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BWFE2015-030478-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 c&�v 4 4 4"cu COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT .Application Number: BWFE2015-0304 Property Address: 79895 FIESTA DR APN: 600061001 Application Description: FALLEUR / 239LF OF BLOCK WALL (2) PILASTERS.20LF METAL FENCE Property Zoning: Application Valuation: $13,000.00 Applicant: SHANE FALLEUR 79895 FIESTA DR LA QUINTA, CA 92253 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjurythat 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. Ucense Class: _ Ucense No.::CONV:14D528101254125771 Date: Contractor: . OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors 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 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars X($500).: (6!J 1, as ownerof 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 no apply to an owner of property who builds or Improves thereon, and who does the worl 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 -bulkier will have the burden of proving that he of she did not build or Improve for the purpose of sate.). i/ (off 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 Contractors' State License Law.). k( 1 am exempt under Sec. . B.&P.C. for this reason _ kQate: % /' i CONSTRUCTION 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 Lender's Address: Owner: SHANE FALLEUR 25 VOiCE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/19/2015 79895 FIESTA DR LA QUINTA, CA 92253 r A- !S e Contractor: f i SHANE FALLEUR t 79895 FIESTA DR i f LA QUINTA, CA 92253 (760)399-6517 Llc. No.::CONV:140528101254125771 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following dedarations•. I have and will malntaln 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 370D 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:_ PollcyNumber^ J' I certify that in the performance of the work for which this permit is issued, I shat 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, !VI forthwith comply with those provisions. Date: �\- --% • .57 I Applicant: WARNING: FAILURE TO SECURE WORKERS' PENSATION 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 NPORTANT: Application Is hereby made to the Building Official for a permit subject to ie conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose .quest and for whose benefit work is performed under or pursuant to any permit sued as a result of this application, the owner, and the applicant, each agrees to, and tail defend, Indemnify and hold harmless the City of La quinta, its officers, agents, and mployees for any act or omission related to the work being performed under or Illowing issuance of this permit. 2. Any permit issued as a result of this application becomes null and vold if work is of commenced within 180 days from date of Issuance of such permit, or cessation of ,or for 180 days will subject permit to cancellatlon. 1 certify that 1 have read this application and state that the above Information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authotae representatives of this city to enter upon the above-rnentloned property for inspection purposes. Date. Signature (Applicant or Agf. FINANCIAL INFORMATION DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00, $0.00 PAID BY METHOD 'RECEIPT# CHECK# CLTD BY V Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $58.00 $0.00 PAID BY METHOD RECEIPT # CHECK #' CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE " WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for FENCE OR FREESTANDING WALL: TOTALS:00 $166.77 $0.00 U i CSM OF W, Permit Detail•s City Of La Quints P.ERMIT Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: UNDER REVIEW NUMBER APPROVED Approved: Parcel No: 600061001 Site Address: 79895 FIESTA DR LA QUINTA,CA 92253 Subdivision: TR 2180 — Block: Lot: 60 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $13,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 239LF OF BLOCK WALL (2) PILASTERS 20LF IRON FENCE [PROTO II SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED BWEE-201[5-0304 ..CHRONOLOGY, DESCRIPTION Description: FALLEUR / 239LF OF BLOCK WALL (2) PILASTERS 20LF METAL FENCE Type: WALL/FENCE Subtype: CITY STANDARD/PRE- Status: UNDER REVIEW Applied: 10/19/2015 SKH APPROVED Approved: Parcel No: 600061001 Site Address: 79895 FIESTA DR LA QUINTA,CA 92253 Subdivision: TR 2180 — Block: Lot: 60 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $13,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 239LF OF BLOCK WALL (2) PILASTERS 20LF IRON FENCE [PROTO II SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA BUILDING CODES. €'+�'�' •c. a,+ Yr � .. L` 4F r,, _! � '"o-'��.a•.l0NAL � � ..,:: = ADDITIONALSITE .S1 , +at .moo' +i^e -sr. �_ n. ,it '�.i ,4 ♦.