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BRES2016-02211 �T r 78-495 CALLE TAMPICO �r 4 :fwQ�w LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT -BUILDING PERMIT Application Number: BRES2016-0221 Property Address: 52830 AVENIDA MENDOZA APN: 773333027 Application Description: NEWMAN / 499SF MASTER BEDROOM ADDITION Property Zoning: Application Valuation: $28,542.80 Applicant: ' BRYAN NEWMAN 52830 AVENIDA MENDOZA LA QUINA, CA 92253 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am 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: 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 ($500)'77—' 1, -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: I2 $`1b Owne-r: _ ' `\G'` 1--`)C WIOMOLYI 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 12/8/2016 W Owner: MICHELLE NEWMAN 52830 AVENIDA MENDO LA QUINTA, CA 92253 �o C O C ti Op a o sa Contractor: V O W OWNER BUILDER Q Q ,C5 CD Llc. No.: 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: _ 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. —`+O APplicantrM \c" -ow WeW\-frxn 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. Daae: Signature (Applicant or Agent Lender's Address: I t Date: 12/8/2016 Application Number: BRES2016-0221 Owner: Property Address: 52830 AVENIDA MENDOZA MICHELLE NEWMAN APN: 773333027 52830 AVENIDA MENDOZA Application Description: NEWMAN / 499SF MASTER BEDROOM ADDITION LA QUINTA, CA 92253 Property Zoning: Application Valuation: $28,542.80 Applicant: Contractor: -BRYAN NEWMAN OWNER BUILDER 52830 AVENIDA MENDOZA LA QUINA, CA 92253. ------------------------------------------------------------------------------------------------- LIC. No.: - Detail: 499SSF MASTER BEDROOM ADDITION [ENGINEERED] THIS PERMIT DOES NOT INCLUDE REMODEL TO THE EXISTING DWELLING. 2013 CALIFORNIA BUILDING CODES FINANCIAL •• • DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $62.36 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $17.40 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF 101-0000-42400 0 $171.14 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF PC 101-0000-42600 0 $121.83 Total Paid for ADDITION: $372.73, DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES ADMINISTRATIVE STAFF 101-0000-42600 0.25 $10.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES ADMINISTRATIVE STAFF 101-0000-42600 0.25 $10.00 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE,- YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600 2.5 $237.50 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600 1.5 $142.50 Total Paid for BLDG CITY STAFF - PER HOUR: $400.00 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 DESCRIPTION ACCOUNTQTY AMOUNT Credit Card Fee 101-0000-43505 0 $23.83 Total Paid for Credit Card Fee: $23.83 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $152.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $50.16 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $202.16 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR 101-0000-42402 0 $36:26 DESCRIPTION ACCOUNT QTY AMOUNT CONDENSER/COMPRESSOR.PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE 101-0000-42402 0 $36.26 DESCRIPTION ACCOUNT QTY AMOUNT FURNACE PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $4.83 DESCRIPTION ACCOUNT QTY AMOUNT f VENT FAN PC ( 101-0000-42600 I 0 I $12.09 Total Paid for MECHANICAL: $137.78 DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP 101-0000-42401. 0 $72.54 - DESCRIPTION ACCOUNT CITY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $72.54 DESCRIPTION - ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT CITY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT CITY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 Total Paid for PLUMBING FEES: $205.52 DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $3.71 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $3.71 1 Bin City of La Quinta Buiidi/ID a Safety Division - 78-495 Cade Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:-� Cwner's Name: A. P. Number: _ Address: Legal D0scrilui0J1: City, ST, Zip: , ,C\ Qq)1n GA Contractor; �1 TcJt pttbnc: . Addresg - Pr oject Description; City, ST, Tip; Telephone yysx) �� fm � ► --�� `` T ��1 G\_ tare Lie. # : Lie. �!>x` Arch., Engr., Designer: -- - - Address: C+ j�. «uC Z City, ST, lip: Telephone: g . ; " "`''"""� `• ```' `' " ``"' ''''' Construction Type: Occupancy, State Lic. P- project type (circle one): Nlew Add'tt Alter Repair Demo Name of Contact Person: ' ma� Ft Sq. .: # Stories; #Units: V Telephone # of Contact Person: p Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE 9 Submittal Req'd Rcc'd TRACIUNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Plan Check Balance Truss Calcs, Called Contact Person Title 24 Catcs. Plans picked up Construction Mechanical Flood plain plan Plans resubmitted Grading plan 2id Review, ready for corrections/issue Electrical Subcontac(or List Called Contact Person Plumbing Grant Deed Plans picked up S.11I.I. MO.& Approval Plans resubmitted Grading IN ROUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LI'.P Pub, Wlcs. Appr Date of permit issue School Fccs, r Total Permit Fees ' �Xy� Date: 10/18/2016 No.: 16-00377-1 Owner: Bryan Newman Address: 52830 Avenida Mendoza City: La Quinta Type: Residential Addition < 500 Sq ft Lot # Street No. 52830 Comments: CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Qunita, CA 92253 (760)771-8515 Street Name Avenida Mendoza #1'fleb sc r wc'oMRitS 0 r pnrauv�+wcus fa CDn❑C�MULiL^ Email: Jurisdiction: La Quinta Tract #: Sq. Feet APN 499 773-333-027 Permit No At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential ads.:' - under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) ❑r replac :: - mobile homes. It has been determined that the above -named owner is exempt from paying school fees at this time due to the following reason: Residential Addition 500 Sq Feet or Less Exempt This certifies that school facility fess imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $0.00 X 499 S.F. or $0.00 have been paid for the property listed above and that building and/or Certificates of Occupancy for this square footage in the proposed project may now be issued. Check No.: Fees Paid By: Exempt - Bryan Newman Telephone: Bank Name/Recipient of Certificate Funding: Exempt By Dr. Gary Rutherford Superintendent _ Fee Collected/ Exempted by: 59aron McGilvrey �''� Amount Due: $0.00 Original Payment(s) Rec'd: $0.00 New Payment Rec'd: f �.. � Over/Under: NOTICE: Pursuant to Government Code Section 66020(d) this will serve to otify ❑u that the 90-day approval period in which you may protest .he I other payment identified above will begin to run from the date on which the�b • dIng or installation permit for this project is issued, or from the date c;i which thane Aon paid to the District(s) orto another public entity authorized to collect them on the District('s) behalf, whichever is earlier. ar RDepartment: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAa OCT 18 Z016 CITY OF LA QUINTA COMMUNITY DEVELOPMENT T Rof 4 4 Quba 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 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 f't�t�Y]1C1C1 �I�ZC:�. ��MrA, C 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. Z�I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" uilding 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 my property. k1. I understand building permits are. not required to be signed by property owners unless they are responsible for the cruction 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 Tni self from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be Iicensed and bonded in California and to list their license numbers on pernmmts and contracts. V+_P5. 1 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 considered an "employer" under state and federal law. r ■ , �. 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. 0-7 I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer theme 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. L' ` 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. r 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue ervice, 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- 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. r- 14. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party � e� and finaAm a moms D for kl oo W�n coon C A it �7� a following address: XN 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. � 12. 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 CoutTactor or employee of that individual or furze 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 oilier veri re, don acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owne � ,_ _ C Date: 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. AUTHOtcIZA TIOlV OF AGEFN1 TO AC 1 O1V YKOPERiTL Y OW1Vr:K'j TLsE—nA .rk 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 JWork): y'-��' Project Location or Address: ��1 lV& e'n o a ■ L 1� gs��31- Ca_ZC~� Name of Authorized Agent: `�`]Q� NeQ2) an Tel No-IU3• �,y✓'Z)-2_ Address of Authorized Agent: rD2� e'[11 C1 y 7��"1 Q� 22_5 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:.4 copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to bepresented when the permit is issued to verify the 1property yoowners signature. Property Owner's Signature: �l Date: ` L`�J �\ TaY 4 SepaurKrw P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-15.04 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.t NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has b • n subrritt d in your name listing yourself as the builder of the property improvements specified at 52-650 w; M 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 sign>fyy ou understand or verify this information. JW 1. 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. 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 1,*J 2. I understand building permits are not required to be sig ned greed 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 myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. SV 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. :k5. 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 considered an "employer" under state and federal law. t_I " 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 me to serious financial risk. 7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures 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 excecd four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. t�li 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 iujwies sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. r�N 9. 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 California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.cslb_ca.gov for more information about licensed contractors. ^. �•� 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally; and financiaJly responsi le for proposed construction activity at the following address: 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern, Owner -Builders as well as employers. i� 12. I agree to notify the issues 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 nnlic•ensed 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 per t. ate: A copy of the property owner's driver's license, form notarization, or other vet fcrrrion acceptable to e e is required to be presented when the permit is issued to verify the property owner's signature. r ` . Signature of property owner Date: l0Alb 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. rK 'uy"n�i�lii V1'i `O AGF_N� 1 T O .A t V- YtLLIYEKlY II VI l�f � �CIS 1SJ+ 1�,1* 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: 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: 4 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 owners signature. Property Owner's Signature: Date: YOUNG ENGINEERING Letter of Transmittal To: City of La Quinta Today's Date: 10-4-16 78-495 Calle Tampico City Due Date: 10-5-16 La Quinta, CA 92253 Project Address: 52830 Avenida Mendoza Attn: Ramses Sevilla Plan Check #: BRES-2016-0221 Submittal: ❑ 15t 0 4tn ® 2nd n 5th ❑ 3rd ❑ Other: We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: Descriptions: Includes: # Of Descriptions: Copies: ❑ Structural Plans ❑ Revised Struct. Plans ❑ Structural Calculations ❑ Revised Struct. Calcs ❑ Truss Calcs ❑ Revised Truss Calcs ❑ Soils Report - Update ❑ Revised Soils Report ® 1 Structural P/C Responses ® 1 Approved Structural Plans / Comments ® 1 Redlined Structural Plans ® 1 Approved Structural Calcs ® 1 Redlined Structural Calcs ® 1 Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ Other: Comments: Structural content is approvable with the following correction. The Engineer of Record shall review the truss package and issue a letter to the Building official stating that the truss design is in accordance with the framing plan. Transit Per Diem= Admin Time = .25 HR Structural Engineer/Principal Review Time = 0 HR Plan Review Engineer Time = 1.5 HR This Material Sent for: ❑ Your Files ® Per Your Request ❑ Your Review ❑ Approval —� r ❑ Checking ❑ At the request of: Other: ❑ - OCT 0 2016 By: Joe Venuti Office: ® (760) 772-5107 crTY Oi L ,; r 111,4TA. C❑E'!imUI'+l11'f DEVELOPME,V Other: ❑