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BRES2016-0141r � I +78-495 CALLE TAMPICO V VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/7/2016 Application Number: BRES2016-0141 Owner: Property Address: 79640 BAYA ST ST ARNOLD YALAM APN: 776250014 P.0 BOX 643 v Application Description: ARNOLD YALAM / REMODEL RANCHO SANTA FE, CA 92253 Property Zoning: Application Valuation: .$5,000.00 Applicant: Contractor: HUDLEY TOM AMERICAN TECHNOLOGIES INC DBA ATI 34159 YUCAIPA BLVD STE C 210 BAYWOOD AVENUE YUCAIPA, CA 92399 ORANGE, CA 92865 (714)283-9990 Llc. No.: 571784 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: B. C47, C21, C39, C-6, CIS, D64, C22 Li nse No.: 571784 D' ate: V'lY�-a1U\V 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).: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, andthe 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 Name: Lender's Address: 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 wo 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 oollicy number are: Carrier. CA%) Polity Number: �Q,— Q l qa G $ t I drtify 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: _Q 11-0 -A 7aa I d Applicant: qkaAA� 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. Date: h(n-O'A—aAL b Signature (Applicant or Agent): DESCRIPTION • FINANCIAL •• • ACCOUNT QTY AMOUNT PAID. PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 1.25 $87.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for, BLDG CITY STAFF - PER HOUR:. $87.50 $0.00 DESCRIPTION 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 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 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for REMODEL: $184.19 $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:00 k Bin's# Permit #i Q n l b "11 Project Address:. 1� 00 City of La Quin to Building &• Safety Division 78-495 Calle Tampico . La Quint CA CA 92253 - (760) 777-7012 ' Building Permit Application and Tracking Sheet Owner's Name: A. P. Number: / Address: Legal Description: City, ST, Zip: L�ed ��J Contractor: I T — ele hone: P Address: /OLT1-6^( Project Description: City, ST, Zips c ,(fid K_ ah,1 C_�2 T a elehn o e. O P s Z- L L 5 1. v State Lic. # : �j� / �� City Lic. #. Arch., Engr., Designer:�Y - Address: c�•� v _ City., ST, Zip: Z 3 f 7 n . ConType: tr - ucti n aneY Occupancy: • �L S State Lic. #:Te[ePho Project type circle one): • New Add'n Alter Pa Demo Name of Contact Person: Sq. Ft.:3' #Stories: ' #Units: l Telephone # of Contact Person: %� — rfv 1YOc� Estimated Value of Projec 6M APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2nd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. I1.O.A. Approval Plans resubmitted Grading IN ROUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date or permit issue School Fees, Total Permit Fees Description: ARNOLD YALAM / REMODEL Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED Applied: 5/18/2016 RSE Approved: 6/3/2016110 Parcel No! 776250014 Site Address: 79640 BAYA ST ST LA QUINTA,CA 92253 Subdivision: TR 28719 Block: Lot: 14 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 Details: REPAIR WATER DAMAGE IN BATHROOM PER 2013 CRC CODES Printed: Tuesday, lune 07, 2016 9:51:12 AM 1 of 3. J UU SYSTEMS CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES NOTE JIM JOHNSON 6/1/2016 6/2/2016 NON STRUC APPROVED WAITING FOR STRUC COMMENTS PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 6/3/2016 6/3/2016 STRUC RFC ON 6/2/2016 RECEIVED PLAN CHECK SENT TO RAMSES SEVILLA 5/18/2016 5/18/2016 OUTSIDE PC PLAN CHECK SUBMITTAL RAMSES SEVILLA 5/18/2016 5/18/2016 RECEIVED TELEPHONE CALL JIM JOHNSON. 6/3/2016 6/3/2016 CALLED TOM TO INFORM HIM THE PLANS ARE READY TO ISSUE CONDITIONS Printed: Tuesday, lune 07, 2016 9:51:12 AM 1 of 3. J UU SYSTEMS INSPECTIONS PARENT PROJECTS RETURNED Printed: Tuesday, June 07, 2016 9:51:12 AM 2 of 3 C SYS7Eti1S • FINANCIAL• PHONE FAX EMAIL NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP APPLICANT HUDLEY TOM 34159 YUCAIPA BLVD STE C YUCAIPA CA 92399 Total Paid for BLDG CITY STAFF - PER HOUR: $87.50 $0.00 BSAS SB1473 FEE CONTRACTOR AMERICAN TECHNOLOGIES INC DBA ATI 210 BAYWOOD AVENUE ORANGE CA 92865 OWNER ARNOLD YALAM P 0 BOX 643 RANCHO SANTA FE CA 92253 $49.31 $0.00 INSPECTIONS PARENT PROJECTS RETURNED Printed: Tuesday, June 07, 2016 9:51:12 AM 2 of 3 C SYS7Eti1S • FINANCIAL• • CLTD DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY HOURLY PLAN CHECK - 101-0000-42600 1.2S $87.50 $0.00 YES Total Paid for BLDG CITY STAFF - PER HOUR: $87.50 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: 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: $184.19 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 1 $0.65 1 $0.00 Total -Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65 $0.00 TOTALS: $273.34 00 INSPECTIONS PARENT PROJECTS RETURNED Printed: Tuesday, June 07, 2016 9:51:12 AM 2 of 3 C SYS7Eti1S C6MOFT1p REVIEW TYPE REVIEWER SENT DATE DUE DATE DATE STATUS REMARKS NOTES IST BLDG NS (2 WK) JIM JOHNSON 5/18/2016 6/2/2016 6/1/2016 APPROVED 1ST CHECK - 1ST BLDG STR (2 JOHN 5/18/2016 6/2/2016 6/1/2016 APPROVED STRUCTURAL MINOR CORRECTION. APPROVED BY JIM J WK) THOMPSON COMMENTS.doc COMMENTS.doc Printed: Tuesday, lune 07, 2016 9:51:12 AM 3 of 3 CRWYSTEMS ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED 1ST CHECK - 1ST CHECK - DOC 6/1/2016 JOHN THOMPSON STRUCTURAL STRUCTURAL 0 COMMENTS.doc COMMENTS.doc 1ST CHECK - 1ST CHECK - DOC 6/1/2016 JOHN THOMPSON STRUCTURAL STRUCTURAL 0 TRANSMITTAL.pdf TRANSMITTAL.pdf Printed: Tuesday, lune 07, 2016 9:51:12 AM 3 of 3 CRWYSTEMS