• . .._��.--;.,_.._-.-w.:�-u.s�:=r•�s-..c.r-annkiw;w.�ti��'-=... �''�"h'x is-•�',. ..CHRONOLOGY, DESCRIPTION ACCOUNT •,�...§, ;y ,,:?,'J..i•,#.',i`..H AMOUNT ��i'.'�. :..� {�-��(-�� `�� '��'T '. 1.'�'y'��fi•� ?bY��4 yt��k �: F-_' D "til-7LvTIO•P.�.-7k� INS4.3 r"'=('b' .!k fit.. `�� Y� _,,� _ .S.:: .F BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00,- 0.00,-Total r CONTACTS. TotalPaid for BUILDING STANDARDS ADMINISTRATION _a._1Ya s .�i'la �,r;.��..±]%v ....'k c'►�t. z.Yfv L �h�."L ci2K.� �L s3.. ,..t_SHANE BSA: FALLEUR 79895 FIESTA DRSHANE FALLEUR 79895 FIESTA DRSHANE FALLEUR 79895 FIESTA DR Printed: Monday, October 19, 2015. 1:29:20 PM 1 of 2 O SYSTEMS LTD CBY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00,- 0.00,-Total TotalPaid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: Printed: Monday, October 19, 2015. 1:29:20 PM 1 of 2 O SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT _ PAID PAID DATE RECEIPT # CHECK #- METHOD PAID BYi _ CLTD BY WALL/FENCE - EA .101-0000-42404 0 $58.00 $0.00 ADDITIONAL 50 LF WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $0.00 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $0.00 100 LF PC Total Paid for FENCE OR FREESTANDING WALL: $166.77 $0.00 TOTALS:• •0 BOND INFORMATION Printed: Monday, October 19, 2015 1:29:20 PM 2 of 2 (1F SYSTEMS T a �a tr CSUINTA BUILDING & SAFETY DEPT. APPROVE® FOR CONSTRUCTION DATE-1 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT (760) 777-7012 FAX (760) 777-7011 Considering Becoming an Owner -Builder? Important information you need to know BEFORE pulling your permit! The term "Owner -Builder" can mean three different things: "Owner. as Worker", "Owner as Contractor" or "Owner as Employer" Understand each has Benefits or Risk, and it is possible to combine them! Hiring a California Licensed Contractor means you do not personally perform any of the construction work, the permit is not taken out in your name, you are not personally responsible for the construction and you are not an Owner -Builder. Instead, you become.a "Customer" and California law provides. you the benefit of protection from poor workmanship, failure to finish the job and financial risk due to worker injury. Benefit/Risk: Hiehest Benefits and the Least amount of Risk. Owner -as -Worker is a type of Owner -Builder where you personally perform the construction. work, the permit is taken out in your name and you are personally responsible for the construction management, knowledge, workmanship, and completion of the job. You benefit by not paying others to perform this work for you and your risk depends on your own ability to complete the job successfully. Benefit/Risk: Possible Benefit with Low Financial Risk Owner -as -Contractor is a type of Owner -Builder where you personally act as your own General Contractor, the permit is taken out in your name and you hire California licensed sub -contractors to perform portions of the construction work. WARNING: The benefit of protection provided by law when you hire only California licensed sub -contractors can turn to serious financial risk if you hire unlicensed contractors to perform any of the work- Benefit/Risk: Possible Benefit and Significant Financial Risk Owner -as -Employer is a type of -Owner -Builder where you pay any unlicensed individual to perform.any construction work valued at more than $500.00, the permit is taken -out in your name *and you are- personally responsible for their employment requirements, supervision, performance, safety and welfare while on your property. WARNING: Cost savings benefit can turn'to serious financial risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker. Benefit/Riski Possible Benefit with Significant Financial Risk (Health and Safety Code Section 19827) The California Legislature declares an "urgent and statewide public interest in assuring" that contractors comply with Contractors' License Law, Business and Professions Code and Workers' Compensation Insurance requirements to ensure property owners are informed about, and protected from the following when improving their property as Owner -Builders: Fraudulent representations - Liability for worker's injuries - Liability for material and labor costs unpaid by contractors - Licensing *requirements • Employers tax liabilities Over .20,000 consumer complaints are filed each year. Many complaints relate to owner/builder projects and include workmanship and workers' compensation issues Homeowners suffer financial harm due to defective workmanship and injured