BELC2019-007178-495 CALLE TAMPICO Twyl D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: ELECTRICAL/ Owner:
Application Number: BELC2019-0071 MACKLIN RICK
Property Address: 55515 RIVIERA 55515 RIVIERA
APN: 775242011 LA QUINTA, CA 92253
Application Description: MACKLIN / ELECTRICAL INSTALLATIONS AT PATIO COVER
Property Zoning:
Application Valuation: $1,000.00 D
Applicant: Contractor:
MACKLIN RICK OWNER BUILDER
55515 RIVIERA JUN 2 5 2019
LA QUINTA, CA 92253
CITY OF LAQUINTA
DESIGN & DEVELOPMENT DEPARTMENT
Llc. No.:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 {commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Class: License No.:
Date:
Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($S
(_) 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 a did not build or improve for the purpose of sale.).
( I, 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.).
() I am exempt under Sec. B.&P.C. for this reason
Date: -L S / Owner:
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:
Date: 6/25/2019
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: _
rtify that In the performance of the work for which this permit is issued, I
shaft A& 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: ' �� �� Applicant: r' .
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: 1-) / 9 Signature (Applicant or AgentL.,
Date: 6/25/2019
Application Number:
BELC2019-0071
Owner:
Property Address:
55515 RIVIERA
MACKLIN RICK
APN:
775242011
55515 RIVIERA
Application Description:
MACKLIN / ELECTRICAL INSTALLATIONS AT PATIO COVER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$1,000.00
Applicant: Contractor:
MACKLIN RICK OWNER BUILDER
55515 RIVIERA
LA QUINTA, CA 92253
r'
{ Llc. No.:
------------------------------------------;-1----- -------------------------------------
Detail: LIGHTING AND ELECTRICAL INSTALLATIONS AT PATIO COVER, REFERENCE BPAT2016-0099. THIS PERMIT DOES NOT INCLUDE INSTALLATIONS IN
UNAPPROVED MODIFICATIONS TO PREVIOUSLY ISSUED AND FINALED PAW COVER, ADDITIONAL PERMITTING MAY BE REQUIRED TO RECEIVE INSPECTION
APPROVALS. 2016 CALIFORNIA BUILDING CODES.
DESCRIPTION
ACCOUNT CITY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES, FIRST 20 PC
101-000042600
0
$26.68
DESCRIPTION
ACCOUNT
CITY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL
101-0000-42403
0
$2.67
DESCRIPTION
ACCOUNT
QTY
AMOUNT
DEVICES/FIXTURES, ADDITIONAL PC
101-0000-42600
0
$0.67
Total Paid for ELECTRICAL: $56.70
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION ACCOUNT CITY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
- -- GEM .,f.b, D E';FRT -
PERMIT# 18E LLabl#. DOW
PLAN LOCATION;
Project Address: Jl��` S A A/ Q
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN
Applicant Nam LJ 14�11
Address: sssjS �r/t�C �4
Gr//�LL �16�1�5
City, ST, Zip: //,L 4V11Vr-71 1!?,Z
Telephone: �� y) 51--S_C/-774e'
2-
Email:
Valuation of Project $ / 0 0, O �
Contractor Name: �GU� �� ��JlL iJ�h
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: �� s'�S je u
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
WC30 -*0144,Nja
OFFICE USE ONLY
#
Submittal
Req'd
Rec'd
Plan Sets
Structural Calcs
Truss Calcs
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
I:E� 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
I&IF0, ANT! NOTICE TO PROPERTY
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 5'/ 5 2 r�r�,�
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
Owrrer-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 ACKNQWLEI]GMENT AND VERIFICATION OF INFORMATION
DtRECTION.S: Read and initial each statement below to signer you understand or verify this information.
�. 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
on rnY Property.
V2. I understand building permits are not required to be signed by property owners unless they are responsible for the
constrtaction and are not hiring a licensed Contractor to assume this responsibility.
• 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 tiled in his or her name instead of my
own-
4
. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
p rrxrits and contracts.
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 rnatcrials, I may be considered an "employer"
Tde6.
r state and federal law.
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
risk.
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
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials,
obligations as an r " from the Internal Revenue
i/�y" 9. I understand I may obtain more informationregarding MY California Department of BenefitPaymen s, and he California
Service, the United States Small Business Administration,
Division of Industrial Accidents. I also understand
I may contact the information about licensed contractors.' State License Board (CSLB) at 1-
800-321-CSLB (2752) or www.cslb.ca.gov for
am the
am aware of and consent to an Owner -Builder building permit applied for in my activity
at and understand that address.
party legally and ftnaneia responsible for proposed construction activi at the following
legally oral financially responsible for this proposed construction activity, I will abide by all
11. I agree that, as the party g Y
applicable laws and requirements that govern Owner -Builders as well as employers.
_Ln. 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 area regulated l$o designed tunable to aotect ssistt you with any financial lose public. If you contract s
someone who does not have a license, the Contractors State LicenseY civil
you may sustain as a result of a complaint.
your
only remy unlicensed Contra d❑r oremplo
yeeuylic n sethat individual o d Contractors mT' ismay be lewhilelworking
important for you to understand that if
an 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 driver's
th ver property
ens formnotarization,returned
to
the agency responsible for issuing the permit. Note: A copy of the property
other verification acceptable to the agency is required to be presented when the permit is issued to verijY the property
owner's signature.
Date:
Signature of property owne 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
authorize
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility,
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, fonn 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:
PI Vl f g z L n1 �"` ❑►EMS _ I
a E �!5 C LIE PA T
IA& A4 rkbF, r •
101JA I_ - o N Tb I's s
�V
evp+c_ .E 1 ��
Notes:
1) GFCI protection required for outdoor receptacles. (CEC
§210.8(A)(3))
--
2) Weather -resistant type receptacle required at all 15- and
20-ampere, 125- and 250-volt receptacles. (CEC §406.9(A) & (B))
3) All luminaires shall be high efficacy in accordance with Table
150.0-A. (CEC §150.0(k)1A)
4) All down light luminaires recessed in ceilings shall contain light
�-
_
sources that are certified JA8 compliant that are not of the
screw -based type. (CEC §150.0(k)1 C)
5) Outdoor lighting permanently mounted to the building must be
controlled by combination of a manual ON/OFF switch and;
Photocell and Motion Sensor. (CEC §150.0(k)3)
6) Conductors installed within raceways located in wet locations,
either above ground or underground, shall be Wet -Rated. (CEC
§300.5(B) and 300.9) Romex/Southwire Type NM is not a
Wet-Rated Conductor.
-
7) An exterior surface -mounted switch shall be equipped with a
weatherproof cover. (CEC §404.4)
8) Exterior receptacles of 15 and 20 amperes installed in a wet
location shall have an enclosure that is weatherproof whether or
not the attachment plug cap is inserted, and be listed and
identified as "extra duty." (CEC §406.9)
I
LIGHTING AND ELECTRICAL INSTALLATIONS AT PATIO
COVER, REFERENCE BPAT2016-0099. THIS PERMIT
DOES NOT INCLUDE INSTALLATIONS IN UNAPPROVED
MODIFICATIONS TO PREVIOUSLY ISSUED AND FINALED
PATIO COVER, ADDITIONAL PERMITTING MAY BE
REQUIRED TO RECEIVE INSPECTION APPROVALS. 2016
CALIFORNIA BUILDING CODES.