BPOL2018-003778-495.CALLE .TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: POOL/PRIVATE
Application Number:
BPOL2018-0037
Property Address:
51980 AVENIDA NAVARRO
APN:
773184012
Application Description:
VALDEZ
Property Zoning:
Application Valuation:
$21,000.00
Applicant:
JOE VALDEZ
51980 AVENIDA NAVARRO
LA QUINTA, CA 92253
D �
MARTI 201
CITY( FLAQUINTA
COMMUNITY DEVELOPMENTDEPARTMENTI
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
al ged exemption. Any violation of Section 7031.5 by any applicant for a permit
fc*.P7
the applicanttoa civil penalty of not more than five hundred dollars ($500).:
s owner ofthe property, or my employees with wages as their sole
sation,willdothe work, and the structure is not intended or offered for sale.
44, 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
texempt
year of completion, the owner -builder will have the burden of proving that he
not build or improve for the purpose of sale.).
owner of the property, am exclusively contracting with licensed contractors to
the project. (Sec. 7044, Business and Professions Code: The Contractors' State
w does not apply to an owner of property who builds or improves thereon,
ontracts for the projects with a contractors) licensed pursuant to the
rs'State License Law.). under Sec. B.&P.CUor this reason
VOICE (760) 777-7126
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/16/2018
Owner:
JOE VALDEZ
51980 AVENIDA NAVARRO
LA QUINTA, CA 92253
Contractor:
OWNER
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
S io 3700 of the Labor Code, for the performance of the work for which this permit is
I,
u JL My workers' compensation insurance carrier and policy number are:
C rr'olicy Number: _
certify.that in the performance ofthe work for which this permit is issued, I
s
hr—eti,
ploy any person in any manner so as to become subject to the workers'
Ic n laws of California, and agre t, ifJ should become subject to the
workers' compen tion provisions of Sed' n3 of the La or I shall forthwith
comply wi 'mhos provision
Da'tUt A. licant
WARNING: FAILURE TO SECURE WORKS' M SATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO MINAL 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.
CONSTRUCTIOENDING AGENCY v I certify that I have read this application and state that the.above information is correct.
I hereby affirm under penalty of perju y at there is a construction lending agency for I agree to comply with all city and county ordinances Qae la relati to buildingthe performance of the work for whit this permit is issued (Sec.3097,Civ.C.). construct' n, a hereby authorize representatives ot en r n the above -
mention pro erty fo inspection purposes.Lender's Name:D'afe. ignatur (Apptfcan Agen
Lender's Address:
Date: 3/16/2018
Application.Nurn*: BPOL2018-0037
Owner:
Pr"O&W'Addresr''l" !'—S1980' AVENIDA NAVARRO
JOE VALDEZ
APN: 773184012
51980 AVENIDA NAVARRO
Application Description: VALDEZ
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $21,000.00
Applicant:
Contractor:
JOE VALDEZ
OWNER
51980 AVENIDA NAVARRO
LA QUINTA, CA 92253
------------------------------------------------------------------------_-------------------
Llc. No.:
Detail: POOL AND SPA AT FRONT COURTYARD [DENISE POELTLER ENGINEERING]
THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS
AND BARRIERS REQUIRED TO BE INSTALLED AT PRE-'PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
rwArdr im 1KIMPUATInAI
�.:•• :•::.K, -,,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
SWIMMING POOL/SPA
101-0000-42404
0
$195.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$106.11
Total Paid for POOL / SPA: $301.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEM=NT FEE: $10.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502=0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: • $5.00
s
C>i'>TtiR:T` •- ........ _.... •
PERMIT# �PoL2wr8-��37
.
PLAN LOCATION:
Project Addresst` %��A�
Conditioned Space
Project Description: Pool, Remodel, _add't, Elect, Plumb, Mech
APN #:
Garage
SF
Telephone:
Applicant Name:�
SF
Address: �l — '/✓�/ %`��lt
Fire Sprinklers
City, ST, Zip:QL
State Lic: City Bus Lic:
Telephone:
Email: U�
Valuation of Project $ ____4L
Contractor Name:��
New SFD Construction:
-
Address:
Conditioned Space
SF
City, St, Zip
Garage
SF
Telephone:
Patio/Porch.
