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BELC2019-000178-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: CHERRY GOOD PO BOX 279 SUMMERLAND, BC VOH12-0 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT ELECTRICAL/ BELC2019-0001 54511 AVENIDA JUAREZ 774262027 GOOD / BACKYARD ELECTRICAL $50.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 {commencing with Section 70001 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 subjects the applicant to a civil penalty of not more than five hundred dollars *a -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 ` she did not guild or improve for the purpose of sale.). i, as owner of the property, am exclusively contracting with licensed contractors t construct the project. (Sec. 7044, Business and Professions Cade: 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 e ontractors' State License Law.). I am exempt under Sec. . BAP.C. W this reason Date1'iu . LIf I 1 Owner: Aeki411 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 Add VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/3/2019 Owner: CHERRY GOOD PO BOX 279 I— SUMMBERLAND, BC C 28 9 536 rr _1�1CY cv z Contractor: ® o i.11 OWNER BUILDER C:) � Q f'= 1 �a c� Llc. No.: LU w n 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 issu Y. My workers' compensation insurance carrier and policy number are: Carri Policy Number: t 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 3700 of the Labor Code, I shall forthwith comply with those provisions. Oat" U 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 far 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 it to nter upon Vhabo-veentioned pprroperty for inspection purposes. Oafs!eSignature (Applicant or Agent): Date: 1/3/2019 Application Number: BELC2019-0001 Property Address: 54511 AVENIDA JUAREZ APN: 774262027 Application Description: GOOD / BACKYARD ELECTRICAL Property Zoning: Application Valuation: $50.00 Applicant: CHERRY GOOD PO BOX 279 SUMMERLAND, BC VOH12-0 Detail: ELECTRICAL SWITCH AND RECEPTACLE AT BBQAND GFI FOR DECORATIVE FOUNTAIN. 2016 CALIFORNIA BUILDING CODES. Owner: CHERRY GOOD PO BOX 279 SUMMBERLAND, BC CANADA VOH, Z8 92253 Contractor: OWNER BUILDER Llc. No.. DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: 51.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $26.68 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $26.68 Total Paid for ELECTRICAL: $53.36 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $101.40 Total Paid for PERMIT ISSUANCE: $101.40 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 ZC4,1 -- (:FN, r,I SI.K F Project Address: APN #: Applicant Name: Address: ��•_j City ST, ZipX� c Telephone: Email: Contractor Name: Address: City, St, Zip Telephone: Email: State Lic: Arch/Eng Name: Address: City, St, Zip Telephone: Email: State Lic: Property Owner's Name: Address: City, ST, Zip Telephone - Email: City Bus Lic: City Bus Lic: am PERMIT # PLAN LOCATION: Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech Valuation of Project $ New SFD Construction: Conditioned Space Garage Patio/Porch Fire Sprinklers Construction Type: Grading: Bedrooms: I Stories: SF SF SF SF Occupancy: # Units: New Commercial / Tenant Improvements: Total Building SF Construction Type: Occupancy: 78495 CALLE TAMPICO LA QUINTA, CA 92253 760-777-7000 (;ei.ty _'"'444 X44 P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 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 BE�RE 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 Iaw provides you the benefit of protection from poor workmanship, .failure to finish the job and financial risk Clue to worker injury. Benefit/Risk: Highest Benefits and the Least $mount of Risk Owner -as -Worker is a type of Owner -Builder where you personally perform the construction work, the permit is taken out its your name and you are personallypert responsible for the construction management, knowledge, workmanship, and completion of the jab. 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. Renefit/Risk: Possible Benefit with I..ow Finastcial Risk Owner-as-Cantracror is a type of Owner -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. Benefft/Risk: Possible Benefit and Si nlf mnt Financial Risk Owner-as-Emplayer 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. 8eneiitlRfsk: Possible Setietit with Si nifcant Financial Risk e declares an and {Health and Safety Code Section f 982ij arse com ply m wr hegContracte s' License Law, "urgent Business ano public interest in assuring" that contract P Y owners are Professions Code and Workers' CompensationrIncur when improving thiree r property aents to sowner-Builders. nce requ informed about, and protected from t g Fraudulent representations - Liability for workerequirements ' injuries - Liability for cater al andi labor costs unpaid by contractors Licensing q over 20,0[]0 consumer complaints are filed each trv� issues Homeowners r. Macomplaints Isuffeate � financial harm duecto and include workmanship and workers' comp' 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 rant awe license st b tt new oaexemption from Workers Comp. • Owner -Builder hires broth ■ Employee falls and sustains multiple spinal and extremity fractures as well as a head injury an 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. ithout Workers Comp is hired by Owner -Builder to install septic Example 3: Employee of contractor w system and suffers injury that results in permanent disability. • The Owner -Builder did not have a homeowner's insurance policy an 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 injure worker. Did you know — unlicensed persons frequently have the Property ertyog his wner o her owntain an Olabor-Bdrmatebuilding permit which erroneously implies that the property P al personally? y not hislhde coverage for injuries sustained on your Did you know — your homeowner's insur ma property by an unlicensed contractor ander employees Did you know — if you are considered an "employer" under stake 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 BEFOREACCEPTING FULL RESPONSIBILITY FOR YOUR CONSTRUCTION ON PERMIT T-lar 4 4 a" P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE 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 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 VERIrICATION OF INFORMATION VT10NS.• Read and initial each statement below to signify you understand or verb 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 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 o my property. 2, I understand building permits are not required to be signed by property owners unless they are responsible for the co struction 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 0 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on pe 'is and contracts. 5. 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" und er state and federal law, 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 unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial ri 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential s ctures 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 the 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 mancial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the r9. nshipormaterials. 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- 0-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 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: 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all i licable laws and requirements that govern Owner -Builders as well as employers. 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I h e 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 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 th a ncy is required to be pr Wed when the permit is 'ssued to verify the property owner's signature. Signature of property owner v Dater Iry �� 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 A ENT 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 be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: r\ ABOVE ROOF LINE ( INSIDE OF PARAPET EXISTING RESIDENCE 1260SQFr— FAIWOFF ADDITION 763 SQ FT TOTAL LIVING �2023 SQ FT +GARAGE ADDITION 1242 SQ Fr or GFI 157ING 200 AW PANEL Iva cop I Axig-EfflF, WA t GFI t I WIRE FOR GARAGE DOOR OPENERS GFI GPI LU. BATH I NG PATIO % le, BED M 2 110, alow F; I r.rw Rr('. Tv Q -0 GFI ROVIDE DISCONNECT A/C UNIT BATH 2 i RECEPTACLE AN 25'/WFATKM WALK-IN BEDROOMI F-XIS OUSE R 0 A GFI " D' DISCONNECT r "C UK' BATH 2 C LE RO RECEPTACLE A) C AN 25.� EATH�RM ROOM I OUSE EXISTING HOUSE DosTING SELF -CLOSING DOOR KITCHEN BEDROOM 3a --- GFI AR LIGHT ABOVE MANTLE DININ GFI V, PROVIDE 01 Ecr FOR A/C UNIT W/ RECEPTA Q. W/I N 257INEAT E RPIR 0�0 F ABOVE ROOF LINE ON INSIDE OF PARAPET �e 0- z ui z SOLAR LIGHTING 6-1 o FOR ADDRESS uJ P Q 0 Lu > :D a: LL dcrz 0 z(!) 0. 0 C-) Q 1= 0 5 u-