BRES2016-001278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
DAZARTH STUDIO
P.O. BOX 5083
LA QUINTA, CA 92247
BRES2016-0012
52768 VIA DONA
Twr °F 4Qurrw
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
777410006
HIDEAWAY / FUSTAFSON / REMODEL (4) FIREPLACES
$32,000.00
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 ss: License No.: 028860
Date: �JI 'I n Contractor: vAwot, fl -A,,
l 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. 70315, Business and Professions Code: Any
city or countythat 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
Lender's
11111111111111111111
26
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/25/2016
Owner:
JOHN GUSTAFSON
2040 E LIVE OAK DR
LOS ANGELES, CA 92253
. D
Contractor:
MONARCH ES
49950 JEFFEf ON STREET #_130
LA QUINTA, CA 92264-' )
EVELOpMENT �EPAaf ME
(951)634-6381 GOMMUM� D
Llc. No.: 02886
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'
co pensation, as provided for by Section 3700 of the Labor Code, for the performance
�'Xrloh,avwe
r hich this permit is issued.
and will maintain workers' compensation insurance, as required by
f the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance.carrier and polity 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 Codej shall forthwith
comply with Pose [rovisions.
Date: 1 & 2 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 -me ioned roperty for inspection purposes.
Date: ! Signature (Applicant or Agent):
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT,.'
QTY, AMOUNT.
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0 $2.00
$0.00
PAID BY
METHOD
.RECEIPT # ..
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION' BSA: $2.00 $0.00
DESCRIPTION,
ACCOUNT. '.
QTY:
AMOUNT
PAID
PAID DATE
FIREPLACE
101-0000-42400
0
$580.12
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY"'
AMOUNT:
PAID'
PAID DATE
FIREPLACE PC
101-0000-42600
0
$870.20
$0.00
PAID BY
METHOD . ;:
RECEIPT#Y.
#
CLTD BY
Total Paid for FIREPLACE: $1,450.32 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$4.16
,$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for STRONG MOTION INSTRUMENTATION SMI:' $4.16 $0.00
TOTALS:••
Description: HIDEAWAY / FUSTAFSON / REMODEL (4) FIREPLACES
ADDITIONAL
Type: BUILDING, RESIDENTIAL
Subtype: REMODEL Status: APPROVED
Applied: 1/26/2016 SKH
Approved: 3/24/2016 JJO
Parcel No: 777410006 Site Address: 52768 VIA DONA LA QUINTA,CA 92253
Subdivision: TR 29894-4
Block: Lot: 6
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $32,000,00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: REPLACE 4 FIREPLACES WITH NEW ISOKERN UNITS PER 2013 CRC CODES
PLAN CHECK COMMENTS
Printed: Friday, March 25,, 2016 4:14:10 PM 1 of 3
17117 SYSTCMS
ADDITIONAL
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME ACTION DATE COMPLETION DATE
NOTES
NOTE
JIM JOHNSON
2/9/2016
2/9/2016
NOTE
JIM JOHNSON
3/10/2016
waiting for the plans to be returned from stru p/c
PLAN CHECK COMMENTS
FROM CONSULTANT
KAY HENSEL
2/8/2016
2/8/2016
STRUC RFC ON 2/3/16. RECEIVED BACK IN OFFICE ON
2
/8/2016
RECEIVED
PLAN CHECK COMMENTS
FROM CONSULTANT
RAMSES-SEVILLA
3/22/2016
3/22/2016
RECEIVED
PLAN CHECK PICKED UP
RAMSES SEVILLA
2/11/2016
2/11/2016
ALBERTO PICK UP PLANS 2/11/16
PLAN CHECK SENT TO
STEPHANIE KHATAMI
3/8/2016
3/8/2016
OUTSIDE PC
PLAN CHECK SUBMITTAL
STEPHANIE KHATAMI
3/8/2016
3/8/2016
RECEIVED
Printed: Friday, March 25,, 2016 4:14:10 PM 1 of 3
17117 SYSTCMS
TELEPHONE CALL
JIM JOHNSON
2/10/2016
2/10/2016
CALLED ALBERTO TO INFORM HIM THE PLANS HAVE
CORRECTIONS .
CONDITIONS
NAME TYPE
NAME
FIREPLACE
101-0000-42400
0
•$580.12
$0.00
ADDRESS1
CONTACTS
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
DAZARTH STUDIO
P.O. BOX 5083
LA QUINTA
CA
92247
Total Paid for FIREPLACE: $1,450.32 $0.00
CONTRACTOR
MONARCH HOMES
499SO JEFFERSON
STREET #130
LA QUINTA
CA
92264 .
OWNER
JOHN GUSTAFSON
2040 E LIVE OAK DR
LOS ANGELES
CA
92253
FINANCIAL INFORMATION
DESCRIPTION ACCOUNTQTY AMOUNT
PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
BY,.
BSAS SB1473 FEE 101-0000-20306 0 $2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION $2,00 $0.00
BSA:
FIREPLACE
101-0000-42400
0
•$580.12
$0.00
FIREPLACE PC
101-0000-42600
0
$870.20
$0.00
Total Paid for FIREPLACE: $1,450.32 $0.00
SMI = RESIDENTIAL
101-0000-20308
0
$4.16
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $4.16 $0.00
TOTALS:0•
INSPECTIONS
PARENT PROJECTS
Printed: Friday, March 25, 2016 4:14:10 PM 2 of 3 CREAS
uff SYSTEMS
1ST BLDG NS (2 WK)
JIM JOHNSON
1/26/2016
2/9/2016
2/2/2016
REVISIONS REQUIRED
ATTACHMENTS
1ST BLDG STR (2
WK)
KURT CULVER
1/26/2016
2/9/2016
2/3/2016
REVISIONS REQUIRED
PATHNAME.
SUBDIR
2ND BLDG NS (2
WK)
JIM JOHNSON
3/8/2016
3/22/2016
3/10/2016
APPROVED
2ND BLDG STR (2•
WK)
KURT CU ER
3/8/2016
3/22/2016
3/21/2016
READY FOR APPROVAL
0
BOND INFORMATION
ATTACHMENTS
Attachment Type.
CREATED
OWNER,
DESCRIPTION
PATHNAME.
SUBDIR
ETRAKIT ENABLED e
1ST REVIEW
BRES2016-0012 - IST
DOC
2/4/2016
AJ ORTEGA
STRUCTURAL FEE SHEET
REVIEW STRUCTURAL
0
(ESGIL)
FEE SHEET.pdf
1ST REVIEW
BRES2016-0012 - 1ST
DOC
2/4/2016
AJ ORTEGA
STRUCTURAL
REVIEW STRUCTURAL
0
CORRECTIONS (ESGIL)
CORRECTIONS.pdf
2ND REVIEW
BRES2016-0012 - 2ND
DOG
3/22/2016
AJ ORTEGA
STRUCTURAL
REVIEW STRUCTURAL
0
TRANSMITTAL
TRANSMITTAL
(APPROVED)
(APPROVED).pdf
Printed: Friday, March 25, 2016 4:14:10 PM 3 of 3
i SYSTEMS