2001. The builder had a provision for one if the home owners Would act upon it to start one, so far, not. As I mentioned yesterday on the phone, the designer of plans for the garage is working on the plan for the deck . but is back up with a couple of other jobs, and 1 will provide that as soon as possible. As a note for the file, what was the third car garage is only being used as a "doghouse" and stc rage. Because of my hectic work schedule, and the floor plan of the house being so open, I could not leave the dogs inside, so I had the garage door removed, I installed the french doors so the dogs could be out there and watchpings going on, have daylight, an*disturothe disturb theeighbors, yet ca go in and out of doors and protected with .he weather. Sincerely, . Kathy A. Wernes 04=03-12003 07:13PM HANDY &. PARKER INSURANCE AGENCY 11735 WEST NORWOOD AVENUE • RIVERSIDE. CA 92505 PO. BOX 8487 • RIVERSIDE, CA 92515 (909] 689-9441 • FAX (909). 689-1705- ARIL 2; !2003 C�TY OF �A QUINTA PO BOX 1 04' LA QUINT I, CgLIFORIVIA 9'2253 RE: 'KAT4Y 'A: WERNESS 44215 VIA CORONADO LA UNITA, CA,92:2�3 PAP, CASE #'7673/J. MISURACA iTTENTI N "OFFICER j7i;'MISURACA: FAX T0: 760-777-7101 2 PAGES THIS ,LETTER WILL•jSERVE..•TO. VERIFY THAT HANDY ,AND' PARKER INSURANCE GENCY IS It THE PROC�SS OF BINDING A WORKMAN'S COMPENSATION INSURANCE BLICY FOR OWNER/BUILI3£R, KATHYRN A WERNESS, 442.95 VIA CORONADO, LA UINTA, (ICALIFORNIA. :THE POLICY IS INTENDED TO PROVIDE WORKERS 'OMPENSA'TION INSURANCE FOR (1) CARPENTER WHILE HE IS BUTLDING;.A gTRUCTURIE ON THE PROPERTY OF KATHYRN A WERNESS. MWE INSURANCE ORRIER !OF THIS POLICY WILL BE STATE COMPENSATION INSURANCE FUND AND THE IND DATE WILL BE SOMETIME. NEXT WEEK, AS SOON AS THE INSURANCE "IS IN. PLACE; STATE FUND WILL PROVIDE THE CITY OF LA QUINTA WITH A �ERTIFICA,TE OF INSURANCE. i I IF YOU `NEED FURTUER VERIFICATION, PLEASE FEEL FREE TO CONTACT 4E AT MY'OFFICE: INCEREL UDY NDY CC: KATAYRN: A WERNES�' 04-03-03 18:`16 RECEIVED FROM: P.01 FROM Insurance OFFICEtes Ins TO 1760?777101 P.01 • Lqv\ _ .. � r.. %'-".� _ ^tom 4 •; �.:i.'F �w t�'�-.Phr. ; y - _ P.O. Box 1504 78-495 CALLS TAMPI.co (760) 777-7000 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-710.1 i NOTI ' CE 01F PUBLIC.. NUISA C N E March 19, 2003 Kathy A.dWernessRE:' 44295 Via Coronado 44295 Via. Coronado Parcel # 604-211-017 , a, -Quints, California 92253 Case # 7673 Officer: J. Misuraca Dear Owner(s): THIS NOTICE is hereby submitted to you as owner(s) of the above. referenced property. A recent inspection ofkyour property revealed'con'ditions in violation of the La Quints''` Municipal -Code. You_ are required to correct these violations within TWENTY-ONE (21) DAYS from the date of this notice. Your property will be re -inspected to verify compliance after the twenty-one (21) day time frame has lapsed. NOTICE OF VIOLATION Case # 7673 - March, 19, 2003 l Page 2 of 4 SEEATTACHED INSPECTION REPORT FOR VIOLATIONS)' AND CORRECTIVE ACTION REQUIRED. Failure to correct the listed violation(s) within the time frame indicated may result in the City initiating abatement proceedings and/or criminal prosecution to correct the violation(s). If the City is forced to proceed with the abatement proceedings, the ownBr(s) of record . may incurthe direct.costs of the abatement. Also, any additional costs. assessed due to possiblejudicial process. , In addition to the above referenced costs, all contractor abatement costs plus an-additional 25% will be charged to the property owner(s).as a lien upon the property and shall become the personal obligation .of the`o-Nner(s) of record. ' You are entitled to appeal the determination that a public nuisance exists to the' planning commission. Within ten (10) days from the date of personal service, posting or mailing,the notice of public nuisance, the appeal shall be in writing and fled with the city clerk. v By acting immediately to correct the violation(s) referenced, you will avo-d these and any future costs. ' If you have any questions, please contact J. Misuraca at-(760) 777-7021. Please provide the complaint number (#7673) and the property address. Your assistance in supporting the Code Compliance Department to' maintain the safety and appearance of our city is greatly appreciated. You may contact me at the above referenced phone number if you require assistance. inc rely, ckie Misuraca' Code Compliance Officer NOTICE OF CODE VIOLATIONS N.• CASE NUMBER: 7673 . PUBLIC NUISANCES Code Violation: L.Q.M.C. 11.72.030 (M) Public Nuisance s -,Location: Free Standing Garage with storage, Third Car Garage- ' Conversion, and a Second Story .Rear Balcony with Staircase. Violation Text: Violation of any of the zoning or sign orc6nances of the :. city or any of the uniform codes adopted by,•the city, including the Uniform, Building Code, Uniform Code for the Abatement of Dangerous Buildings, plumbing code, electrical code, mechanical code, swimming pool code-,-'-. fire code, health code and Uniform Housing Code. Correction: The property owner must obtain all required permits, inspections and approvals to construct o- demolish the structure(s) from the Building & Safety Department. For', information on obtaining permits call (760) 777-7012: L Reinspection Date: April 10, 2003 i NOTICE •OF CODE VIOLATIONS • 4 CASE'NUMBER: 7673 t _ PUBLIC NUISANCES Code Violation: L.Q.M.C. 8.01.060 Permits Required Location: Free Standing Garage with storage, Third Car. Garage' Conversion, and a Second Story Rear Balcony with Staircase. Violation Text: It shall be unlawful for any person, firm or corporation to erect, construct; enlarge, alter, repair, move, improve, .' remove, convert or demolish any building or, structure, including a swimming pool, spa or hot tub, or make any • installation, alteration, repair, replacement, or remodel any building service equipment' including swimmin g pool, spa and hot tub equipment, regulated by this Title, t _ . except as specified in Section 301.2.1, or cause the same .to be done without first obtaining a separate,. 'appropriate permit for each building, structure or service equipment from the Building Official., T Correction: The property owner must obtain all required permits, , inspections and approvals to construct o demolish the , structure(s) from the Building & Safety Department. For, J information on obtaining permits call (760) 777-7012. Reinspection Date: April 10, 2003 �"