BRES2017-015378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
'c%4l�4�;�rw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Permit Type/Subtype: BUILDING RESIDENTIAL/REMODEL
Application Number:
BRES2017-0153
Property Address:
51150 CALLE OBISPO .
APN:
770142003
Application Description:
TRYON /REMODEL
Property Zoning:
Application Valuation:
$4,800.00
D _
Applicant:
-
TERRY TRYON
NOV 2 7 201
51150 CALLE OBISPO
•
LA QUINTA, CA 92253
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
sub' cts the applicant to a civil penalty of not more than five hundred dollars ($500).:
((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 gwner-builder will have the burden of proving that he
or she did not build or improve for the purpose of sale.).
, a�s 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
Co ractors' State License Law.).
• l am exempt under Sec. . B.&P.C. for this reason
Date: I�' — /'_7 Owner:
CONSTR ION 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/27/2017
Owner:
TERRY TRYON
51150 CALLE OBISPO
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 3100 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 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.
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-
mentioned property for inspection purposes. _
Date: /L o2 7 1 7 Signature (Applicant or Agent): G
i. y
Date: 11/27/2017
Application Number: BRES2017-0153 Owner:
Property Address: 51150 CALLE OBISPO TERRY TRYON]
APN: 770142003 51150 CALLE OBISPO
Application Description:. TRYON /REMODEL LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $4,800.00
Applicant: Contractor:
TERRY TRYON OWNER BUILCER
51150 CALLE OBISPO `
LA QUINTA, CA 92253
Llc. No.:
Detail: TRYON / REMODEL/ALTERATION. REMOVE AND REPLACE ALL DRYWALL, LIGHTING, PLUGS AND SWITCHES AT GARAGE AND ADD R-15 TO WALLS
AND R-38 INSULATION TO CEILING. REMOVE AND REINSTALL EXISTING WATER HEATER. INSTALL (4) 12"X16" WINDOWS AT SOUTH WALL OF GARAGE
BETWEEN EXISTING STUD BAYS. CUT OFF EXISTING FASCIA AND SUPPORTING FRAMING AT VARIOUS EXISTING OVERHANGS AND ADD 4"X8" CORBELS
PER ENGINEERED DESIGN. FRAME PONY WALL AT FRONT PORCH (CONVENTIONAL FRAMING). ALL WORK COMPLETED WITHOUT PERMIT OR
INSPECTION --CONSTRUCTION MAY NEED TO BE REMOVED TO ALLOW FOR INSPECTION (REFERENCE CODE CASE CE2017-001305). THIS PERMIT DOES
NOT INCLUDE THE INSTALLATION OF ANY MECHANICAL SYSTEMS TO SERVE THE GARAGE. 2016 CALIFRONIA BUILDING CODES.
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
DEVICES, FIRST 20
101-0000-42403
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES, FIRST 20 PC
101-0000-42600
0
$26.01
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$10.40
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL PC
101-0000-42600
0
$2.60
Total Paid for ELECTRICAL: $65.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$23.41
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$18.72
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 100 SF
101-0000-42400
0
$53.05
DESCRIPTION
ACCOUNT
QTY
AMOUNT
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$145.12
Total Paid for REMODEL: $240.30
DESCRIPTION ACCOUNT QTY AMOUNT
•SMI -RESIDENTIAL 101-0000-20308 0 $0.62.
Total Paid for STRONG MOTION INSTRUMENTATION. SMI:
$0.62
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$S.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
��6p�rzTY 71
t _
5►40hyo
$RG-51•�1 - 0 53
CITY OF LA OL INTA
BUILDING & SAFE DEPT.' or
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APPROVE.
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Bin #
city of.La Quanta
Building 8T Safety Division
78-495 Calle Tampico
?j La Quinta, CA 92253.- (760)777-7012
Building Permit Application and Tracking Sheet
Permit #
j�(LSZoI�I- D
Project Address: 5 CA LL a C>,X,(5,20,
Owner's Name:
A. P. Number: %doi.5-73
Address:
Legal Description:
City, ST, Zip: LK! k A174- GA 3
Contractor: ti
Telephone: h ne- `7 60
Address: A �O V
Project Description:
City, ST, Zip:
jZ. ;,.j .
ne•
Telephone:
Po . h
� L ti'
r1-i
State Lic. # :
City Lie. #..
Arch., Engr., Designer
/a ,� (� L ► sI t— /
Address:
LL It
f' 1A ci: < nr
City, ST, Zip:
e tctA�/
Telephone:
State
S to Lic. #
Construction Type: Occupancy:
,
Project type (circle one): New Add'n Alter epair Demo
Name of Contact Person:
Sq. Ft: ®�
# Stories:
#Units:
Telephone # of Contact Person:
Estimated Value of Project: 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACIQNG
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates'.
Reviewed, ready.for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2ad Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.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 Permit Fees
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: Highest Benefits and Ahe 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 ofOwner-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/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 ares
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.
f
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 .
T4hf. 4lw4"
P.O. BOX 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING &G 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 Properly Owner:
An application for a building permit has been submitted in your name 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 tisk 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 signer you understand or verify this information.
r%KI understand a frequent practice of unlicensed persons is to have the property
building permit that erroneouslylies that the roe p P riy owner obtain an "Owner -Builder"
imp. property rty 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.
kc
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.
e l understand as an "Owner -Builder" I am the responsible party of record on the permit_ I understand that I may protect
%yself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
el understand Contractors are required by law to be licensed and bonded in California and to list their license number
permits and contracts. s on
I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
o my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
understand if I am considered an "employer under state and federal law, I must register 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 rime to.serious financial
risk.
I understand under California Contractors' State License Law, an Owner -Builder who builds sin le-famil residential
structures cannot legally build- g y ential
g y number
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.
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 California Contractors' State License Board (CSLB) at 1-
800-321-CSLB (2M) or www.cslb.ca.gov for more information about licensed contractors.
.0. 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:
-I. 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.
�I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
ovided on this form Licensed contractors are regulated by laws designed to protect the public. If ou 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 f -rn 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.
Signature of property owner `'7 — 3 / i
Date:
Note: The following Authorization Form is required lobe 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 b esented when the pe it is issued to verify the property owners signature.
Property Owner's Signature: L Date: