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BRES2014-1231Vol �a w 78-495 CALLE TAMPICO C�� D 4 i LA QUINTA, CALIFORNIA 92253 I COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2014-1231 Property Address: 56118 BALTUSROL APN: 775360018 Application Description: ADDITION - 640 SQ FT Property Zoning: Application Valuation: $80,000.00 Applicant: LENCH DESIGN STUDIO, INC. P.O. BOX 450 LA QUINTA, 'CA FEB 2 5 2015 CITY OF LA QUINTA 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 Clas : B License No.: 781834 Date: 2. 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 of the Business and Professions Code) or that he or she is exempt therefrom and the I 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).: (_J 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.). (_J 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 Na Lender's Address: ��-h-- C91 q(0 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 2/25/2015 Owner: ARTHUR AND GAYLE SCHULER 56118 BALTUSROL LA QUINTA, CA 92253 Contractor: BRAUCKMANN INC 50855 WASHINGTON STREET NUMBER 227 LA QUINTA, CA 92253 (760)972-8092 Llc. No.: 781834 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: _ -4 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 worker compensation laws of California, and agree that, if I should become subject to workers' compensation provisions of SectioZ2�� orthwith comply with t ose pr visions. i [sate: � �J Aonlicant: WARNING: FAILURETO 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 p,ppertyfor inspection purposes. pate:2_ %J Signature (Applicant o6rig_�: 1 FINANCIAL • DESCRIPTION ACCOUNT _ QTY AMOUNT PAID PAID DATE ADDITION, EA ADDITIONAL 500 SF 101-0000-42400 0 $62.36 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY 'AMOUNT PAID PAID DATE ADDITION, 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 ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ADDITION, FIRST 100 SF PC 101-0000-42600 0 $171.14 $0.00 PAID BY - METHOD RECEIPT # CHECK # CLTD BY Total Paid forADDITION: $371.73 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $4.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $4.00 $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,OOOSF, PC 101-0000-42600 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY i I Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCE REPAIR/ALTERATION 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE APPLIANCE REPAIR/ALTERATION PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for M ECHAN I CAL: $16.92 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC '101-0000-42600 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY' AMOUNT PAID' PAID DATE ROOF DRAIN 101-0000-42401 0 $36.27 $0.00 PAID BY METHOD. RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ROOF DRAIN PC 101-0000-42600 0 $36.27 $0.00 PAID BY METHOD - RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $96.72 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $10.40 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $10.40 $0.00 TOTALS:00 Description: ADDITION - 640 SQ FT Type: BUILDING, RESIDENTIAL Subtype: ADDITION Status: APPROVED Applied: 11/19/2014 SKH Approved: 2/24/2015 JJO Parcel No: 775360018 Site Address: 56118 BALTUSROL LA QUINTA,CA 92253 Subdivision: TR 28961 Block: Lot: 28 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $80,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NOTES Details: 640 SQ. FT. ADDITION TO MBR, HER CLOSET,HIS CLOSET, MASTER RETREAT, KITCNEN AND DINNING AREA IN CASITA. PLANS WERE REVISED TO SHOW 499 SQ. FT. A/C. ADDITION WITH 141 SQ.FT. NON A/C PATIO FURNITURE STORAGE ROOM. MASTER BEDROOM WAS CHANCED. Printed: Wednesday, February 25, 2015 9:58:22 AM 1 of 4 RWSYSTEMS ADDITIONAL CHRONOLOGY - CHRONOLOGY TYPE E STAFF NAME . ACTION DATE COMPLETION DATE NOTES ASSUMING JIM WILL COMPLETE ARMEN'S PLAN CHECKS, I NOTE KAY HENSEL 1/28/2015 1/28/2015 CHANGED THE BUILDING BUCKET 2ND N/S PLAN CHECK TO JIM PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 12/10/2014 12/10/2014 STRUC RFC. 12/09/14 RECEIVED PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 2/2/2015 2/2/2015 STRUC APP 2/2/2015 RECEIVED PLAN CHECK PICKED UP MARY FASANO 12/11/2014 12/11/2014 PLAN CHECK SENT TO KAY HENSEL 11/19/2014 11/19/2014 STRUC TO YOUNG - DUE 12/3/14 OUTSIDE PC PLAN CHECK SUBMITTAL KAY HENSEL 11/19/2014 11/19/2014 PLANS RECEIVED AT FRONT COUNTER BY SK. RECEIVED Printed: Wednesday, February 25, 2015 9:58:22 AM 1 of 4 RWSYSTEMS PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 1/27/2015 1/27/2015 RECEIVED INFORMATION TELEPHONE CALL ARMEN ALTOUNIAN 12/11/2014 12/11/2014 PLANS READY FOR PICK-UP. TELEPHONE CALL JIM JOHNSON 2/6/2015 2/6/2015 CLTD CALLED SKIP LENCH TO INFORM HIM PLANS ARE READY TO ACCOUNT QTY AMOUNT PAID PAID DATE ISSUE. SCHOOL FEES AND CONTRACTOR NEEDED TO ISSUE. TELEPHONE CALL JIM JOHNSON 2/24/2015 2/24/2015 CALLED SKIP TO INFORM HIM REVISION ARE READY TO ISSUE NEED UPDATED ASSESSORS SET. BY CONDITIONS 101-0000-42400 0 $62.36 $0.00 CONTACTS ADDITIONAL 500 SF NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT LENCH DESIGN STUDIO, INC. P.O. BOX 450 LA QUINTA CA (760)578-1077 CONTRACTOR BRAUCKMANN INC 50855 WASHINGTON LA QUINTA CA 92253 (760)578-1077 STREET ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 OWNER ARTHUR AND GAYLE SCHULER 56118 BALTUSROL LA QUINTA CA 92253 (760)578-1077 0 $171.14 Printed: Wednesday, February 25, 2015 9:58:22 AM 2 of 4 RWYSTEMS FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY ADDITION, EA 101-0000-42400 0 $62.36 $0.00 ADDITIONAL 500 SF ADDITION, EA 101-0000-42600 0 $17.40 $0.00 ADDITIONAL 500 SF PC ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $0.00 ADDITION, FIRST 100 SF 101-0000-42600 0 $171.14 $0.00 PC Total Paid forADDITION: $371.73 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $4.00 1 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $4.00 $0.00 BSA: Printed: Wednesday, February 25, 2015 9:58:22 AM 2 of 4 RWYSTEMS INSPECTIONS M SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL" CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY 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 forELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00 APPLIANCE 101-0000-42402 0 $12.09 $0.00 REPAIR/ALTERATION APPLIANCE 101-0000-42600 0 $4.83 $0.00 REPAIR/ALTERATION PC Total Paid forMECHANICAL: $16.92 $0.00 FIXTURE/TRAP 101-0000-42401 0 $12.09 $0.00 FIXTURE/TRAP PC 101-0000-42600 0 $12.09 $0.00 ROOF DRAIN 101-0000-42401 0 $36.27 $0.00 ROOF DRAIN PC 101-0000-42600 0 $36.27 $0.00 Total Paid for PLUMBING FEES: $96.72 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $10.40 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $10.40 $0.00 TOTALS:00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL" Printed: Wednesday, February 25, 2015 9:58:22 AM 3 of 4 C�� SYSTEMS NON-STRUCTURAL BUILDING 11/19/2014 12/3/2014 11/24/2014 REVISIONS REQUIRED RFC CREATED BUCKET DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED STRUCTURAL KATHRYN 11/19/2014 12/5/2014 12/9/2014 REVISIONS REQUIRED 11/24/2014 STRUC RFC 12/09/14 SAMUELS 0 COMMENTS.docx DOC 1/27/2015 STEPHANIE KHATAMI HOA LETTER BRES2014- SENT TO YOUNG NON-STRUCTURAL JIM JOHNSON 1/27/2015 2/10/2015 2/6/2015 APPROVED SEE CRONO 2/6/2015 PLANS APPROVED. SEE CRONOLOGY 2/6/15 STRUCTURAL KATHRYN 1/27/2015 2/10/2015 2/2/2015 APPROVED APPROVED SAMUELS Printed: Wednesday, February 25, 2015 9:58:22 AM 4 of 4 SYSTEMS ATTACHMENTS Attachment Type CREATED OWNER. DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED N/S 1ST REVIEW DOC 11/24/2014 ARMEN ALTOUNIAN 56-118 BALTUSROL.docx 0 COMMENTS.docx DOC 1/27/2015 STEPHANIE KHATAMI HOA LETTER BRES2014- HOA LETTER BRES2014- 0 1231.pdf I 1231.pdf Printed: Wednesday, February 25, 2015 9:58:22 AM 4 of 4 SYSTEMS Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA: AMOUNT LEVEL ONE AMOUNT: LEVEL TWO AMOUNT: MITIGATION AMOUNT: COMM/IND. AMOUNT: DATE: RECEIPT: CHECK INITIALS CERTIFICATE OF COMPLIANCE California Education Code 17620) Project Name: ,Schuler _(Residence _@_PGA West) Date: February 24, 2015 Owner's Name: Phone No. Project Address: 56-118 Baltusrol, La Quinta, CA Project Description: Room Addition APN: 775-360-018 Tract #: Lot #'s: Type of Development: Residential XX! Commercial Industrial Total Square Feet of Building Area: 499 SQ. FT Certification of Applicant/Owners: The person signing certifies that the above information is recc and makes this statement under penalty of perjury and further represents that he/she is authorized to sign�n-behal--9f t er/developer. Dated: Z �� Signature: *********************************************************************** SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE) Education Code 17620 Number of Sq.Ft. Amount per Sq.Ft. Amount Collected Gov. Code 65995 499 EXEMPT 0.00 Project Approval Building Permit Application Completed: Yes/No By: Elsa F. Esqueda, Director of Facilities and Maintenance Certificate issued by: Leticia Torres, Facilities Analyst Agreement Existing Not Subject to Fee . Prior to 1/1/87 Requirement " Noe r Pursuant to AB 181 any room additions or -enclosures-of NO -01. )s.f._or_ less . are exempt -from -developer _fees. Any mobile homes being relocated within the same school district's jurisdiction are exempt from developer fees. Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requi?ettllat this District provide (1) a written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of Compliance is valid for thirty (30) days.from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up to three (3) such extensions may be granted. IM V:c/nydocs/dcvfces/cerliiicalc ofeolnpliancc Corm updated 3-2007 11/2010