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BPLB2017-003878-495 CALLE TAMPICO D �KML1Cl/ LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPLB2017-0038 Property Address:. ,54475 AVENIDA DIAZ APN: 774233026 Application Description: ALFARO / ABANDON SEPTIC/COMNNECT TO SEWER Property Zoning: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 1 Date: 2/24/2017 ; Owner: ANA L ALFARO 54475 AVE141DA DIAZ LA QUINTA. CA 92253 Application Valuation: $1,000.00 _ ® /\ Applicant: Contractor: ANA L ALFARO OWNER BUILDER O Q Q 54475 AVENIDA DIAZ C\1 j >; LA QUINTA, CA 92253 Llc. No.: V O� --------------------------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DELLA ION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 1 hereby affirm under penalty of perjury otw of the following decla 3�tions: (commencing with Section 70001 of Division 3 of the Business and Professions Code, and _ I have and will maintain a certificate of consent to self -insure for workers' my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class: _ License No.: _ of the work for which this permit is issued. _ I have and will maintain worker_' compensation in as required by Date: Contractor: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurarce carrier and policy number are: OWNER -BUILDER DECLARATION Carrier: d!.C•Policy Number: ' I I hereby affirm under penalty of perjury that I am exempt from the Contractor's State (:,_!•1 certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Profeisions Code: Any shall not employ any person in any manner.so as,to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair any compensation laws of California, and agree that, if I should become subject to the structure, prior to its issuance, also requires the applicant for the permit to file a signed workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith statement that he or she is licensed pursuant to the provisions of the Contractor's State comply withose pr isions. 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 Date: Applicant: alleged exemption. Any violation of Section 7031.5 by any applicant fora permit -,subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 0( A.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 or sh 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 �ntr�y ctors' State License Law.). ( �Fem exempt under Sec. B.&P.C. for this reason 'Date: "717-4117 Owner: (./14f, Ls l,,2 ' 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: WARNING: FAILURE TO SECURE WORKERS' ,:OMPENSATION 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 tais 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 applcation becomes null and void if work is not commenced within 180 days from date of isstiance of such permit, or cessation of work for 180 days will subject permit to cancellation. . I certify that I have read this application and mate that the above information is correct. I agree to comply with all city and county ord-nances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above- mentionecipr perty f r inspection purposes. Date: ignature (Applicant -x Agent): Date: 2/24/2017 Application Number: BPLB2017-0038 Owner: Property Address: 54475 AVENIDA DIAZ ANA L ALFARO APN: 774233026 54475 AVENIDA DIAZ Application Description: ALFARO / ABANDON SEPTIC/COMNNECT TO SEWER LA QUINT., CA 92253 Property Zoning: Application Valuation: $1,000.00 Applicant: Contractor ANA L ALFARO OWNER BUILDER 54475 AVENIDA DIAZ LA QUINTA, CA 92253 -------------- ----------------- LIc. No.: ---------------------------- Detail: PLUMBING.- ABANDON SEPTIC/CONNECT TO SEWER. 2016 CALIFORNIA BUILDING CODE. --------—------------------------ f DESCRIPTION I ACCOUNT I QTY I AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTR.aTION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $96.27 Total Paid for PERMIT ISSUANCE: $96.27 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER 101-0000-42401 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT BUILDING SEWER PC 101-0000-42600 0 $17.73 Total Paid for PLUMBING FEES: $43.06 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 ' $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: r $5.00 From: 02/24/2017 16:00 02/24/2017 15:17 #381 P.003/005 70.07779035 FEDEX OFFICE 2028 PACiE 03/04 BUILDING & SAFETY DEPARTMENT 78-495 CALLE'TAMMP (760) 277-7012 LA QUINTA, CA.LIFpRN1A 92253 FAX (760) 777-7011 Considering Becoming an Owner -Builder.? arltt�a11ovt p Lh- viuta.