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DRVA 2019-0001 Issued 01-07-2019P D zAs, 0 ai See below for Finance Revenue Codes 0 JAN 0 7 2019 a & -- GEM ofib, DESERT — — CITY OF LAQUINTA DRIVEWAY APPROACH DESIGN & DEVELOPMENT DEPARTMENT PUBLIC WORKS CONSTRUCTION For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS. DATE: 1/7/2019 LOCATION OF CONSTRUCTION (Street address or Description): 55075 MONROE PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH DESCRIPTION OF CONSTRUCTION: MORROW / DRIVEWAY APPROACH DIMENSION OF INSTALLATION OR REMOVAL: iAPPROXIMATE TIME WHEN WORK WILL BEGIN: 1 7 2019 _ TIME OF COMPLETION: 3/7/2019 II ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing permanent resurfacing and/or replacing improvements) COMMENTS: TEMPORARY DRIVEWAY APPROACH FOR HORSE TRAILER ACCESS. In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started at (760) 777-7097. To submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 prior to 1:30 P.M. at least twenty-four (24) hours prior to the anticipated inspection. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and re I"vns of the City of and to pay for any additional replacement necessary as the result of this work. r Si ure scant or Agent SCOTT MORROW 55075 MONROE LA QUINTA, CA 92253 Name of Applicant (please print) Business Address OWNER BUILDER , Name of Contractor and Job Foreman Business Address ®Wr�c-rrg (3vl L.pEoz_ Contractor's License No. Applicant's Insurance Company Finance Revenue Code PERMIT INSPECTION DRIVEWAY RESIDENTIAL $160.00 TECHNOLOGY ENHANCEMENT FEE $5.00 TOTAL: $0.00 City Business License No. Policy Number PERMIT NO: DRV 2019-0001 DATE ISSUED: I b I Z0(9 EXPIRATION DATE:_ / 'Z�'f 'L-;> BY. WORtIPECTED BY*: PERMIT COMPLETION DATE*: (949)533-5050 Telephone No. Telephone No. *If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council. ta Q�dwra - r,ENI ot-dw DFr ERT - DRIVEWAY APPROACH PERMIT APPLICATION Applicant Information: Applicant/Owner (please print name heref Applicant Agn—o77� vil oti rzoew— L& C' 01_2_Z<5 Number Street City State Zip Code Address or Pa,.wel No. of work location, if different from applicant's address Number Street City 0. Date. ll Applicant's Phone No: Applicant's Signature: Approximate Start Date:11 Approximate Completion Date: I / Contractor Information: Address: Owt ejsvz 'FjQQ roc- 2— Number Street Phone Number: ( ) City Business License Number: General Liability Insurance Company: State Zip Code City State Zip Code Contractors License Number: Policy No. Request for Inspection - Please call (760) 777-7097 before 1:30pm to request an inspection at least 24 hours prior to your requested inspection date. The Hub Counter (760) 777-7125. Please Note: Inspections are normally performed Monday through Friday between Sam and 4pm Permit Fee $160 + $5 Technology Enhancement Fee = $165 Total Fee Permit No. Permit Issued by: Expiration Date / / Signature of Administrative Authority Work Inspected by: Inspector's Signature Comments: Date Issued Permit Completion Date: Note: Driveway approach must be constructed per City of La Quinta Standard #221 REV: 11 /27/2018 T4hf at ep4" BUILDING & SAFETY DEPARTMENT 78-495 CALLE TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 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 nieans 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/Wsk: —Highest Benefits and the 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 join. You benefit by not paying others to perform this work for you and your risk depends on your own ability to complete (lie job successfully. Benefit/Risk: Possible Benefit with Low Financial Risk Owner-as-Canlractor 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 (lie 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 SignificantFinancialRisk 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 acid you are. personally responsible for their employment requirements, supervision, performance, safety and welfare while on your property. WARNING: Cost savings benefit can ium,ta serious financial risk if you fail to deduct payroll taxes or provide workers compensation insurance for each worker. Benefit/Risk: Possible 13enefit with Significant Financiai Risk 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 $S0'7S MO(%Cce. St Lc, OL4 i pt4, A � 3 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 DIRECTIONS: Read and initial each statement below to signs you understand or verify this information. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder„ b ding permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, 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. _&�. 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. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect self from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. k2-I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on s and contracts. lis5, I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value my construction is at least five hundred dollars ($500), including Iabor and materials, I may be considered an "employer" under state and federal law. G. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal ovemment, 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. 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. n vi 11 LI M iU,wwrr ry wr run improving inerr 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 Z: 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 active license but filed an exemption from Workers Comp. • Owner -Builder hires brother-in-law to install a new roof. a Employee fails and sustains multiple spinal and extremity fractures as well as a head 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 clam. 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,2 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 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 iancial 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 xvice, 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- 800-32I-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 arty legally. and financially responsible for proposed construction activity at the following address: 11. I agree that, as the party Iegally and financially responsible for this proposed construction activity, I will abide by all plicable laws and requirement$ that govern Owner -Builders asmell as employers. 2.1 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 loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also importiant for you to understand that if an unlicensed Contractor or employce of that individual or firm is injured while working on your property, you maybe 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 he presented when the permit is issued to verb the property owner's signature. Signature of property owner Date: SI6b I l� Note: the following Authorization Form is required to be completed by theproperty 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: -A ZAA1 AJ Tel No '%. O -77-�8 Address of Authorized Agent:gypy GD S tfio 5 12r— > 4,( 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: