BPOL2024-0102BUILDING PERMIT
DESIGN & DEVELOPMENT
DEPARTMENT
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
PHONE (760) 777-7125
WWW.LAQUINTACA.GOV
APPLIED DATE: 04/04/2024
ISSUED DATE: 05/14/2024
Permit Type:
Permit Number:
Property Address:
APN:
Legal Description
Property Zoning:
Valuation:
Pool
54925 AVENIDA JUAREZ
BPOL2024-0102
774265022
Lot 10 MB 19/50 SANTA CARMELITA VALE
LA QUINTA UNIT 25
$50,000.00
RC, 10
Owner:Henry S Wynne
54925 Avenida Juarez, La Quinta, CA 92253
Applicant:Henry S Wynne
54925 Avenida Juarez, La Quinta, CA 92253
Contractor:
Declaration / Acknowledgement
PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR
CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE
FOLLOWING:
LICENSED CONTRACTOR OR OWNER-BUILDER DECLARATION (1 or 2)
1) They are licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professions Code, and the
referenced
License is in full force and effect, or;
2) That they are exempt from the Contractors’ State License Law for the
reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or
she is exempt from licensure by a valid exemption. [Section 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
Contractors’ State License Law (Chapter (commencing with Section 7000)
of Division 3 of the Business and Professions
Code] 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).)
a) As owner of the property, or my employees with wages as their sole
compensation, will do all of or portions of the work, and the structure is
not intended or offered for sale (Section 7044, Business and Professions
Code: The Contractors’ State License Law does not apply to an owner of
property who, through employees’ or personal effort, builds or improves
the property, 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 it was
not built or improved for the purpose of sale.).
b) As owner of the property, will be exclusively contracting with licensed
c) Are exempt from licensure under the Contractors’ State License Law.
As an Owner-Builder, they acknowledge that, except for their personal
residence in which they must have resided in for at least one year prior to
completion of the improvements covered by this permit, they cannot legally
sell a structure built as an owner-builder if it has not been constructed in
its entirety by licensed contractors. It is understood that a copy of the
applicable law, Section 7044 of the Business and Professions Code, is
available upon request when this application was submitted at the
following Web site:
http://www.leginfo.ca.gov/calaw.html.
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If
applicable)
A construction lender will be used for completion of the improvements
covered by this permit and the name and information of which is on file for
public inspection during the regular business hours of the public entity.
Failure of the applicant to indicate the construction lender on the
application does not relieve that person of the requirement to give the
construction lender preliminary notice from that duty.
WORKERS’ COMPENSATION DECLARATION (1, 2 or 3)
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.
1) Has and will maintain a certificate of consent to self-insure for workers’
compensation, issued by the Director of Industrial Relations as provided for
by Section 3700 of the Labor Code, for the performance of the work for
which this permit is issued.
2) Has 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.
3) Certifies that, in the performance of the work for which this permit is
issued, shall not employ any person in any manner so as to become subject
to the workers’ compensation laws of California, and agree that, if should
become subject to the workers’ compensation provisions of Section 3700 of
the Labor Code, shall forthwith comply with those provisions.
NOTICE TO APPLICANT (1, 2 and 3)
1) Each person upon whose behalf this application was made, each person
at whose request and for whose benefit work is being 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 360 days from date of issuance of such
permit, or if cessation of work for 180 days will subject permit to
cancellation. On or after January 1, 2019, every permit issued shall become
invalid unless the work on the site authorized by such permit is commenced
within 12 months after its issuance, or if the work authorized on the site by
such permit is suspended or abandoned for a period of 12 months after the
time the work is commenced.
3) Certified that they read the application and state that the information
provided is correct. 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.
IMPORTANT: An Application for Permit was made to the Building Official,
subject to the conditions and restrictions set forth at the time of application,
which is now hereby an Issued Permit. If any part of the information being
supplied on this permit is inaccurate or untrue, please contact the City of La
Quinta at (760) 777-7125 immediately for correction.
