BRES2016-007378-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
RAY BOOKER - ARCHITECT
49410 BRIAN CT
LA QUINTA, CA 92253
. T4'�p44Q"
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
BRES2016-0073
46485 CAMEO PALMS DR
643181010
DANIELS RESIDENCE / 484 SF PATIO TO LIVING
$40,000.00
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 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 subjects the applicant to a civil penalty of not more than five hundred dollars
(:
(, 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 she did not build or improve for the purpose of sale.).
as owner of the property, am exclusively contracting with licensed contractors
ft, 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
thp_Contractors' State License Law.).
( I am exempt under Sec. . B.&P.C. for this reason
iT : �
Da� 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
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Owner:
ROBERT DANIELS
78435 CAMEO DUNES
LA QUINTA, CA 92253
Contractor:
OWNER BUILDER
Llc. No.:
Date: 4/20/2016
WORKER'S COMPENSATION DECLARATION
ereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
mpensation, as provided for by Section 3700 of the Labor Code, for the performance
the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
ction 3700 of the Labor Code, for the performance of the work for which this permit
issued. My workers' compensation insurance carrier and policy number are:
Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
all not employ any person in any manner so as to become subject to the workers'
mpensation laws of California, and agree that, if I should become subject to the
)rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
mply wit those provisions.
rte: 'ZD Applicant
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
JD SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
VE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
)MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
TEREST, AND ATTORNEY'S FEES.
. APPLICANT ACKNOWLEDGEMENT
(PORTANT: Application is hereby made to the Building Official for a permit subject to
e conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
quest and for whose benefit work is performed under or pursuant to any permit
ued as a result of this application , the owner, and the applicant, each agrees to, and
all defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
nployees for any act or omission related to the work being performed under or
Ilowing issuance of this permit.
Z. Any permit issued as a result of this application becomes null and void if work is
t commenced within 180 days from date of issuance of such permit, or cessation of
irk for 180 days will subject permit to cancellation.
ertify that I have read this application and state that the above information is correct.
)gree to comply with all city and county ordinances and state laws relating to building
nstruction, and hergby authorize representatives of this y to enter upon he
ove-mentjod prdperty for inspection purpossl"11
ite: Signature (Applicant orent)
a
a
w
c.�
w
�a
Cq
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a
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U
WORKER'S COMPENSATION DECLARATION
ereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
mpensation, as provided for by Section 3700 of the Labor Code, for the performance
the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
ction 3700 of the Labor Code, for the performance of the work for which this permit
issued. My workers' compensation insurance carrier and policy number are:
Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
all not employ any person in any manner so as to become subject to the workers'
mpensation laws of California, and agree that, if I should become subject to the
)rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
mply wit those provisions.
rte: 'ZD Applicant
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
JD SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
VE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
)MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
TEREST, AND ATTORNEY'S FEES.
. APPLICANT ACKNOWLEDGEMENT
(PORTANT: Application is hereby made to the Building Official for a permit subject to
e conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
quest and for whose benefit work is performed under or pursuant to any permit
ued as a result of this application , the owner, and the applicant, each agrees to, and
all defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
nployees for any act or omission related to the work being performed under or
Ilowing issuance of this permit.
Z. Any permit issued as a result of this application becomes null and void if work is
t commenced within 180 days from date of issuance of such permit, or cessation of
irk for 180 days will subject permit to cancellation.
ertify that I have read this application and state that the above information is correct.
)gree to comply with all city and county ordinances and state laws relating to building
nstruction, and hergby authorize representatives of this y to enter upon he
ove-mentjod prdperty for inspection purpossl"11
ite: Signature (Applicant orent)
DESCRIPTION
FINANCIAL
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 for ADDITION: $371.73 $0.00
DESCRIPTION
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
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
HOURLY PLAN CHECK - YES
101-0000-42600
1.5
$105.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for BLDG CITY STAFF - PER HOUR: $192.50 $0.00
DESCRIPTION
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
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
CONDENSER/COMPRESSOR
101-0000-42402
0
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK$f
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
CONDENSER/COMPRESSOR PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FURNACE
101-0000-42402
0.
