BWFE2018-021178-495 CALLE TAMPICO T4ht D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 10/4/2018
Permit Type/Subtype: WALL/FENCE/CITYSTANDARD/PRE-AP PROVED Owner:
Application Number: BWFE2018-0211 CHAVEZ, OSCAR FLORES/ AYALA JOSE GLORIA
Property Address: 52290 AVENIDA VALLEJO 52290 AVENIDA VLLEJO
APN: 773263002 LA QUINTA, CA 92253
Application Description. GLORIA / 166 LF GARDEN WALL
Property Zoning:
Application Valuation: $7,000.00
Applicant: Q Contractor:
CHAVEZ, OSCAR FLORES / AYALA JOSE GLORIA Q OWNER BUILDER
52290 AVENIDA VLLEJO D
LA QUINTA, CA 92253 OCT 0 42018
CITY OF LAQUINTA Llc. No.:
DESIGN & DEVELOPMENT DEPARTMENT
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 theA
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).:
• - ) 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 she did nat build or improve for the purpose of sate.).
-6) I, as owner of the property, am exclusively contracting with licensed contractors
o construct the project. (Sec. 704-4, 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.).
() I am exempt under Sec. B.&P.C. for this reason
Date: /o —Owner:If
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:
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:
Caryl r: Policy Number:_
• I certify that in the performance of the work for which this permit is issued, I
sh 1 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, I shall forthwith
comply with those provisions.
Date/0— • Applicant: 4 C7 �� c.�
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:A�_A�` { • Signature (Applicant orAgent):C��'O�
Date: 10/4/2018
Application Number:
BWFE2018-0211
Property Address:
52290 AVENIDA VALLEJO
APN:
773263002
Application Description
GLORIA / 166 LF GARDEN WALL
Property Zoning:
Application Valuation:
$7,000.00
Applicant:
CHAVEZ, OSCAR FLORES / AYALA JOSE GLORIA
52290 AVENIDA VLLEJO
LA QUINTA, CA 92253
Owner:
CHAVEZ, OSCAR FLORES / AYALA JOSE GLORIA
52290 AVENIDA VLLEJO
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No. -
Detail: 166LF OF 6' GARDEN WITH (2) GATES [CITY SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE 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.
DESCRIPTION
WALL/FENCE - EA ADDITIONAL 50 LF
DESCRIPTION
WALL/FENCE - FIRST 100 LF
DESCRIPTION
WALL/FENCE - FIRST 100 LF PC
DESCRIPTION
BSAS SB1473 FEE
DESCRIPTION
RECORDS MANAGEMENT FEE
DESCRIPTION
TECHNOLOGY ENHANCEMENT FEE
ACCOUNT CITY
AMOUNT
101-0000-42404 0
$31.20
ACCOUNT CITY
AMOUNT
101-0000-42404 0
$52.01
ACCOUNT CITY
AMOUNT
101-0000-42600 0
$65.02
Total Paid for BLOCK WALL:
$148.23
ACCOUNT QTY
AMOUNT
101-0000-20306 0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
ACCOUNT CITY
AMOUNT
101-0000-42416 0
$10.00
Total Paid for RECORDS MANAGEMENT FEE:
$10.00
ACCOUNT CITY
AMOUNT
502-0000-43611 0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
$5.00
ta 0"fra
;F\1 41/, 1� SFKI—
PERMIT# `n3��Z�(�f �2.1
PLAN LOCATION:
G I/� \ '
Project Address: `� qoI �� vI�JU
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
0 i
Applicant Name: Q 101-ck,
Address: 3 d )t—sslcu�
City, ST, Zi
Telephone: —* 0 1) — "l
Email:
Valuation of Projects
Contractor Name: 1
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:
Construction Type: Occupancy:
Address:
Grading:
City, St, Zip
Telephone:
Bedrooms: Stories: # Units:
Email:
State Lic: City Bus Lic:
Property Owner's Name:
New Commercial / Tenant Improvements:
Address: b2261() ` aA o
Total Building SF
City, ST, Zip �lX1U,� q ZZS
Construction Type: Occupancy:
ne:U—l}
Eai
78495 CALLE TAMPICO
LA QU I NTA, CA 92253
760-777-7000
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
44"
BUILDING & SAFETY DEPARTMENT
(760)777-7012
FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Permits
I1!lP PRTANP NOTICE TQ PROPERTY GwNER
Dear Property 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 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 VERMCATiON F INFORMATION
DIhECT1DN3: Read and initial each sfutement below to signify 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 employers 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.
J7,6 2. 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.
Jj_(-13. I understand as an "Owner -Builder" I am the responsible party of record an 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.
-3•64. I understand Contractors are required bylaw to be licensed and bonded in California and to list their license numbers on
permits and contracts.
J G 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 Iabor and materials, I may be considered an "employer"
understate and federal law.
J'G 6. I understand if I 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 unemploent
compensation for each "employee." I also understand my failure to abide by
risk. these laws may subject me to serious financial
c },U 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build therm, 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. 1 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 owater(s) that result from any latew construction defa s in the
workmanship or materials.
-3'(19. 1 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 I-
800-32I-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
3'6 10. 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:
J'yl l . I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable Iaws and requirements that govern Owner -Builders as well as employers.
I2. 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 Ioss
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 age
owner's signature. ncy is required to be presented when tl+e permit is issued to verb the property
Signature of property owner p ! r Date:. 5
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.
A[hT'H IRIZATION 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 ofperjury 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 bepresented when thepermit is issued to verify theproperty owner's signature.
Property Owner's Signature: Date:
CITY OF LA QUINTA SUB -CONTRACTOR- LIST
JOB ADDRESS PERMIT NUMBER OWNER f _ BUILDER
This forn-i shall be posted ❑n the job with the Building Inspection Card at all times in a cons i uous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance.
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
Trade-1 Classification. Cpntra..ctor State Contractor's. -License Workers Compensation .l.nsu.rance City 8u siness . Licetf se
Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp. Date
(e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) (xx/xx/xx) (xxxx) (xx/xx/xx)
EARTHWORK (C-1-2) T —
CONCRETE (C-8)
FRAMING: (C:5)
STRUCT. STEEL (C 51.)
MASONRy (C-29.) i�\A
PLUMBING (C-36) '
LATH, PLASTER (C 35)
DRYWALL (G9.)
HVAC (C-20)
ELECTRICAL (G40)
:ROOFING (C-39)
SHEET :METAL (C-43)
FLOORING (C-15)
GLAZING (C-17)
1NSU:L.ATION (C.-21
SEWAGE DISP. (C-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
.FENCING (C-13)
LANDSCAPING. (C=271
POOL (C-5.3)
I
F-
s Z117 ?W;5
779
Z
0
t g 10? 1 Dr-1 o r,,-a ry I
n �
c
C5
OI��Z
N �
N
LO
ti
r
�l
r ,
r
ISO
Chavez Oscar Flores ! Ayala Jose Glo...
52290 Avenida. Vallejo La Quinta, CA 9225E3
Riverside County
i
AP'N: 773-263-002 Built: 2018 5q Ft: 1,662
Type: Residential / Residential Lot Beds: 3 Baths: 2
Order Customer Service Costshrst^ grid to Farm List
Report Name Actions Available Allowance
6
Combined Report Edit I Run
Property Profile
E
Run
94
100
r
Transaction history
Run
93
100