- Important ini'otrniatiton you Geed to'itnowROFORE purring your permit! The berm "Owner -Builder" can mean three different things: "Owner as Worl ee, "Owner as Contracroe oc' 4OIA ,er as .irMplotKk" Understood each has Benefits or Risk, and it is possible to combine tblern! Hiring a California Ueemsed CoAtractor means your do not personally perforin any of the construction work, the pextnit is not tal= out in your name; You are not personally responsible for the construction and you are nol an Owner -Builder. InsteaQ� yoq o a risk"Cus a to and California law provides you the beirefYt of protection from poor wvrkmaasMp, failure to fetish the job and f3nsacial risk due to worker injury. Be' 01 H�hest Benefits and the Least amount of Risk 47woer-as-Worker is a type of Owner -Builder where. you ,personally perforni alio consuvccion. work, the p�rinit is taken out in, yotu ttam�e atui you are personally responsible for the construction tnt�nagement, knowledge, wor1Q anship, and ccmpietion of the job. You benefit by not paying•othcrs to perform th;s work for you and your risk depends on your own'ability to compiiete tiro job successfully: Benefit/Iiisk: 1°2EgWe Benefit with liQW $inaacial Risk Owner-as-Cofteractor k- a type of Owan X -builder where you pelsonally Adt as your own, General Contractor, the permit is taken out in -your name and you hire California licensed sub-contrdctors to perform portions of the construction .� ork. WARNMG: Ilse benefit of protection provided by lav when you. hire only California licensed sub -contractors cirri turn to serious financial risk if you hire unlicensed cvutractArs to perform any of the.work. Benefit/Risk: Possible Benefit and Significant Finaneial'Msk Owner -as -Employer is a tape. of_Owner-Builder Ktrere• you pay any unlicensed indivi.ddal to perforin any Cor struction work valued -at MOte.than 5500.00, the permit is takenn-oui in your name and you are•personally responsible ,for (heir employment requirements, supervision, petfoonance, safeTv and welfare u$il`c on your prgerty. WARNING: Cost saN ings benefit coni tura to serious financial t'ck sr':,ii fail to d?duct��a�roli:_res::r provide ive,rkerc �. m ,rc:. �,, t o p 4(ic irsun:ncc: for r.aclt a•crlrcr. _ From: 02/24/2017 15:17 #381 P.004/005 02/74/7617 16: rho 7607779038 FEDEk OFFICE 2021 PAGE 04/ 04 (Health and SafeCy Code Sectio n 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 0Ver'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 -amployees. Following are alarming examples of what has occurred with Owner -Builder permits: Example I : Homeowner r+eoeived insurance motley to rebuild burned -down home. Owner/Builder permit pulled to rebtAd-structune. Unlicensed contractor built substandard_s' bUcture — must'be.torn down and replaced. Estimated financial injury is $22s,Qt?0., ■ Additional financial injury - IRS •threatened to }ak tnsuranee payout if house rid -the year. t completed by tt►e end of- Example fExample 2! Brother-in-law had active license but filed'an exemption from Workers Comp. . Owner -Builder hires brother-tn4dw ta.irtstalfa n6iiroof.; ` Employee falls and sustains multiple spiinaf.arid '+eiitremfty fractures as well as ahead injury and remains ima'coma to this day! R The OKrner.-Builder, who teas sold the home, is now a defendant.m a lawsuit for relmbursement for benefds paid to the injured 'worker. Example 3: Employee of contractar*without Workers Comp is -hired .by Owner -Builder to install septic system and suffers Injury that results 1h permanent disability. The Owner -Builder did not have a Mmeownees insurance policy on the house against which to submit a claim. The•.Owner-Builder is now a defendant in a lawsuit for reimbursement for benefits paid to th worker, e injured'. Did you know — unlicensed person$fiEquentiy:have the property.owper obtain an °Owner 3dildef. building permit whictr erroneously implies that the'propedy owner is providing her own lab and material personally? Did you know — your homeowner's insurance may not provide.coveragefor injuries sustained on your property by an unlicensed contractor.and.his/her emplbyees? . Did you khow 7 if you are considered an 'ei'nployel° under state and federal law, you must register.wlth the state and federal government; withhold payrolvtaxes; provide�workers compensation and .disability insurance and contribute to unemployment compensation for each`am ployee,?. Old .you know — that if you fail to abide by these laws you maybe subjectea to serious financial risk?. OWNERS BEWARE AND CONSIDER THE RISK BEFORE ACCEPTING FULL R1-SPONSIBILITY FOR YOUR C.4N5TRUCTION PERMIT . From: 02/24/2017 15:16 02/24/2017 16:00 7507779035 FEDEX' OFFICE 2028 #381 P.001/005 PAGE 01104 P.O. Box 1504 ' LA QUINTA, CALI.FORNIN 92247-15.04 J3LTILAINKr & SAFETY DEPARTMENT - 78 -495 CALLS TAMPICQ (76.0) 777-7012 LA QUINTA, CALIFORNIA 9.2253. AX (760) 777-7011 PROPERTY OWNER'S PACKAGE Disclosures & Forms -for Owner -Builders Applying for Constlruciilota Permits AfPORTANrl NoTfCE TO MOVERW OWNER. Dear Property Owrter: . An application for a bttildi permit has_6orn _a�tvrilolg +A your nanx _ . _ youtnrsebf as the bt:ilder of the property: improvements .spee fieri at We are providing yoU with ext Owner=rniilde> Aektagwledgtneat an Information V ation Form to taken and 'osstble risk You may yo aware of your responsibilities a p Y Y incur by having this pedtlpit issued iu your rJarnc� as the Owner -Builder. 