SF
Email:
Fire Sprinklers
SF
State Lic: City Bus Lic:
'Arch/Eng Name: y
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Construction Type: Occupancy:
Telephone:
Bedrooms:
Stories:
#Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address: ��/
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
r..
OFFICE USE ONLY
1 �,
#
Submittal
Req'd
-Reed
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM 10)
Landscape Plan v
Subcontractor List
Grant Deed
HOA Approval
School Fees
Butrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
0
20'-0
0
O
SETBACK J II I a
2to
EXISTING DRIVEWAY
EXISTING RESIDENCE
z CA•
EXISTING
� - .
' BLOCK WALL SETBACK
y
I r!ew r,ti�Vlc
10
O. PLANTER °
5
w -
r SPA TO BE RAISED
v 3' w 18 - HIGH WITH7t
IXISTING BLOCK WALL z 5� ?9� CONCRETE CAP STONE
• 70* VENEER
HAND co - I
z HOLDS) — 1 (E) SEALED CONC.
(E) 4" STEP (E) 4" STEP (E) SEALED CONC. EXISTING /C O
BOND
4' O
• +t
O 1ND NEW PAVERS NEW WOOD FENCE
m IT,�00A J GFCI PANEL EXISIIN ODA MAIN -PANEL
j Go o 4 •-2' 22'—°r POOL EQUIP 3' MI 0 NG GAS PANEL
W PAVERS
. _ .. OND 1. PLANTER THERAPY .E NE -!
! EXISTING BLOCK WALL 31'—Oj" EXISTING BLOCK WALL
CT_
BONDING WIRE TO T x
CONNECT TO REBAR (E) GATE- a
la
PROPERTY: LI - W
•F'
o
CITY OF LA QUINTA
BUILDING & SAFETY DEPT'. _
APPROVED
FOR CONSTRUCTION
• rMI �G��I�r' _ ��
P.D. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLS 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 permit has been u nutted in your pave listing yourself as the builder of the property -
improvements specified at.�—�
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 ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
CTIONS: Read and initial each statement below to signi you understand or verify this informatian.
Wa,wAmner-Builder,
understand a frequent practice of unlicensed persons. is to have the property owner obtan an ."Owner -Builder"
ermit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
may be held liable and subject to serious financial risk for any injuries sustained Ly an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not pro%ide coverage for those
urij s, I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers
on 7 property.
understand building permits are not required to be signed by property owners unless they. are responsible for the
ion and are not hiring a licensed Contractor to assume this responsibility.
understand as an "Owner -Builder" I am the. responsible party of record on the permit. I underhand that I may protect
from potential financial risk by hiring a licensed Contractor and having the permit filed in his or -zer name instead of my
I understand Contractors are required by law to be licensed and bonded. in California and to list t>keir license numbers on
and contracts.
,Tunderstand if I employ or otherwise engage any persons, other than California licensed Contrac-ors, and the total value
construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
;tate and federal law.
rsatiton
rstand if I am considered an "employer" under state and federal law, I must register wide the state and federal
owithhold payroll taxes, provide workers' compensation disability insurance; and contribute to unemployment
for each "employee." I also understand my failure to abide by these laws may subject ne to.serious
ri financial
understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
es cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
ntractors and the number of structures does not exceed four within any calendar year, or all of 'he work is performed
under contract with a licensed general building Contractor.
t�an
nderstand as an Owner -Builder if I sell the property for which this" permit is issued, I may be held liable for any
r personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
hip or materials.
nderstand I may obtain,more information regarding my'obligations as an "employer" from the Internal Revenue
e United States Small.Business Administration, the California Department of Benefit Payments, and the California
f Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-
~21-CSLB (2752) or www.cslb..ca.gov.for more information about licensed contractors.
1 . I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I. am the
a legally , and financially responsible for proposed construction activity at.' the following address:
f.agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by.all
laws and requirement$ that govern Owner -Builders as.well as employers.
agree to notify the issuer of this form immediately of any additions, deletions, or changes. to any of the information I
ided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
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 per 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 accep tl ag s IreuJireMdbe presented when the permit is issued to verify the property
owner's signature.
Signature of property o . n Date: �v
. / L,/ .
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: Tel No
Address of Authorized Agent:
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 the permit is issued to verify the property owner's signature.
Property Owner's Signature: Date: