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BRES2016-0265R 78;495 CALLE'TAMPICO 4 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2016-0265 Property Address: 79755 FIESTA DR APN: 600052001 Application Description: NELSON / 391SF ADDITION TO CASITA Property Zoning: Application Valuation: $45,776.96 Applicant: SANDBORN A/E INC. - ALLEN SANBORN 71780 SAND JACINTO DR E-1 RANCHO MIRAGE, CA 92270 DEC 0 9 2016 CITYOFLAOUINTA — COMMUNITY DEVELOPMENT DEPARTMENT 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 A&,e�he applicant to a civil penalty of not more than five hundred dollars ($500).: e#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 oyyss ,,did not build or improve for the purpose of sale.). /'� =w— 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 wh co ontracts for the projects with a contractor(s) licensed pursuant to the ?C tr tors' State License Law.). m exempt under Sec. . B.&P.C. for this reason Dat ri : � CONSTRUCTION LENDING AGEN I hereby affirm under penalty of perjury that there is a constructs lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/9/2016 Owner: LAWRENCE NELSON 79755 FIESTA DR LA QUINTA, CA 92253 Contractor: OWNER/BUILDER 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 Df 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: _ _ 1 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 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. es. i D i Sign�ture (Applicant or a a Date: 12/9/2016 Application Number: BRES2016-0265 Owner: Property Address: 79755 FIESTA DR LAWRENCE NELSON APN: 600052001 79755 FIESTA DR Application Description: NELSON / 391SF ADDITION TO CASITA LA QUINTA, CA 92253 Property Zoning: " Application Valuation: $45,776.96 Applicant: Contractor: SANDBORN A/E INC. - ALLEN SANBORN OWNER/BUILDER 71780 SAND JACINTO DR E-1 RANCHO MIRAGE, CA 92270 - ------------------------------------------------------------'-------------------------------- Llc. No.: Detail: ATTACHED CASITA REMODEL EXISTING 377 SQ. FT. AREA AND ADD NEW 391 SQ. FT. LIVING AND GARAGE AREA 117.6 SQ. FT. PER 2013 CRC . CODES. THIS CASITA WILL HAVE FULL KITCHEN a a 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 $120.83 DESCRIPTION ACCOUNT QTY AMOUNT ADDITION, FIRST 100 SF PC 101-0000-42600 0 $171.14 Total Paid for ADDITION: $371.73 DESCRIPTION ACCOUNT QTY AMOUNT HOURLY CHARGE - ESGIL STRUCTURAL ENGINEER 101-0000-42600 2 $240.00 Total Paid for BLDG CITY STAFF - PER HOUR: $240.00 DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 DESCRIPTION ACCOUNT QTY AMOUNT RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 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 EXHAUST HOOD 101-0000-42402 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $4.83 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 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $4.83 Total Paid for MECHANICAL: $154.70 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $48.36 DESCRIPTION ACCOUNT QTY AMOUNT DESCRIPTION FIXTURE/TRAP PC 101-0000-42600 0 $48.36 101-0000-20308 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN 101-0000-42401 0 $36.27 DESCRIPTION ACCOUNT QTY AMOUNT ROOF DRAIN PC 101-0000-42600 0 $36.27 DESCRIPTION ACCOUNT QTY AMOUNT • WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 Total Paid for PLUMBING FEES: $193.44 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF 101-0000-42400 0 $21.75 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $17.40 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $49.31 DESCRIPTION, ACCOUNT QTY AMOUNT REMODEL, FIRST 500 SF PC 101-0000-42600 0 $134.88 Total Paid for REMODEL: 5223.34 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $5.95 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $5.95 U�4 Bin # 5� Permit # Project Address: — t1' S arty of La Quanta Building U Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701:2 Building Permit Application and Tracking Sheet Owner's Name: A. P. Number: 60 -052- — 00 I Address: 9? -75-5' r Legal Description: 50c -k)4-.....29 7-6-5; 2L City, ST, Zip:La A 9 2 2 5 3 Contractor: T n ele h e: Po Address: Project Description: City, ST, Zip:. Re 64 / Telephone: le h Po . State Lic. # : City Lie. #c Arch., Engr., Designer: S` Id C Address: ? j_ Sci. 4a City, ST, Zip: 24 ER�• 922/ 70 3TelePhone. �Q 6 0 D 7�2 Construction TY Pe: I r Q ecu aneY: P State , Lic. #. Project tYPa (circle ondeNewAd' Alter Repair. Demo Name of Contact Person:. SG.....�j0� j1....,, Sq. Ft.: '32 7 7 # Stories: # Units: Telephone # of Contact Person: �6 G L� 2 3 OG Estimated Value of Project: yO OOU APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd . Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance. Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"Reviciv, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. li;O.A. Approval Plans resubmitted Grading IN HOUSE:- Jrd Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Aper Date of permit issue School Fecs, Total Permit Fees Date: 11/2/2016 No.: 16-00402-1 Owner: Nelson Address: 79-755 Fiesta Dr City: La Quinta Type: Residential Addition < 500 sq ft Lot # Street No. 79755 Comments: CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Qunita, CA 92253 (760)771-8515 Street Name Fiesta Dr J'otleb s r°y c°o N BERUWADUNES RANCHO MIRAGE F { INDIAN�gWELLS y` C�. PC'oACFiEL A f ly u ooWW OOlo lot Y� Email: Jurisdiction: La Quinta Tract #: Sq. Feet APN Permit No. 391 600-005-001 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking eating, or sanitation) or replace rner,t 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 