BRES2016-013278-495 CA LLE- TAMPICO Ct 0 D ''i �rwNllCl/
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2016-0132
Property Address:
79914 DANDELION DR
APN:
604491002
Application Description:
BROWN / BATHROOM REMODEL
Property Zoning:
of th k for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
Application Valuation:
$5,000.00
Applicant:
n 3700 of the Labor Code, the performance of the work for which this permit
SMITH & SONS CONSTRUCTION INC.
9416 WILSON RANCH ROAD
PHELAN, CA 92371
Carrier: _ Policy Number:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
Date:
5/27/2016
Owner:
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
CORDYN BROWN
of th k for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
�-
Date:Contractor:
79914 DANDELION DR
.5
n 3700 of the Labor Code, the performance of the work for which this permit
LA QUINTA, CA 92253
is issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
Er-.a
Contractor:
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 Business
SMITH & SONS CONSTRUCTIO9416
of the and Professions Code) or that he or she is exempt therefrom and the
Date: I� Applican
WILSON RANCH ROAD
permit subjects the applicant to a civil penalty of not more than five hundred dollars
PHELAN, CA 92371
($500).:
AND SHALL SUBJECT AN EMPLOYER. TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
(909)885-2220
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation; will do the work, and the structure is not intended or offered for sale.
Llc. No.: 810,322
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTOR'S DECLARATION I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
I hereby affirm under penalty of perjury one of the following declarations:
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
I have and will maintain a certificate of consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: B License No.: 810322
�..,'
of th k for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
�-
Date:Contractor:
Seco for
.5
n 3700 of the Labor Code, the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
OWNER -BUILDER DECLARATION
Carrier: _ Policy Number:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
I certify that in the performance of the work for which this permit is issued, I
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any manner so as to become subject to the workers'
city or county that requires a permit to construct, alter, improve, demolish, or repair
compensation laws of California, and agree that, if I should become subject to the
any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisions.
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
3 Business
p� —�
of the and Professions Code) or that he or she is exempt therefrom and the
Date: I� Applican
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
WARNING: FAILURE TO SECURE WORKERS' COM 4NSATION COVERAGE IS UNLAWFUL,
($500).:
AND SHALL SUBJECT AN EMPLOYER. TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
( 11, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
compensation; will do the work, and the structure is not intended or offered for sale.
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE;
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to .
within one year of completion, the owner -builder will have the burden of proving that
the conditions and restrictions set forth on this application.
he or she did not build or improve for the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(_) I, as owner -of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result of this application , the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
the Contractors' State License Law.).
following issuance of this permit.
(� I am exempt under. Sec. . B.&P.C. for this reason
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.
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
Lender's Address:
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 0
above-mentioned property for inspection purposes. 1
Date: A Signature (Applicant or Agent
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY AMOUNT. PAID PAID.DATE
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $0.00
PAID BY
METHOD RECEIPT # CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00. $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$145.03
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RESIDENTIAL, FIRST 1,000SF, PC
101-0000-42600
0
$47.86
$0.00
-PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
VENT FAN
101-0000-42402
0
$24.18
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
VENT FAN PC
101-0000-42600
0
$9.66
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for MECHANICAL: $33.84 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FIXTURE/TRAP
101-000042401
0
$48.36
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FIXTURE/TRAP PC
101-0000-42600
0
$48.36
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WATER SYSTEM INST/ALT/REP
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
WATER SYSTEM INST/ALT/REP PC
101-0000-42600
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $120.90 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID �.
PAID DATE
REMODEL, EA ADDITIONAL 5.00 SF
101-0000-42400
0
$21.75
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
'PAID DATE'
REMODEL,.EA ADDITIONAL 500 SF PC
101-0000-42600 '
0
$17.40
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT -
QTY-
AMOUNT,
PAID
PAID DATE
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
:DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$134.88
$0.00
4 PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY .
Total Paid for REMODEL: $223.34 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI _ RESIDENTIAL
101-0000-20308
0
$0.65
•$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65 $0.00
TOTALS:••
Description: BROWN / BATHROOM REMODEL
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED
Applied: 5/9/2016 SKH
Approved: 5/26/2016 JJO
Parcel No: 604491002 Site Address: 79914 DANDELION DR LA QUINTA,CA 92253
Subdivision: TR 24197-2 Block: Lot: 2
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $5,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
RAMSES SEVILLA
Details: REMODEL BATHROOM, DELETE TUB AND ENLARGE SHOWER, REPLACE SINKS, NEW CACINETS, REPLACE FAUCETS, REPLACE
FANSAND FAN LIGHTS PER 2013 CRC AND CPC.
Printed: Friday, May 27, 2016 10:27:43 AM 1 of 3
CRIfflySTEMS
ADDITIONAL
CHRONOLOGY TYPE
STAFF NAME
CHRONOLOGY
ACTION DATE
COMPLETION DATE
NOTES
PLAN CHECK PICKED UP
RAMSES SEVILLA
5/23/2016
5/23/2016
RESUBMITTAL
STEPHANIE KHATAMI
5/25/2016
5/25/2016
TELEPHONE CALL
JIM JOHNSON
5/17/2016
5/17/2016
called George martin to inform him the plans are ready for
corrections
TELEPHONE CALL
JIM JOHNSON
5/26/2016
5/26/2016
CALLED GEORGE MARTIN TO INFORM HIM THE PLANS ARE
READY TO ISSUE
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY STATE
ZIP PHONE FAX EMAIL
APPLICANT. SMITH & SONS CONSTRUCTION INC.