$36.26
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
FURNACE PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for MECHANICAL: $120.86 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$5.20
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $5.20 $0.00
TOTALS:00
Description: DANIELS RESIDENCE / 484 SF PATIO TO LIVING
Type: BUILDING, RESIDENTIAL Subtype: ADDITION Status: APPROVED -CONDITIONS
Applied: 3/14/2016 MFA
Approved: 4/20/2016 JJO
Parcel No: 643181010 Site Address: 46485 CAMEO PALMS DR LA QUINTA,CA 92253
Subdivision: TR 2117 Block: Lot: 48
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $40,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
STAFF NAME
Details: RELATED TO CODE CASE - CODE2016-000258.
APPLICANT SUBMITTED WITH ADDRESS OF 78435 CAMEO DUNES BUT PER BURT, THE DRIVEWAYS ARE ON CAMEO DUNES, BUT
ADDRESS GIVEN WAS 46485 CAMEO PALMS. PLEASE ADVISE APPLICANT. ADD NEW ROOM AT SIDE PATIO AREA. PER 2013 CRC
CODES.THIS PERMIT DOES NOT INCLUDE NEW BATHROOM AS SHOWN ON PLANS.ALL CONSTRUCTION SHALL BE PER 2013 CRC
CODES
Printed: Wednesday, April 20, 2016 2:38:38 PM 1 of 5 CRSYSTEMS
ADDITIONAL
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE COMPLETION DATE
NOTES
NOTE
RAMSES SEVILLA
4/18/2016
4/18/2016
RAY DROP ENERGY FORMS WITH NEW ADDRESS AND SQ RSE
PLAN CHECK COMMENTS
FROM CONSULTANT
KAY HENSEL
3/28/2016
3/28/2016
STRUC RFC 3/28/2016
RECEIVED
PLAN CHECK COMMENTS
FROM CONSULTANT
STEPHANIE KHATAMI
4/14/2016
4/15/2016
APPROVABLE
RECEIVED
PLAN CHECK PICKED UP
RAMSES SEVILLA
3/29/2016
3/29/2016
PLAN CHECK SENT TO
MARY FASANO
3/14/2016
3/14/2016
OUTSIDE PC
PLAN CHECK SENT TO
STEPHANIE KHATAMI
3/31/2016
3/31/2016
OUTSIDE PC
Printed: Wednesday, April 20, 2016 2:38:38 PM 1 of 5 CRSYSTEMS
PLAN CHECK SUBMITTAL
MARY FASANO
3/14/2016
3/14/2016
RECEIVED
PLAN CHECK SUBMITTAL
STEPHANIE KHATAMI
3/31/2016
3/31/2016-
RECEIVED
CALLED RAY TO INFORM HIN THE PLANS ARE READY FOR
TELEPHONE CALL
11M JOHNSON
3/29/2016
3/29/2016
CORRECTIONS
CALLED RAY TO IMFORM HIM THE TITLE -24 NEED TO BE
TELEPHONE CALL
JIM JOHNSON
4/15/2016
4/15/2016
REVISED SQ. FT. NOT PER PLANS.
CALLED. RAY ROOKER TO INFORM HIM THE PLANS ARE READY
TELEPHONE CALL
JIM JOHNSON
4/19/2016
4/19/2016
TO ISSUE PENDING SCHOOLTEES.
CONDITIONS
CONDITION
CONTACT
DATE
DATE
DATE
STATUS
REMARKS
NOTESi'
TYPE
ADDED
REQUIRED
SATISFIED
READY TO ISSUE
TITLE -24 NEED S TO BE REVISED
JIM JOHNSON
4/19/2016
4/19/2016
COMPLETE
CHECKLIST
TITLE -24 REVISED
READY TO ISSUE
SCHOOLS FEES REQUIRED
JIM JOHNSON
4/19/2016
4/19/2016
4/20/2016
COMPLETE
CHECKLIST
SCHOOL FEES RECEIVED
CONTACTS
NAME TYPE
NAME
ADDRESSi
CITY
STATE
ZIP
PHONE FAX EMAIL
APPLICANT
RAY BOOKER - ARCHITECT
49410 BRIAN CT
LA QUINTA
CA
92253
(310)286-2470
CONTRACTOR
OWNER BUILDER
(310)286-2470
OWNER
ROBERT DANIELS
78435 CAMEO DUNES
LA QUINTA
CA
92253
(310)286-2470
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
BY
ADDITION, EA 101-0000-42400 0 $62.36 $0.00
ADDITIONAL 500 SF
Printed: Wednesday, April 20, 2016 2:38:38 PM 2 of 5 CRWsrs TEMs
Printed: Wednesday, April 20, 2016 2:38:38 PM 3 of 5 CB WsrsrEMS
