BPOL2017-0127� t
,� aw
78-495 CALLE TAMPICO 0 D .
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPOL2017-0127
Property Address: 78390 VIA DIJON
APN: 604600026
Application Description: ACEVES / POOL AND SPA, FIRE PIT, AND BBQ AT REAR YARD
Property Zoning:
Application Valuation: $38,000.00
Applicant:
CARLOS & SILVIA ACEVES AUG 1 1 2017
78390 VIA DIJON r
LA QUINTA, CA 92253 CITY OFLA�s
'DESIGN AND DEVELOPN;Eu)T DEPARTMENT
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 Professions 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).:
5 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 or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that he
oshe 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 who contracts for the projects with a contractor(s) licensed pursuant to the
C tractors' State License Law.).
(I am exempt under Sec. B.&P.C. for this reason
Date:
Owner:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/11/2017
Owner:
CARLOS & SILVIA ACEVES
78390 VIA DIJON
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
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: _
.� 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, l shall forthwith
comply with those provisions.
c
Date: I , Applicant:
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 Building Official 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.
CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is correct.
I hereby affirm under penalty of perjury that there is a construction lending agency for I agree to comply with all city and county ordinances and state I relating to building
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). construction, and hereby authorize representatives of this cit to ente upon the above-
mentioned property for inspection purposes.
Lender's Name:
Ty Date:' i,I Asignature (Applicant or A nt):
Lender's Address: (ob
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
CARLOS & SILVIA ACEVES
78390 VIA DIJON
LA QUINTA, CA 92253
BPOL2017-0127
78390 VIA DIJON
604600026
ACEVES / POOL AND SPA, FIRE PIT, AND BBQ AT REAR YARD
$38,000.00
Owner:
CARLOS & SILVIA ACEVES
78390 VIA DIJON
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
Date: 8/11/2017
Detail: POOL, SPA, BBQ, FIRE PIT AND FUTURE GAS LINE FOR ADDITIONAL FIRE BOWL AT REAR YARD, WITH 17 LF OF 4' HIGH EQUIPMENT WALL (CITY
STANDARD DETAIL). RELOCATION OF TWO EXISTING CONDENSERS TO NEW POOL EQUIPMENT ENCLOSURE AREA. [TODD L. LACHER ENGINEERING].
ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/FENCE -FIRST 100 LF
101-0000-42404
0
$50.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$63.33
Total Paid for BLOCK WALL: $114.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$25.33
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$25.33
Total Paid for ELECTRICAL: $50.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR
101-0000-42402
0
$76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$50.66
Total Paid for MECHANICAL: $126.66
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$25.33
Total Paid for PLUMBING FEES: $38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$190.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$103.36
Total Paid for POOL / SPA: $293.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
T4hf 4 4auhrw
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA; CALIFORNIA 92253
BUILDING- & SAFETY DEPARTMENT -
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permithas been submitted itted in your name li ting yo self as she builder of the property
improvements specified at qQ t ,C 2 Z 5?�
We are providing you with an Owner -Builder Acknowledg ent and reformation 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 signs you understand or verify this information.
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. 1, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustair_ed 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 cov-,rage for injuries to workers
on my property.
2. 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.
SR 3. 1 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.
56��_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. ,
c—SA-6. I understand if I am considered an "employer" under state and federal law, I must registe- with.the state and federal
goverment, 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.
c�7. I understand under California Contractors' State License Law, an Owner -Builder who builJs 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 al of the work is performed
under contract with a licensed general building Contractor.
IS -4 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
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
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 Califomia Contractors' State License Board (CSLB) at 1=
800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
�ft10. 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 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. I 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 maybe unable to assist you with any financial 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 Contractor or employee of that individual or firm is injured while working
oij 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 t er J. Note. A copy of the property owner's driver's license, form notarization, or
other verification acceptable to thented when the permit is issued to verify the property
owner's signature. er 7:75
Q
Signature of property Date:
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 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 of Work):
Project Location or Address:
Name of Authorized 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 thepermit is issued to verify the property owners signature.
Property Owner's Signature: Date:
Bin#
—Acailding
City of La Quinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Permit Application and Tracking Sheet
Permit#
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Owner's Name: /� /
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A.P. Number
Address: Q — 3 �o
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Legal Description:
City, ST, Zip:
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Telephone:
Address:
Project Description:
City, ST, Zip:
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Telephone:
State Lie. #:
City Lie #:
Arch, Engr., Designer:
Address:
City, ST, Zip:
Telephone:
Construction Type:
Proj. Type New Add'n
Occupancy:
Alter Repair Demo
State Lie. #:
Name of Contact:j
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#Stories
# Units:
Telephone of Contact:
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Estimated Value of,POect:
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APPLICANT: DO NOT WRITE BELOW THIS LINE
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Submittal
Req'd
Rec'd
TRACKING
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 Cales
Plans Picked Up
Construction:
Flood Plain Plan
Plans Resubmitted
Mechanical:
Grading Plan
2nd Rev, Ready for corrections /
Electrical:
Subcontractor List
Called Contact Person
Plumbing:
Grant Deed
Plans Picked Up.
S.M.I.
HOA Approval
Plans Resubmitted
Grading
IN-HOUSE
3rd Rev, Ready for corrections /
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Apps
Date of permit issue
School Fees
Total Permit Fees
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LA QUINTA DEL ORO COMMUNITY
ASSOCIATION
August 3, 2017
Carlos and Silvia Aceves
78390 Via Dijon
La Quinta, CA 92253
Regarding: 78390 Via Dijon Via Dijon; Architectural Request Approval
Dear Carlos and Silvia Aceves,
The Architectural Committee at La Quinta Del Oro Community has approved your
Architectural request to install a new pool, spa, fire pit and BBQ as per the plans
submitted.
Please advise your contractor that the common areas/streets are not to be used for
storage of any equipment or materials. Any debris from construction in the street
must swept up and then the area washed down each day by the contractor. The
contractor may not post signage at the property. The cost of repair for any
damage done to the common area is your responsibility.
La Quinta Del Oro Community permits construction from 7am to 5pm, Monday
through Friday and Saturday 8am-5PM. Please make your contractor aware that
they must follow all rules and regulations for the community.
It is the homeowner's responsibility to ensure all permits required by the City of La
Quinta are obtained.
Sincerely,
,yy
Veronica Delgado
Avail Property Management
51350 Desert Club Dr. Suite 4, La Quinta, CA 92253
Tel: (760) 771-9546 Fax: (760) 771-1655
service@availhoa.com