Loading...
10-0698 (BLCK)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000698 Property Address: 78365 VIA DIJON APN: 604-032-999-40 -305212- Application description: WALL/FENCE Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 725 Applicant: 0 Tay/440" Architect or Engineer: �lk 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 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 pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and r_ 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.). (_) I, 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 ho contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License wJ. (_ 1 I am exempt under Sec. , B.&P.C.' r this reason Date• .7 � l d ner• CONSTRU ION 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 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 7/29/10 Owner: DENISE YATES 78-365 VIA DIJON LA QUINTA, CA LA QUINTA, CA 92253 Contractor: Fw- Owner III I JUL 29 2010 ip LA QUINTA ----------------------------------------------- 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 - - - - - - - - - - ------ - - - - -- - Policy Number 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 become subject to the workers' compensation laws of California, and agree that, if I s d _come subject to the workers' compensation provisions of Section 3700 of the bor ode II forthwith comply with those provisions. j�' a D e: - //G pplicant: WARNING: F URE TO SECURE ORKE '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 voe information is correct. I agree to comply with all city �i5unty ordinances and state laws relating to bu . g construction, and hereby authorize representatives of thty to/nterupon the above-mentioned prop/rt4to inspection purposes. ate: / GOSi ture (Applicant or Agent): T c� Application Number . . . . . 10-00000698 Permit . Additional desc Permit Fee Issue Date Expiration Date WALL/FENCE PERMIT 21.00 Plan Check Fee . Valuation . . . . 1/25/11 .00 725 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 2.0000 HND BLDG 501-2,000 6.00 ---------------------------------------------------------------------------- Special Notes and Comments 29 L.F. 6' GARDEN WALL TO CREATE FRONT COURTYARD WITH 2 PILASTERS AND GATE. CITY STANDARD. 2007 CODES --------------- Other Fees . . . . . .p BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged -------------------- Paid Credited -------------------- Due ----------------- Permit Fee Total 21.00 .00 .00 21.00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1.00 .00 .00 1.00 Grand Total 22.00 .00 .00 22.00 LQPERMIT -------- ----' CITY OF LA QVINTA BUILDING/& SAFETY DEPT. AP FIOVED FOR CO/ NS _ i 7f°V�r ✓ U' s�' \A Q\: S a a� V-1 . moo® / 1 P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 EUILDING & SAFETY DEPARTMENT PROPERTY O'WNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Apelging for Construction Permits ISP UNT1 MOTIC) Tri pu . ury QWNRR Dear Property Owner. An. aWlication for a building permit has been submitted in your name listing r)urself as the builder of the property improvements specified at We are providing you with an Owner -Buil" Acknowled$ment.and information Verification Foran to make you awm of your Mpewibilities and possible risk you may incur by halving this permit issued in your name as the Ovines -Builder. we wilt n. *ssue abuudiwper4mit-untiRyou4h.:ve-read;initiafo&your--understandiu"f each ision, — 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. brmation. k u 1. I understand a frequent practice of unlicensed persons is to have the progerty owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personaft-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 may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am 'aware of the limits of my nsurance coverage for injuries to workers on my property - 2 - roperty2. I understand building permits are not required to be signed by property owners' unless they are responsible for the co truetion 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 thepermit. I understand that I may protect m if from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my 0 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on pe its and contracts. 5.1 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. 6. I understand_ if I am considered an "employer" under state and federal tart, I must register with the state and federal v J , ent, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment co nation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial tis . 7. 1 understand under California Contractors' State License Law, an Owner-3uilder who builds single-family residential 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 ca°endar year, or all of the work is performed under contract with a licensed general building Contractor. 8. I understand as an Owner -Builder if I sell the property for which this permit :is issued, I may be held liable for any nancial or personal. igj.uries sustained by any subsequent owneris) that result from any latent construction defects in the wo anship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer' from the Internal Re*enue ` 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 I- -CSLB (2752) or www.csib.ca.gov for more information about licensed contra tors. 1 am aware of and consent to an Owner -Builder building permit applied for is my name, and understand that I am the i8;legally and financially responsible for proposed construction activity at the following address: r�l -J. agrve that, as the party legally and financially responsible for this proposed construction activity, I will abide by all appl' Ie 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, to any of the information I ave 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 umable to assist you with any financial_ loss . you may sustain as a result of a complaint. Your only remedy against unlicensed Cantractors may be inVivil court- It is also important for you to: understand that if as ualicensod Contractor or employee of that individual or Bryn is injured while w0dcing on your Property,' You may be held liable for damages. If you obtain a permit as Ov.gw-Builder and wish to hire ConU*Ctors, you will be .remote& for vedf)dna of narepedT-Rcense and the status of their waiters' compensation insurance coverage. Before a building permit can be issued, this .form must be completed and signer by the property owner and returned to the agency responsible for issglttg; the;perarit. ote: A copy of the property own-w's dkive�:'s ei form" 4 O other verirwadon acceptable to the agenry is ulrad to be presented when eke pe. Mu is iarsueil to verify the prapeM owner's signature. Signature of property owner Date: l0 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 BFHn Excluding the Notice to Property Owner, the execution of which I understand is nri personal responsibility, I hereby authorize the following person(s) to act as my 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.o.f Work): _ Project Location or Address: Name of authorized Agent: Address of Authorized Agent: T, -I 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 verif cation acceptable to the agency is required to bepresented when the permit is issued to verify the property owner's signature.. Property Owner's Signature: Date: Bin # Qty of La Quin LQ Building 8r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # W AP Project Address: 7 D S V1 I J 0 AJ Owner's Name: -b i $-f Va fe- A. P. Number: Address: 793(,� V Legal Description: City, ST, Zip: 00 / N 7-4 Clj- q�) �_7 Contractor: Telephone: 3 9 Address: Project Description: City, ST, Zip: Telephone: o State Lie. # City Lie. #.. Arch., En r., Designer: o Fr 154 jh J - Address: City, ST, Zip: Telephone: ....... . .... . . ..... . . . . . . . . . . . . . . . . . . ... X0 onstruction Type: e/L Occupancy: State Lie. Ce Project type (circle one) W Add'n Alter Repair Demo Name of Contact Person ja4n 61/1&I'� Sq. Ft.: I # Stories: I # Units: Telephone# of Contact Person:tR ?420,909-39n'-- Estimated Value of Project: � :?000.0c) APPLICANT: DO NOT WRITE BELOW THIS LINE Submittal Req'd Rec1d TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Ame-unt' Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance. Title 24 CaIcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd 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.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 1,%