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BWFE2017-017378-495iCALLE TAMPICO• LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant:. NANCYCOOGAN 53225 AVENIDA'HERRERA LA QUINTA, CA 92253 c&t�p 4 � V DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT WALL/FENCE/CITY STANDARD/PRE-APPROVED BWFE2017-0173 53225 AVENIDA HERRERA 774053023 COOGAN/ 125LF OF 6' WALL AND -6 RETAINING $8,000.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9( ' commencing with Sectiori 7000) of Division 3 of the Business and Professions Code, anmy 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 Contractors 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).: (J, 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 she did not build or improve for the purpose of sale.). 1 (`%-P {•, 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.). . 4?4,e�Lam exempt under Sec. - . B.&P.C. for this reason Date: t Owner: 1 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 Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 9/22/2017 Owner: NANCY COOGAN 53225 AVENIDA �ERRERA LA QUINTA, CA 92253 Contractor: OWNER BUILDEF Llc. No.: WORKER'S COMPENSA'ION DECLARATION I hereby affirm under penalty of perjury one cIf 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 perfornance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Ca r. Policy Number: itcertify that in the performance of -the work for which this permit is issued, I shall not employ any person in any manner spas 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 =700 of the Labor Code, I shall forthwith. comply with ose provisions. Date: l Z( Applicant: l WARNING: FAILURE TO SECURE WORKERS' CCIVIPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIIUAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FO:i 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 owne r, 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 cancelation. I certify that I 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 authorize representatives of this city to enter upon the above-mentionedroperty for inspection purposes. Date: IZ l� ignature (Applicant orAgent): z � 3 n -L 0 T . N o O D v WORKER'S COMPENSA'ION DECLARATION I hereby affirm under penalty of perjury one cIf 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 perfornance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Ca r. Policy Number: itcertify that in the performance of -the work for which this permit is issued, I shall not employ any person in any manner spas 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 =700 of the Labor Code, I shall forthwith. comply with ose provisions. Date: l Z( Applicant: l WARNING: FAILURE TO SECURE WORKERS' CCIVIPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIIUAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FO:i 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 owne r, 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 cancelation. I certify that I 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 authorize representatives of this city to enter upon the above-mentionedroperty for inspection purposes. Date: IZ l� ignature (Applicant orAgent): Date: 9/22/2017 Application.Number.. A ,., .BWtEE2017-0173 Owner: Property Address: 53225 AVENIDA HERRERA NANCY COOGAN APN: 774053023 53225 AVENIDA HERRERA Application Description: COOGAN/ 125LF OF 6' WALL AND'6 RETAINING LA QUINTA, CA 92253 Property Zoning: Application Valuation: $8,000.00 Applicant: Contractor: NANCY COOGAN OWNER BUILDER 53225 AVENIDA HERRERA LA QUINTA, CA 92253 Llc. No.: --------------------------------------------------------------------------------------------- Detail: 125LF OF 6' WALL INSIDE PL AND 162LF OF'3 CO1V160 WALL [CITY SPECIFICATIONS) PRECISION CONCRETE BLOCK SHALLBE COVERED WITH STUCCO, PAINT., OR TEXTURED COATING,WHERE VISIBLE FROM OUTSIDE THE PROPERTY. THE AREA BETWEEN THE BACK OF CURB AND ANY FENCING SHALL BE LANDSCAPED, HAVE A SUITABLE PERMANENT IRRIGATION SYSTEM, AND BE CONTINUOUSLY MAINTAINED BY THE PROPERTY OWNER. 2016 CALIFORNIA BUILDING CODES. a k FINANCIAL •R • c.'DESCRIPTION ACCOUNT CITY AMOUNT' RETAINING/COMBINATION WALL EA 50LF 101-0000-42400 0 $60.80 DESCRIPTION ACCOUNT QTY AMOUNT WALL/FENCE - EA ADDITIONAL 50 LF 101-0000-42404 0 $15.20 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: $190.00 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 . $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 N Bin# City o, f La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit# }I LL c Project Address:3 2a5 n� �� • Owne__ r__ s__Nam� A.P. Number Address: S 3 a j j Legal Description: City, ST, Zip: ^ `` 12-7-5 Contractor: Telephone: Address: Project_D scriptit - City, ST, Zip: n_ 1 Telephone: MCity State Lic. #: Lic #: 9 Lj 1 Arch, Engr., Designer: ' V Address: City, ST, Zip: Telephone: Construction Type: Occupancy: State Lic. #: Proj. Type New Add'n Alter Repair Demo Name of Contact: 's IU G� /1 I loU SgFt: #Stories # Units: Telephone -of Contact:a O 3 2-13 Ekima� ted_ Value of Project:�1 O D 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 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 Bin# City of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 '/ Building Permit Application and Tracking Sized Permit# G2 T Project Address: I �22 ALK"@ (1 Up Q,NA Jv L11 t Owner's Name'? am � ` Fi'Y R CIA �'*1 A.P. Number Address: 15 w CN11P,D�=1VUeQ—A0 Legal Description: City, ST, Zip: Contractor. T 2 1, Telephone: � 1 C) U O 3 Address: Project Descripdon: City, ST, Zip:, 'VR> L_C)c.