employees. Following are alarming examples of what has occurred with Owner -Builder permits: Example 1: Homeowner received insurance money to rebuild burned -down home. • Owner/Builder permit pulled to rebuild structure. • Unlicensed contractor built substandard structure — must be torn down and replaced. Estimated financial injury is $225,000. • Additional financial injury - IRS threatened to tax insurance payout if house not completed by the end of the year. Example 2: Brother-in-law had active license but fled an exemption from Workers Comp. Owner -Builder hires brother-in-law to install a new roof. .Employee falls and sustains multiple spinal and extremity fractures as.well as ahead injury and remains in a coma to this day. The Owner -Builder, who has sold the home, is now a defendant. in a lawsuit for reimbursement for benefits paid to the injured worker. Example 3: Employee of contractor without Workers Comp is hired by Owner -Builder to install septic system and suffers injury that results in permanent disability. ■ The Owner -Builder did not have a homeowner's insurance policy on the house against which to submit a claim. • The Owner -Builder is now a defendant in a lawsuit for reimbursement for benefits paid to the injured worker. Did you know — unlicensed persons frequently have the property -owner obtain an "Owner -Builder" building permit which erroneously implies that the property owner is providing his or her own labor and material personally? Did you know — your homeowner's insurance may not provide coverage for injuries sustained on your property by an unlicensed contractor and his/her employees? Did you know — if you are considered an "employer" under state and federal law, you must register with the state and federal government, withhold payroll taxes, provide workers compensation and disability insurance and contribute to unemployment compensation for each "employee"? Did you know — that if you fail to abide by these laws you may be subjected to serious financial risk?. OWNERS BEWARE AND CONSIDER°THE RISK BEFORE ACCEPTING FULL RESPONSIBILITY FOR YOUR CONSTRUCTION PERMIT . 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 peinnit has beer submitted in your name listing yourself as. the builder of the property improvements specified at . '7 91'72< . F-) e s R • _i) r - . L y1 Q,� •�� Cf} -2 S3 . 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 uthority: OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. S�'_ L 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. I, 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. 012. 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. S� 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. 4p 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. 5r? 6. I understand if'l 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. 4r 7. I understand under California Contractois' 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. S 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. S 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. S ¢ 10. 1 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 finan�cially responsible' for proposed construction activity at the following address: '77b9S F, esjrr 75r_ 1-4A, .CA 92,;ZS73 �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. 5 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 may be 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 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 prese ed when the permit is issued to verify the property owner's signature, Signature of property owner 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 aboveand 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 owners signature. Property Owner's Signature:. Date: Bin # City of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: 7 Owner's Name: S )�xwP— A. P. Number: Address: -D, _ Legal Description: City, ST, Zip: 1_4 aol; C4 5 D aS-3 Contractor: . Telephone: 7D 3 9— S Address: Project Description: z 3 City, ST, Zip: r' O G �< (/V A LO rx ^t P, S / Telephone: \\ ►� d pp 1N �,y. N N ✓ � ov �' C \ 1 f` on) e 9' 4� � G2 State Lic. # : City Lie. #.: Arch., Engr., Designer: Address:• City, ST, Zip: Telephone: • Construction T YPe• Occupancy: State Lie. #: Project tYPa circle one): New Add'n Alter Repairair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: / oDo APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd 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 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2". Review, ready for correctionstiissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"' 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 0 �J �9