'We will not issue a building permet until you have read, initialed your umderstamdiug of -each provision, signed, aud. returned this form to us at our official address indfeated. An agent of the owner ca=t.execute this notice . }mlass you, the property owner•, obtain the prior approval of the peau itting authority. OVVN)F.12'S AQGNOWLEDC +'nrr ANp IERIRC_ TION OF IIKFORMATION DIRECTIONS: Read and enh al each statement below to signVyyou understated or verify this inforrriatYOn P&" 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain 'sn "Owner Builder' building permit that erroneously implies that the properly owner is providing his or her own labor and material personally. X, as art Owner -Builder, May be held liable and subject to serious financial risk for -any injuries sustained by uulicenaed person and his ox her employees while arorking on my property. i<sy homeowner's insurance may not provice cov=Ve for those injuries. I atrn willfully acting as an Owner -Builder and am aware of the limits of my instic on nay Property ance coverage for injuries to workers kAll-A-2- I Luxlerstand building permits are not required to be sigrttd by property owners unless they ar responsible for the coustructbn and are not hiring a licensed •Cb==tm to assume titin responsibility. Pt ',-A 3. i understand as art "Owner-Bdilder" T am the respousiible party of record on *e permit, Z utuietataetd. that I may protect thyself from potential, fivaacial risk by hiring a licensed Contractor and having the Permit fffed in his or he: name instead of trhy UwIL 4.1 understand Contractors are (required bylaw to be lioeltsed. and bonded permits and contracts_ in California and to fist their license numbers on f\ ln�S. I understand if Y employ or othencise engage arty persons, other than California licensed Contractom, and the total value Of my con bttctiorr is at leasE £tvc hundred dollars (S500), including labor and materials, I m4y be considered an, "employer" under state and federal taw. N� F. I understated if I am considered an "enTIOyer" under state and federal law, I must register with the state and federal government, v,•ithhold payroll taxes, provide workers' compcusation disability irlsuranee, and coniribu� to urtemploymetlt cutnpensation for each "employee." I'also tutderstaod fry failure fi abide by these laves may subject me to.serious financial risk ki 14 f understand tuedcr California CcrrltTan.Tjrs, State License Law, an pvncr_Buildcr r.'lto builds sinsie-tztt�,l:' resider_ti�l :i "J:. :'.'L'".ut sr�L:;'•'•, :..L':' . s'tcOntr. :::i-:. ttnlc-s c:. :.,;�1; ;: }chi; - �:'tors zmd iitC nUrnLcr e' ,tctcri ,?r illi'% i li..cns« :ec nc:,>aet:_ =o•_ .rthia.m .;:�ern9 �• „. _.'.: ��j Lc-l:'irl;t'!c Pi..Tr.-iI7�T.?? From: 02/24/2017 1E:00 02/24/2017 15:16 #381 P.002/005 7607779038 FEDEK OFFICE 202E: PAGE 02/04 fit -'A 8. I understand as an Owner -Builder. if I sell the property for which this perivit is issued, i may be. held liable for any 'financial or persopal injuries'sustaincd by any.subsequeirt ownei(s) that result from any latent construction. defocte' in the workmanship or materials. 9. I understand I niay obtain more infbr-nation regarding nayas art."eiuploya" ftm the. Internal Revenue Service, the United States Small.Business Adminiustraliod,, fire California Department of Benefit Payments, and the California Division of Industrial Accidents. I ulso understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321;CSL B (2752) or wNvw_cslb.ca.gov for more inforrnation about licensed contractors. LW 10. i am aware of and consent to an Owner -Builder building penult applied for.in my name, and understand that I am the pgyA�and� furanc\ially re9pcle for pyoposed ooustructign avitythe following address! ►4 � Il - I agree that, as tho .party legally and fncanc4y responsiblc for this proposed eonsftwfion activity, I wii abide by all applicable laws and requirements that govern owner -Builders as well as employers . 12. I agree to notify the issuer of this fo= inmw iaatcly of any _ndditit ns, deletions, or changes to- any o£thc iinfortnaxion I have provided on this form Licensed contractors are regulated by laws designed to protect the public.. If you ooalracx with someone wbo does not havb st license, the Contsac hm, State Liccnse Board may be unable. to assist yva, with any financial loss you way sustain as a result of a coral iat. Your only remedy against unlieeased Contractors may be in civil-pomt. Iris also imp ortitnt. for you to.rmdmstmd that•if an nnliomsed Coubuctm *r ei"ployec of that individual or firm is injured witch vvor>ang on your property, you may be held liable for damages. If you obtain a permit as OwneriB%Wder and. wish to. hire Contraeuxicry YOU will, be responsible for 'verifying whether or not those' Cominco are properly licensed aitd the status of d3;cir workers• con3lPenation insurance coverage. Before a boarding pernfit can be issued, .fits forms mnst'be cntttpleted and s4ped by the property owner and r etucttod to tate agency responsible far issming the perxWL Nota A copy of €heproperiy owner's dnivir's•f mmse, forrrr nolar�na,• pr other Wr(Ocatiorr acceptable to the icy is regained to ire pnraw wed where. Bre permit is issued to vertJy tke property owner's stBvraetare. Signature of propcny owner OL Date: Note: The following Authorization Form is regrdt'ed to be completed by Ilse property owner only when dmignating . an agent of the property owner to apply fora emm* ucdon permit for the Owner=Builder. P►a.i i nli►M& A 1'10N Ukc A(jMT TO ACT ON PR01?FJ TY OWNER'S BEL'i<�i;F F_:cluding the Naiicc to proputy Owner, the .execution of which I understand is my personal responsibility, I Hereby authorize the following persons) to act as my agent($) to apply int, sips; and file the documents'necessary to obtain an Ownc rwilder Permif for my project. Scope of Construction Project (or Description of Work): - Project Location or Address. •� 4 `��.5 �r��ls ��? �� r�v�t`rt� G1-2..53 Nawo of Authorized Agent AddiYss'ofAuthcrizedAgen't: eS NL/%� Aur--:A1iD& 1911A7 I declare under penalty of perjury that I axn rite property owner for -the address listed above acid I personslly fill .ed -out the abo�'e infOrmAhOn and certify its accuracy, )Vote: A copy of the.owwer's drivier Is &cense, forst notarizatto>r, or other ver fcation acceptable to the izgency is required to be presented when dee. permit is krsuipd• to verify the prop -city owner's signottcre. FA)perty O%vncr's Sizaturc -�� LCA ):late:i- 1 ' t—�— Bin ri Permit 71; 0/U`J l Project Address: 4 City of La Q uin ta' Buildin; 8t' Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking S.ieet Owner's Name: A. P. Number: Address: z Legal Description: City, ST, Zip: Contractor: or. Tele ho 11 P n Address: Project Description: City, ST, Zip: Telephone: State Lie. # : City Lie. #; Arch., Engr., Designer: Address: City, ST, Zip: Telephone: PancY: Constructiontraction Type: Occupancy: State Lie- #: r Demo Project hP (circlele one):: New A dd'n Alter Repair-ai Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone # of Contact Per -so — Estimated Value of Project: 1 Nz– APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted. Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Leposit Truss Cates. Called Contact person Plan Check Balance, Tile 24 Cates. Plans picked up Construction ' Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical . Subcontact'or List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. II.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 Perniio Fees COACHELLA VALLEY WATER DISTRICT 0fttit P.O. BOX 1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 INVOICE Date: 218/2017 SUBJECT:.., SANTA CARMELITA, 54475 AVENIDA DIAZ, LA QUINTA, LOT 11, LID 690364 "SCC FEE ONLY" t FERNANDO FLORESProject: 17-7805 + 54475 AVENIDA DIAZ Project Date: 2/8/2017 Amount Due: $4,851.00 LA QUINTA; CA' 92253 GEO: 06-06-13-2 c- _ , .. ��, _ Y• Planner: - SANDRA VILLALOBOS` TO INSURE PROPER CREDIT, PLEASE RETURN THIS PORTION WITH _ REMITTANCE AND INCLUDE THE PROJECT ON YOUR CHECK 1.00 FF SCC -COLLECTION $2 I t i I SANTA CARMELITA, 54475 AVENIDA DIAZ, LA QUINTA, LOT 11, LID 690364, "SCC FEE ONLY" I • -SUBJECT: ` COACHELLA VALLEY WATER DISTRICT P.O. 60X,1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel ,415.00 $2,415.00 1.00 FJ SCC -TREATMENT $2.436.00 ------ nn $4,851.00 • PAID $�: 851• oo ✓ #� a 1.5 Development Services Department - FEB 2 4 2017 3. 5k _ Coachella Valley Water District 75-515 Hovley Lane East Palm Desert; CA 92211 ` c•�' -—-.,�..-.. f; . _ rP�.•Aa .�._ i _. ._. P _. -- 4 --. . • i � V a .. __. - r �L. fJ-- a. � - .. a' 3:. in. - Vr. Q�.rrvt �s4o � :a h•able a i0 � •l�'�p-r'f' t goo �aa��'l33 . � ` ;- I t i I SANTA CARMELITA, 54475 AVENIDA DIAZ, LA QUINTA, LOT 11, LID 690364, "SCC FEE ONLY" I • -SUBJECT: ` COACHELLA VALLEY WATER DISTRICT P.O. 60X,1058, COACHELLA, CALIFORNIA 92236 (760) 398-2651 Pagel