9416 WILSON RANCH
ROAD
PHELAN CA
92371
Printed: Friday, May 27, 2016 10:27:43 AM 1 of 3
CRIfflySTEMS
ZIP PHONE FAX EMAIL
NAMf°TYPE, < , ,, � """"NAME `- . _ ADDR ESSi CITY STATE _ '
CONTRACTOR SMITH & SONS CONSTRUCTION INC. 9416 WILSON RANCH PHELAN CA 92371
ROAD
OWNER CORDYN BROWN 79914 DANDELION DR LA QUINTA CA 92253
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID
CLTD
PAID DATE RECEIPT CHECK # METHOD PAID BY
,#
BY
BSAS SB1473 FEE 101-0000-20306 0. $1.00 $0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
RESIDENTIAL, FIRST
101-0000-42403
0
$145.03
$0.00
1,000SF
RESIDENTIAL, FIRST
101-0000-42600
0
$47.86
$0.00
1,000SF, PC
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00
VENT FAN
101-0000-42402
0
$24.18
$0.00
VENT FAN PC
101-0000-42600
0
$9.66
$0.00
Total Paid for MECHANICAL: $33.84 $0.00
FIXTURE/TRAP
101-0000-42401
0
$48.36
$0.00
FIXTURE/TRAP PC.
101-0000-42600
0
$48.36
$0.00
WATER SYSTEM
101-0000-42401
0
$12.09
$0.00
INST/ALT/REP
WATER SYSTEM
101-0000-42600T07
$12.09
$0.00
INST/ALT/REP PC
Total Paid for PLUMBING FEES:. $120.90 $0.00
REMODEL, EA
101-0000-424000
$21.75
$0.00
NAL
ADDITIO500 SF
Printed: Friday, May 27, 2016 10:27:43 AM 2 of 3
EFEIF sysrrnas
INSPECTIONS
PARENT PROJECTS
REVIEW TYPE
,.., NT DA,.
REVIEWER SE TE
:........ .......
DUE DATE
;R'ETURNED,,,,,,,
REVIEWS
,,,5�`ATIJ.. ,,..,,..
S
REM"..._........
ARKS
NOTES
GATE
CL
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
REMODEL, EA
101-0000-42600
0
$17.40
$0.00
WK)
ADDITIONAL 500 SF PC
REMODEL, FIRST 100 SF
101-0000-42400
0.
$49.31
$0.00
REMODEL, FIRST 500 SF
101-0000-42600
0
$134.88
$0.00
PC
Total Paid for REMODEL: $223.34 $0.00
SMI - RESIDENTIAL
101-0000-20308
0
$0.65
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65 $0.00
TOTALS:•0
INSPECTIONS
PARENT PROJECTS
REVIEW TYPE
,.., NT DA,.
REVIEWER SE TE
:........ .......
DUE DATE
;R'ETURNED,,,,,,,
REVIEWS
,,,5�`ATIJ.. ,,..,,..
S
REM"..._........
ARKS
NOTES
GATE
1ST BLDG NS (1 WK)
JIM JOHNSON
5/9/2016
5/16/2016
5/17/2016
REVISIONS REQUIRED
2ND BLDG NS (1
JIM JOHNSON
5/25/2016
6/2/2016
5/26/2016
APPROVED
WK)
Printed: Friday, May 27, 2016 10:27:43 AM 3 of 3 .;.
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BUILDING & SAFETY DEPT.
6o" PROVE®
FOR ONSTRUCTION
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Construction is NOT PERMITTED
on the following Code Holidays:
New Year's Day
Dr. Martin Luther King Jr. Day
President's Day
Memorial Day
Independence Day
Labor Day
Veteran's Day
Thanksgiving Day
Christmas Day
"AN ADEQUATELY SIZED DEBRIS CONTAINER
IS REQUIRED OJOB
ON AND MUSTALL
BE
PHASES OFC CONSTRUCTION
EMPTIED AS NECESSARY, FAILURE TO DO SO
MAY CAUSE THE Ci f'( TO HAVE THE CONTAINER
"!MPED AT THE F —,',ISE OF THE OVVNER/
?r;CTOR."
A RE -INSPECTION FEE OF $ 17,2. 5 2 -
WILL
WILL BE CHARGED IF THE APPROVED
PLANS AND 10B CAR[* ARE NOT ON
THE SITE FOR A SCHEDULED
INSPECTION
NO EXCEPTIONS!
CONS'TRUC'TION HOURS
()ctober 1st - April 30
l,Jonday - Friday. 0 a0m .m. to ®0:30 p p.m. to Saturday:
S3� n4 Say : Novae
Gove, vert Code Holidays: None
1 i .ay st _
September 30th
%,,xdt ayr - Friday: 5:00 a.m. to 7:00 p.m.
8:00 a.m. to 5:00 p.m.
Rlaidgyr: Norge
.n 3ernment Code Holidays: None