391 S.F. or $0.00 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in the proposed project may now be issued. Fees Paid By: Exempt - Tom Nelson Bank Name/Recipient of Certificate Check No.: Telephone: Funding: Exempt By Dr. Gary Rutherford i Superintendent Fee Collected/, Exempted by: Sharo cGily y am ount Dii6:,„ $0.09;, O I Pay rnent(s) Rec''d: $0.0(;--- 1 New Pa'yrnent Rec'd'- $0.0 1 U er%Under: a NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o, other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NCRE j)artment: THIS DOCUMENTMALID ONLY IF IMPRINTED WITH EMBOSSED SEAL. NOV 02 2016 CITY OF LA OUINTA COMMUNITY DEVELOPMENT Permit Number: BRES2016-0265 _—Description: NELSON/ 391SF ADDITION TO CASITA Applied: 9/23/2016 Issued: Status: UNDER REVIEW Parent Permit: Parent Project: Details: Approved: Site Address: 79755 FIESTA DR Finaled: City, State Zip Code: LA QUINTA, CA 92253 Applicant: <NONE> Owner: LAWRENCE NELSON Contractor: <NONE> LIST OF RETURNED>, SENT DATE DUE DATE TYPE CONTACT STATUS REMARKS DATE Review Group: BLDG 1ST.(1WK) 10/6/2016 -- — _. — -10/13/2036 - 1ST PLANNING (1 WK) CARLOS FLORES' Notes 4+) r �}a rr ibI i. yfi Review Group: BLDG 1ST (2WK) 9/23/2016 10/7/2016 1ST BLDG NS (2 WK) BUILDING BUCKET YeNotes a M� • ;3 ✓ 2 f is ' �.1`.r. ryt 9/23/2016 10/3/2016 10/7/2016 1ST BLDG STR (2 WK) KURT CULVER REVISIONS REQUIRED Notes: r Printed: Thursday, 06 October, 2016 i 1 of 1 ,. RWYS7EMS y r� f EsGil Corporation In Partnership with Government for Building Safety DATE: October 28, 2016 JURISDICTION: La Quinta PLAN CHECK NO.: BRES2016-0265 PROJECT ADDRESS: 79-755 Fiesta Dr SET: II PROJECT NAME: Remodel & Addition for Nelson Residence ❑ APPLICANT ❑ JURIS. ❑ PLAN REVIEWER ❑ FILE ® The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. ❑ The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ❑ The check list transmitted herewith is for your information. The plans are being held at EsGil Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. ❑ The applicant's copy of the check list has been sent to: ® EsGil Corporation staff did not advise the applicant that the plan check has been completed. ❑ EsGil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Ac Date contacted: (by: Email: Mail Telephone Fax In Person® ❑ REMARKS: By: Abe Doliente EsGil Corporation ❑GA [:1 EJ ❑MB OC CON, eI� T 2416 Enclosures: Old plans. UtV� Q��N ❑ PC 10/25/16 uPV640p 'q NF/vr 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax (858) 560-1576 C&hf 4 4V a" 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 at7"fS— j(• .14' 92,:L" 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 signify you understand or verify this information. �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. 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. ,f& I 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 1 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. tit 04.1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. .6. 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 dollars500 ($ ), including labor and materials, I may be .considered an employer„ under state and federal law. 6. 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 t risk. o.serious financial 47' 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 exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. w � r knancial . I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my, obligations as an. "employer" from the Internal Revenue rvice, the United States Sma11.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. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the pdrty .Qgally` and financially responsible 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. 2. I 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 hue 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 re uired to be presented when the permit is issued to verify the property owner's signature. Signature of property owner Date: Note: The following Authorization Form is required lobe completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT 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: /yi ,eiG ry%y �✓.✓!/K Tel No 21re -- 51v — 2�S0 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: fl copy of the.owner's driver's license, form notarization, or other verification acceptable to the agency is required to be a permit is issued to verify the property owners signature. Property Owner's Signature: j )ate: / z / 1 CITY. OF LA QUINTA .SUB -CONTRACTOR LIST JOB ADDRESS 71 ' �s� �" `es C'4 /J� PERMIT. NUMBER6Y-EjZ01k- OWNER laN► �yo ®- BUILDE13 e c 1So � This form shall be posted on the iob with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this 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 building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response. .. ... sif i;at 5ti. Tra .... bnt ... ..... ........<: ..,,. t....... ........... .... .: ........... ...................::..:........::;:.:;..:::.:.�.:.-.;:;.:•;::>..>;<;s:->s�:.::.:.>%.:: .. , stafe.. 6n 'for. t_iden ............... ............:... . C. frac s se .. ................:....... .. ...:... . ...... ,.. ..... . :•;�.;:.:::>:;:.::;.::;�.>:;: ..,<Wor � s�Com' eri`-"--i"'''� .:.:suranse;;;;.::.:.y,.;>..• •��C t� � �: sine ss..Uc nse:�<`'>�'. Company Name Classification License Number Exp. Date Carrier Name Polic Number y Exp. Date License Number Exp. Date `%�`::`:>s;�::::a;.>:.::::;•:�>: e. - ( A BCS' 9 xx ( x xxx } x x x / x x ( x ? a e. State u ( g. 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