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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