Printed: 9/26/24 12:26 pm Page 1 of 3
Permit Type:
Permit Number:
Property Address:
Pool
BPOL2024-0102
54925 AVENIDA JUAREZ
BUILDING PERMIT
POOL AND SPA AT REAR YARD [POOL ENGINEERING] THIS PERMIT DOES NOT INCLUDE EQUIPMENT ENCLOSURE. APPROVED SITE
PLAN AND WET STAMPED POOL ENGINEERING SHEET REQUIRED TO BE ONSITE FOR INSPECTION. TWO DROWNING PREVENTION
SAFETY FEATURES AND THE REQUIRED ENCLOSURE SHALL BE IN PLACE AT PRE-PLASTER INSPECTION. 2022 CALIFORNIA
BUILDING CODE.
Use of Permit
Construction Details
Ron Lacher, R.C.E.Engineer of Record 0Quantity of Detached
Spa(s)/Water
Feature(s)
0BBQ Electrical (EA)
0Number of Gas
Outlet(s)
0Mechanical Equipment
Relocation (QTY)
0Garden Wall Linear
Foootage
15Combination Retaining
Wall Linear Footage
15Total Wall Length
(Linear Footage)
RCZoning
MHDRGeneral Plan Within La Quinta LimitsCity Limits SANTA CARMELITA VALE
LA QUINTA UNIT 25
Subdivision Name
10Lot Number 674.676Lot Size 100059Centerlines
Lot 10 MB 19/50 SANTA
CARMELITA VALE LA
QUINTA UNIT 25
Legal Description
Valuation Details
Type Group Sq Ft Value
Financial Information
Fee AmountFee Amount PaidInvoice No.
INV-00006580 $76.28 Block Wall - First 100 LF PC $76.28
$124.49 Swimming Pool / Spa PC $124.49
$8.00 Technology Enhancement Fee $8.00
$18.31 Retaining / Combination Wall - Each 50 LF $18.31
$12.00 Digital Archiving and Records Management Fee - OTC $12.00
$2.00 Building Standards Administration $2.00
$61.02 Block Wall - First 100 LF $61.02
$228.84 Swimming Pool / Spa $228.84
$530.94 $530.94 Total for Invoice INV-00006580
Grand Total for Permit $530.94 $530.94
Workflow / Inspections
Workflow Step / Action Name Action Type Start Date End Date
Application Completeness Check v.1 04/04/2024 15:37 04/04/2024 15:37
Submittal Document Verification v.1 Generic Action 04/04/2024 15:37
Plan Check v.1 04/04/2024 0:00 04/22/2024 16:50
Building Review (1 Day) v.1 Receive Submittal 04/04/2024 0:00 04/05/2024 16:15
Building Review (1 Day) v.2 Receive Submittal 04/08/2024 0:00 04/08/2024 11:54
Building Review (1 Day) v.3 Receive Submittal 04/19/2024 0:00 04/22/2024 16:50
Permit Issuance v.1 05/13/2024 16:55 05/14/2024 10:32
Verify Contractor info & Conditions have been met v.1 Generic Action 05/13/2024 16:55
Printed: 9/26/24 12:26 pm Page 2 of 3
Permit Type:
Permit Number:
Property Address:
Pool
BPOL2024-0102
54925 AVENIDA JUAREZ
BUILDING PERMIT
Verify & Invoice Fees v.1 Generic Action 05/13/2024 16:55
Verify Fee Payment & Issue Permit v.1 Generic Action 05/14/2024 10:32
Print, Attach, and Email Building Permit v.1 Create Report 05/14/2024 10:32 05/14/2024 10:32
Pool Permit Inspection v.1 05/29/2024 0:00
Pre-Gunite v.1 Inspection 05/29/2024 0:00 05/29/2024 11:38
Underground Plumbing v.1 Inspection 06/10/2024 0:00 06/11/2024 13:06
Underground Electrical v.1 Inspection 06/10/2024 0:00 06/11/2024 13:04
Underground Gas v.1 Inspection
Deck Bond v.1 Inspection 06/18/2024 0:00 06/19/2024 12:30
Deck Bond v.2 Inspection 06/19/2024 0:00 06/20/2024 13:04
Pre-Plaster v.1 Inspection 08/02/2024 0:00 08/06/2024 12:15
Pre-Plaster v.2 Inspection 08/07/2024 0:00 08/08/2024 12:27
Footing v.1 Inspection
Bond Beam v.1 Inspection 06/13/2024 0:00 06/17/2024 11:05
Bond Beam v.2 Inspection 06/27/2024 0:00 07/01/2024 11:15
Inspections - Final v.1 09/15/2024 0:00 09/17/2024 14:09
Final Pool v.1 Inspection 09/15/2024 0:00 09/17/2024 14:09
Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work
shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be
construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections
presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be
valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for
inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of
any material required to allow inspection.
It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for
inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this
code.
Inspections
A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion
thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a
certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances
of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the
jurisdiction shall not be valid.
Certificate of Occupancy
A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building
or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by
the building official.
Service Utilities
Printed: 9/26/24 12:26 pm Page 3 of 3
CITY OF LA QUINTA
30B ADDRESS 54925Avenida Juarez La Quinta, CA PERMIT NUMBER ???4????? OWNER Henry Wynnehleidi Seward BUILDER Owner
Xhij form shall be posted on the iob with the Suildina Inspection Card at all times in a s e. Only persons appearing on the 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 huildino oermmit. For each anolirable trade. all Information requested helnw must he rmmnleted by the annlirant_ 'On FiIP" is not an arrpnarhlo rvsennea
TRAM/CLASSIFICATION
CONTRACTOR
STATE CONTRACTOR'S LICENSE
WORKER COMPENSATION INSURANCE
CITY BUSINESS LICENSE
Name
Classification
(Co. A.e, c-9)
alifor ni
CaliforniaCompany
Number
Exp. Date
Carrier Nerve
(e.g. State Fund, CalComp)
Policy Numbers
(Format Varies
Exp. Date
License Number
Exp. Date
EARTHWORK (C-12)
Los Toritos Excavation.
C-53
1083749
ti>30125
Upland Specially Inc
IATCA16005301-2
11/11/24
76M
1/31125
ONCRETE(C-8)
Go GoGunite,Inc.
C•53
78MI
1/g0/25
HUF International
CST5026586
1/1/24
62%
95Q124
FRAMING (C-5)
STRUCT. STEEL (C-51)
Alvarado's Pool, Inc.
C-53
1031847
1f30125
ICW Group
WSD-5057696-01
10/14Q4
MASONRY (C-29)
Ortega's Masonry
C-53
809220
International liability & Fire Ins
Hudson Ins Co.
PLUMBING (C-36)
Alvarado's Pool, Inc.
C-53
1031847
1134/25
ICW Group
WSD-5057696-01
10/14/24
LATH, PLASTER (C-35)
DRYWALL(C-9)
HVAC (C-20)
Priority One
C•20
752100
ELECTRICAL (C-10)
Alvarado's Pool, Inc
C-10 & C•53
1031847
1f30I25
ICW Group
WSD-5057696-01
10/14/24
ROOFING (C-39)
Aim Electric
C-10
920721
Active
Hudson Ins Co
SHEET METAL (C-43)
FLOORING(C-16)
GLAZING(C-17)
INSULATION (C-2)
SEWAGE DISP. (C-42)
PAINTING (C-33)
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (C-27)
POOL (C-53)
ta Qa 0 itev
CALIFORNIA
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT1 NOTICE IQPROPERTY 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 54925 Avenid Juarez La Cuinta, CA M53
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 VER,IEI,QATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
,1
1. 1 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 personalty. 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
he limits of my insurance coverage for injuries to workers on my property.
2. 1 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
y protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or
er 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 permits and contracts.
�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 labor and materials, I may be
nsidered an "employer" under state and federal law.
6. 1 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
e to serious financial risk.
X 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family
esidential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by
censed subcontractors and the number of structures does not exceed four within any calendar year, or all of the
f
on 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.
Page 3 of 4
X 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 Califomia Division of Industrial Accidents. I also understand I may contact the California Contractors' State
icensq Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed
ors.
lW10. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand
a—tl am the party legally and financially responsible for proposed construction activity at the following address:
54925 AVENIDA JUAREZ LA QUINTA,CA 92253
F12
. i agree that, as the party legally and financially responsible for this proposed construction activity, I will
y all applicable laws and requirements that govern Owner -Builders as well as employers.
. 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 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 agency is required to be presented when
the permit is Issued to verify the property owner's signature.
Signature of Property Owner. r Date:
HENRY STEVEN WYNNE AND HEIDI SEWARD
5/13/2024
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.
AUTHORIMIML QE AQENT 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: Phone:
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, 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 Date:
Page 4 of 4