\z w ALL, Telephone: State Lie. #: City Lie #: Arch, Engr., Designer: Address: City, ST, Zip: Telephone: Construction Type: OccupF-ncy: State Lie. #: Proj. Type New Add'n Alter Repair Demo Name of Contact: SgFt: #Stories # Units: Telephone of Contact: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERM -T FEES Plan Sets Plan Check Submitted Item Amount Structural Calcs Reviewed, ready for corrections Plan C�eck Deposit: Truss Calcs Called Contact Person Plan C:aec� Balance: Title 24 Calcs Plans Picked Up Constraction: 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 / Develaper Impact Fee Planning Approval Called Contact Person A:I.P.F- Pub. Wks. Apps Date of permit issue School Fees Total Fermit Fees �� ' t t� f':,dr t; :eY ,,,� r 1 .A _ �j. �. 3 CITY OF LA QUINT ++ Bd;IL01NCa & SAFETY DEPT. OIL. - APPROVED _ IVS •TION4F OAT . t FOR CO T t2U0[Zf7 By «� �y..•�+i.� �Y` rR .�, �4 i.. �• -_ w/ i-. w -+IM•w •t. ' ..w y�..z - rt - .�. • - 0 BUILDING & SAFETY DEPARTMENT 78-495 CALLS TAMPICO (760) T77-7012 LA QUINTA, CALIFORNIA 92253 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 Etnpliyer" 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 -Budder. 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: Hi hest Benefits and the Least amount of Risk Owner -as -{Porker 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, anc 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 Contracoor, 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 Sienifrcant 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 tum•to serious financial risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker. Benefit/Risk: 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 a head 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 policyon th a claim. e house against which to submit • 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 TitY 414 QU&M P.O..Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLS TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKArF (760)777-7012 FAX (760)777.-7011 Disclosures & Forms for -Owner -Builders Applying for Construe- ion Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has b n submitted in your name listing yourself as the -wilder of the.property improvements specified at �i 3a t ��^�� We are providing you with an Owner Acknowledgment and Information Verification Form to make you aware of your CLL 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 unless you, the prope, notice rty owner, obtain the prior approval of the permitting authority. -`Ax 0 h. �.v vv1,LUly1VM1N t AiND VERIk'ICATION 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. 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 pro%ide 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. 'A_-2. I understand building permits are riot required to be signed by property owners unless they ire 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. I understand Contractors are required bylaw to be licensed and bonded in California and to list &.eir license numbers on p8rmits 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 con.;idered an "employer" under state and federal law. 11•r_6. I understand if I am considered an "employer". under state and federal law, I must register wit 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. 1r--7. I understand under California Contractors' State License Law, an Owner -Builder who builds sir_gle-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 tie 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 financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 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. 0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the k party legally. and financially responsible f r proposed construction actio, at the following address: 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 may beunable 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 presented when the permit is issued to verify the property owner's signature. C Signature of property owner J Date: Z 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 penaltyof 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 the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: