BRES 2016-015678195 Masters Cir
BRES2016-0156
78-495 CALLE TAMPICO (J /(/ a NN / VOICE (760) 777-7125.
P
LA QUINTA, CALIFORNIA 92253 FAX_(•7.60)_7.77-7`011,
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (1760) 777-7153
" BUILDING PERMIT D ._._ ---III II
Date 7/112/2016
Application Number: BRES2016-0156 X Owner:
JUL 1 c0 6.. `IJ .
Property Address: •78195 MASTERS CIR, DAN AG NEW CITY (3FLAQUINTA"
APN: 770360013 P 0 BOX 579
COMMUNITY DEVELOPMENT DEPARTMENT
Application Description: " AGNEW RESIDENCE / 168 sf ADDITION CENTRALIA, WA 9225'3
Property Zoning:
Application Valuation: $50,000.00 °
Applicant: Contractor:
GREGORY JOHNSON CORP DBA G JOHNSON CONST GREGORY JOHNSON CORP DBA G JOHNSON CONST
78365 HIGHWAY 111 SUITE 177 78365 HIGHWAY 111 SUITE 177
LA QUINTA, CA 92253 " LA QUINTA, CA 92253
(7.60)567-2026
Llc. No.: 992255
-------------------------------------=--.-----------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION '
I hereby affirm under penalty of perjury that Lam 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: B License No.: 992255
Date: / " 2— 1 Contractor: n VA.) CiMS
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
($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 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:
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 Ad
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 wDrICfor 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: _
I 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.
Date: 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 seYforth 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: ^ Signature (Applicant or Agent)
FINANCIAL .
.
s s.a. 3DESCRIPTION . r `� €
'r` ACCOUNT x`?
QTY ° t `AMOUNTF R
, sPAlps
PAID DATE;
p t
Fps , a
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400.
0 $62.36
$62:36
7/12/16
x �� PAID.BY,' �; I
* :. METHOD "` `�
F €RECEIPT # :
�..
t CHECK #
CLTD BY
, t
a i, ,:
..
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE
,, a
aDESCRIPTION;ACCOUNT
AMOUNTSr
PAID tj<
iPAID DATE
e
ADDITION, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$17.40
$17.40
7/12/16
PAID BYA' °
METHOD �� i
{'RECEIPT # `
CHECK # b `
CLTD BYE
r «
x$ _>
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002-
5042
RSE
DESCRIPTION4:
AMOUNT
PAID;'PAID:DATE'qq
...
ADDITION, FIRST 100 SF
101-0000-42400
0
$120.83
$120.83
7/12/16
to ,, PAID BY ` � ;_ j
-,T'i t -2-7"_ ,`�
�n� F :; r+ ���
METHOD F t
a =RECEIPT # t
CHECK #CLTD
BY<'
µ ,
_
c
r
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE
t DCRIPTION4: ', .;�
ES
r a ACCOUNT
QTYr
¢MOUNT _•.
PAID
'.Alb: DATE
_....... y - _ : <.-.
.. ....._._ :...,_ . .... �; P.- r;t
Q•
ADDITION, FIRST 100 SF PC
101-0000-42600
0
$171.14.
$171.14
7/12/16
BY'��',"fr
�.s METHODRECEIPT#{:CHECK#
CLTD BY
yPAID tty
t 7
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE
Total Paid for ADDITION: $371.73 $371.73
-.DESCRIPTION ' '
k ',�
" ACCOUNT n
"QTY
4yM x AMOUNTS
PAID* `4
PAID:DATE:
,
.
HOURLY PLAN CHECK - YES
101-0000-42600
4
$280.00
$280.00
7/12/16
METHOD �« ` z `t
` «'`RECEIPT # x
CHECK # '-
CLTD BY q:
GREGORY JOHNSON CORP DBA G 10H
CHECK
R17002
5042
RSE
Total Paid for BLDG CITY STAFF - PER HOUR: $280.00 $280.00
s, s DESCRIPTIONT#'
ACCOUNT'`
QTYAMOUNT;
`
.PAID _
PAID DATE:
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$2.00
7/12/16
} ,F:.`= PAID BY
�RECEIP,T #
as CHECK-#L,`'e
CLTD BYy is
,
GREGORY JOHNSON CORP DBA G 10H
CHECK
R17002
5042
RSE
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $2.00
s; DESCRIPTION `�a'
ACCOUNTS
QTY'
;'AMOUNT .
PAID =
IPAID DATE<
fie. Y ., y.e..1 C69
:� .'S • :'t* ,j+'t
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$145.03
$145.03-
7/12/16
r+. PAID BY j�
M 4 z s� METHOD #
u RECEIPT # r
CHECK #'
CLTD BYt
GREGORY JOHNSON CORP DBA G 10H
CHECK
R17002
5042
RSE
lf,
F
'AMOUNTS. *
PAID
PAID DATEiACCOUNTDESCRIPTION
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$47.86
$47.86
7/12/16
u� PAID BY E z<
• t t METHOD �n.,�
t `RECEIPT # y
" ` CHECK #'
CLTD BYE,.;
-
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 , $192.89
,DESCRIPTION '.z r c
(ACCOUNT
QTY
-.
:; i PAID' Y,"
PAID DATE.;
&�
A,AMOUNT
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$36.26
$36.26
7/12/16
r _� `y
r PAID BY
�k �_ _ C
RECEIPT # s ¢µ
-' CHECK #
CLTD BY,
r'
.METHOD
t
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE _
c" .. , x`M DESCRIPTION 4`=-'
E AMOUNT;;
PAID
. €a.l
tACCOUNTa x yQTY
rs
4PAID,DATE
OTHER MECHANICAL EQUIPMENT PC.
101-0000-42600
0
$36.26
$36.26
7/12/16,
PAID BYE {g''
METH,OD
RECEIPT# s§t
k; `CHECK # 3
"xCLTD BY$y
Y '-
t
p X F i't4:
u
n
CK ,c ,..'tl
bi .d,.n•:. •x..
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE
Total Paid for MECHANICAL: $72.52 $72.52
ri _ DESCRIPTION$ s
QTsYz
`"` AMOUNTg %
PA'' ,
PAID DATE,
xACCOUNTg'
$
SMI - RESIDENTIAL
101-0000-20308
0
$6.50
$6.50
7/12/16
PAIDTF
"
#sx dti
£ T
CHECK # ::4
c
CLTD BY a
rt ?,= i
.z.> .
.z. u.RECEIPT
a
GREGORY JOHNSON CORP DBA G JOH
CHECK
R17002
5042
RSE
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $6.50 $6.50
TOTALS:
Description: AGNEW RESIDENCE / 168 sf ADDITION
Type: BUILDING, RESIDENTIAL
Subtype: ADDITION Status: APPROVED
Applied: 6/8/2016 MFA
Approved: 7/8/2016 BHA
Parcel No: 770360013 Site Address: 78195 MASTERS CIR LA QUINTA,CA 92253
Subdivision: TR 28867
Block: Lot: 85
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $50,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: 168 SQ.FT. BEDROOM ADDITION TO EXISTING MASTER BEDROOM. 2013 CODES
STEPHANIE KHATAMI
ADDITIONAL SITES
Applied to Approved _
Printed: Tuesday, July 12, 2016 9:17:59 AM 1 of 4
SYSTEMS
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE COMPLETION DATE
NOTES
NOTE
RAMSES SEVILLA
6/29/2016
6/29/2016
GREG JOHNSON CAME TO THE COUNTER TO ASK FOR BURT
PLAN CHECK COMMENTS
FROM CONSULTANT
STEPHANIE KHATAMI
6/21/2016
6/21/2016
'STRUCTURAL NOT APPROVABLE.
RECEIVED
PLAN. CHECK PICKED UP
STEPHANIE KHATAMI
6/23/2016
6/23/2016
GREG JOHNSON
PLAN CHECK SENT TO
KAY HENSEL
6/8/2016
6/8/2016
STRUC TO YOUNG - DUE BACK 6/22/2016
OUTSIDE PC
PLAN CHECK SUBMITTAL
MARY FASANO
6/30/2016
6/30/2016
BURT ASKED ME TO PROCESS THIS PLAN CHECK AND NOT
RECEIVED
SEND TO STRUCTURAL.
TELEPHONE CALL
BURT HANADA
6/23/2016
6/23/2016
NOTIFIED GREG JOHNSON THAT CORRECTION PACKAGE IS.
READY FOR PICKUP.
Printed: Tuesday, July 12, 2016 9:17:59 AM 1 of 4
SYSTEMS
PHONED CONTRACTOR TO NOTIFY HIM THAT PLANS ARE
TELEPHONECALL BURT HANADA 7/8/2016 7/8/2016 APPROVABLE AND THERE ARE ITEMS TO BE SUBMITTED
PRIOR TO PERMIT ISSUANCE. .
CONDITION DATE DATE . DATE '
TYPE ADDED, REQUIRED:,SATISF.IEO
MARKS' NOTES::
CONTACT: _ STATUS RE
READY TO ISSUE DESIGNER TO'SIGN PLANS.
CHECKLIST BURT HANADA 6/23/2016 7./12/2016 COMPLETE
HOA APPROVAL RECEIVED ON 6/08/2016.
NAME -TYPE NAME;:.
ADDRES51
CITY ;- •:
STATE
ZIP''
":'PHONE:.-
FAX'
EMAIL,
APPLICANT
GREGORY JOHNSON CORP DBA G
JOHNSON CONST
78365 HIGHWAY 111.
SUITE 177
LA QUINTA
CA
92253
(760)360-9998
CONTRACTOR
GREGORY JOHNSON CORP DBA G
JOHNSON CONST
78365 HIGHWAY 111
SUITE 177
LA QUINTA
CA
92253
(760)360-9998
0
$62.36
ENGINEER OF
RECORD
REZA ASGHARPOUR _
77570 SPRINGFIELD
LANE SUITE D
PALM DESERT
CA
92211
(760)360-9998
ADDITIONAL 500 SF
'OWNER
DAN AGNEW
P'0 BOX 579
CENTRALIA
WA
92253
.(760)360-9998'
CORP DBA G JOH
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
ADDITION, EA
101-0000-42400
0
$62.36
$62.36
7/12/16
R17002
.5042
CHECK
GREGORY JOHNSON
RSE
ADDITIONAL 500 SF
CORP DBA G JOH
ADDITION, EA
101-0000-42600
0
. $17.40
$17.40
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE
ADDITIONAL 500 SF PC
CORP DBA G JOH
ADDITION, FIRST 100 SF
101-0000-42400
0
$120.83
$120.83
7/12/16
R17002
5042
CHECK.
GREGORY JOHNSON
RSE
CORP DBA G JOH
ADDITION FIRST 100 SF
GREGORY JOHNSON
'PC 101-0000-42600 0 $171.14 $171.14 7/12/16. R17002 5042 CHECK RSE
CORP DBA G JOH
Total Paid for ADDITION: $371.73 $371.73
Printed: Tuesday, July 12, 2016 9:17:59 AM 2 of 4
SYSTEMS
.....
INSPECTIONb
PARENT PROJECTS
Printed: Tuesday, July 12, 2016 9:17:59 AM 3 of 4
0TWSYSTEM's
F ^^¢ -moo.
ACCOUNT <
TY>
AMOUNT',
PAID:
PAIDDATE
s.
-:RECEIPT #
CHECK #.'
x BY:
DESCRIPTION:`
a .
, Q
4
au
.
J
;METHOD ,
PAID
s
HOURLY PLAN CHECK -
101-0000-42600
4
$280.00
$280.00
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE
YES
CORP DBA G JOH
Total Paid for BLDG CITY STAFF - PER HOUR: $280.00 $280.00
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$2.00
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE
CORP DBA G JOH
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00 $2.00
BSA:
RESIDENTIAL, FIRST
101-0000-42403
0
$145.03
$145.03
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE
'I,000SF
CORP DBA G JOH
RESIDENTIAL, FIRST
101-0000-42600
0
$47.86
$47.86
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE '
11-000SF, PC
CORP DBA G JOH
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $192.89
OTHER MECHANICAL
101-0000-42402
.0
$36.26
$36.26
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE
EQUIPMENT
CORP DBA G JOH
OTHER MECHANICAL
101-0000-42600
0
$36.26
$36.26
7/12/16
R17002
5042
CHECK.
GREGORY JOHNSON
RSE
EQUIPMENT PC
CORP DBA G JOH
Total Paid for MECHANICAL: $72.52. $72.52
SMI - RESIDENTIAL
101-0000-203080..
$6.50
$6.50
7/12/16
R17002
5042
CHECK
GREGORY JOHNSON
RSE
CORP DBA G JOH
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $6.50 $6.50
TOTALS:.4
.....
INSPECTIONb
PARENT PROJECTS
Printed: Tuesday, July 12, 2016 9:17:59 AM 3 of 4
0TWSYSTEM's
1ST BLDG STR (2
BRONZ
6/8/2016
6/22/2016
6/21/2016
REVISIONS REQUIRED
WK)
YOUNG
1ST REVIEW
2ND BLDG NS (1,
BURT
6/30/2016
7/8/2016
7/8/2016
APPROVED*
BURT HANADA
WK)
HANADA
0
78195 MASTERS
78195 MASTERS
BOND INFORMATION
ATTACHMENTS
.... ...xY-.:'
tactim'entT a CREATED` ;01NNER, DESCRIPTION PATHNAMEs.t SUBD R. '.:
+F,
KIT E
E7RA NABL DD
At _Yp .k. . -
« _ _:-._ ; EA .- . _ •w_. . m ... . ". .. _
,.`
1ST REVIEW
1ST REVIEW
CORRECTION LIST -
CORRECTION LIST -
DOC
6/23/2016
BURT HANADA
0
78195 MASTERS
78195 MASTERS
CIRCLE.pdf.
CIRCLE.pdf
HOA APPROVAL 78195
HOA APPROVAL 78195
DOC
6/23/2016
BURT HANADA
MASTERS CIRCLE.pdf
MASTERS CIRCLE.pdf
4ST CHECK -
1ST CHECK -
,
DOC
6/21/2016
JOHN THOMPSON
-STRUCTURAL
-STRUCTURAL
0
-
TRANSMITTAL.pdf
TRANSMITTAL.pdf
1ST CHECK -
1ST CHECK -'
DOC
6/21/2016
JOHN THOMPSON
STRUCTURAL
STRUCTURAL
• 0
COMMENTS.doc
COMMENTS.doc
F