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
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 for ADDITION: $371.73 $0.00
HOURLY PLAN CHECK -
101-0000-42600
1.25
$87.50
$0.00
YES
HOURLY PLAN CHECK -
101-0000-42600
1.5
$105.00
$0.00
YES
Total Paid for BLDG CITY STAFF - PER HOUR: $192.50 $0.00
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00 $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
CONDENSER/COMPRES
101-0000-42402
0
$36.26
$0.00
SOR
CONDENSER/COMPRES
101-0000-42600
0
$24.17
$0.00
SOR PC
FURNACE
101-0000-42402
0
$36.26
$0.00
FURNACE PC
101-0000-42600
0
$24.17
$0.00
Total Paid for MECHANICAL: $120.86 $0.00
SMI - RESIDENTIAL
101-0000-20308
0
$5.20
$0.00
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $5.20 $0.00
Printed: Wednesday, April 20, 2016 2:38:38 PM 3 of 5 CB WsrsrEMS
TOTALS: $885.18 $0.00
INSPECTIONS
Printed: Wednesday, April 20, 2016 2:38:38 PM 4 of 5 cpa"SYSTEMS
PARENT
PROJECTS
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE
RETURNED
REVIEWS
STATUS
REMARKS.. ,
NOTES
46-485 CAMEO
GATE
DOC
3/30/2016
11M JOHNSON
PALMS.docx
PALMS.docx
WAITING FOR PLANS TO BE RETURNED FROM
1ST BLDG NS (2 WK)
JIM JOHNSON
3/14/2016
3/28/2016
3/29/2016
REVISIONS REQUIRED
4/19/2016
YOUNG
1ST BLDG STR (2
JOHN
3/14/2016
3/28/2016
3/28/2016
REVISIONS REQUIRED
46-485 CAMEO
WK)
THOMPSON
0
DOC
4/20/2016
11M JOHNSON
PALMS.docx
PALMS 1.docx
2ND BLDG NS (2
JIM JOHNSON
3/31/2016
4/14/2016
4/19/2016
APPROVED
1ST CHECK -
WK)
DOC
3/28/2016
JOHN THOMPSON
STRUCTURAL
STRUCTURAL
0
2ND BLDG STR (2
JOHN
3/31/2016
4/14/2016
4/14/2016
READY FOR APPROVAL
'
WK)
THOMPSON
1ST CHECK -
1ST CHECK -
DOC
3/28/2016
Printed: Wednesday, April 20, 2016 2:38:38 PM 4 of 5 cpa"SYSTEMS
BOND INFORMATION
Attachment Type
CREATED
OWNER
DESCRIPTION
PATHNAME
SUBDIR
ETRAKIT ENABLED
46-485 CAMEO
46-485 CAMEO0
DOC
3/30/2016
11M JOHNSON
PALMS.docx
PALMS.docx
SCHOOL FEES BRES2016-
SCHOOL FEES BRES2016-
0
DOC
4/19/2016
11M JOHNSON
0073.pdf
0073.pdf
46-485 CAMEO
46-485 CAMEO
0
DOC
4/20/2016
11M JOHNSON
PALMS.docx
PALMS 1.docx
1ST CHECK -
1ST CHECK -
DOC
3/28/2016
JOHN THOMPSON
STRUCTURAL
STRUCTURAL
0
COMMENTS.doc
COMMENTS.doc
1ST CHECK -
1ST CHECK -
DOC
3/28/2016
JOHN THOMPSON
STRUCTURAL
STRUCTURAL
0
TRANSMITTAL.pdf
TRANSMITTAL.pdf
Printed: Wednesday, April 20, 2016 2:38:38 PM 4 of 5 cpa"SYSTEMS
Printed: Wednesday, April 20, 2016 2:38:38 PM 5 of 5 CR srsTEMS
ATTACHMENTS
AttachmeritType .
CREATED
OWNER
DESCRIPTION
PATHNAME `
SUBDIR
ETRAKIT ENABLED,
2ND CHECK -
2ND CHECK -
DOC
4/14/2016
JOHN THOMPSON
STRUCTURAL
STRUCTURAL
0
TRANSMITTAL.pdf
TRANSMITTAL.pdf
DOC
3/31/2016
STEPHANIE KHATAMI
2ND CHECK LIST AND
2ND CHECK LIST AND
0
COMMENTS 3-31-16
COMMENTS 3-31-16.pdf
2ND SUBMITTAL
DOC
4/15/2016
STEPHANIE KHATAMI
2ND SUBMITTAL
TRANSMITTAL 4-14-
0
TRANSMITTAL 4-14-16
16. pdf
Printed: Wednesday, April 20, 2016 2:38:38 PM 5 of 5 CR srsTEMS
I�IA M P '�h P J AA-��
BinY
La Q Cit of uinta
Building & Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
4e5 Building Permit Application and Tracking Sheet.
Permit #
r SLl
Project Address: L� leu
Owner's Name: FOp)ey- ^ I L
A. P. Number:_ l
(�
Address: Z
J
Legal Description:
City, ST, Zip: v t
Contractor:
Telephone:
Address:
Project Description: _ r
City, ST, Zip:
Telephone:
State Lic. # :
City Lic"
rch. ngr.,Designer: D -Y ao0 �Ct�It'C,Y 1
Address: gW10 60L C-7
City., ST, Zip: au I _
Telephone: v
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YPe:�-
Construction T `�1C'
l L 1% Occupancy:
S tateL c. i . #
~��i
Project type circle one): New Adn ARepair Demo
Name of Contact Person:
Sq. Ft.:
es
#Units:e
Telephone # of Contact Person:
Estimated Value of Project L440 O p 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
3'! Reyiew, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.K.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees
r
CttJEc'L.,"azc'�
If
Date:4/20/2016
No.: 16-00191-1
Owner: Robert Daniels
Address: 46485 Cameo Palms
City: La Quinta
Type: Residential Addition < 500 sq ft
CERTIFICATE OF COMPLIANCE
JNC�EG s
Desert Sands Unified School District
' cy%
47950 Dune Palms Road
ES
ySR% �MIWIGE
La Qunita, CA 92253
. P� IU.M W (RT , Y
ua l y�
(760)771-8515000
Lot # Street No. Street Name Sq. Feet
46485 Cameo Palms 484
Comments: Gym Addition
Email:
Jurisdiction: La Quinta
Tract M
APN Permit No.
643-181-010
` 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 replacement
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 484 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 - Robert Daniels Check No.:
Bank Name/Recipient of Certificate Telephone:
Funding: Exempt
By Dr. Gary Rutherford
Superintendent
Fee Collected/ Exempted by: Sha, n McGily' � y
Amount Due: $01000
�
Original PaymeiiY(s) Rec'd: ,�$0.00;1 =
New Payment Recd` --$0.00
o C: g"r/Under:- $0.00`'i:
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which ycmay protest the.fe s ori
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.
Notice to Building Department: THIS DOCUMENT VALID ONLY IF IMPRINTED WITH EMBOSSED SEAL.
3
YOUNG
ENGINEERING
c °
T
Letter of Transmittal
To: City of La Quinta Today's Date:
4-14-16
78-495 Calle Tampico City Due Date:
4-14-16
La Quinta, CA 92253 Project Address:
46485 Cameo Palms Drive
Attn: Ramses Sevilla Plan Check #:
BRES2016-0073
Submittal: ❑ 1si !
4th
® 2nd
❑
5th
❑ 3'd
❑
Other:
We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup
Includes: Descriptions: Includes:
# Of Descriptions:
Copies:
❑ Structural Plans
®
1 Revised Struct. Plans
❑ Structural Calculations
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1 Supplemental Struct. Calcs
❑ Truss Calcs
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Revised Truss Calcs
❑ Soils Report Update
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Revised Soils Report
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Approved Structural Plans
® 1 Redlined Structural Plans
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Approved Structural Calcs
® 1 Redlined Structural Calcs
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Approved Truss Calcs
❑ Redlined Truss Calcs
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Approved Soils Report
❑ Redlined Soils Reports
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Other:
Comments: Structural content is:approvable. 1st submitted structural calculations shall be combined with the
2nd submittal calculations as the approved set of.structural calculations
Structural Plan Review Time = 1.25 HR
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ASR 14 2016
CPQ OP LA OU1NTA
C0MMU114M UEMOPMENT,
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 peimit has be submitted in
_ty name lis yourself as the builder of the property
improvements specified at
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 signs you understand or verify this information.
L 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.
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.
derstand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
(rn from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own
��derstand`
Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
�5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
y construction is at least'fnve hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
�
I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
ernment, 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 to.serious financial
risk.
J-7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
tures cannot legally build g y unld 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.
71yr—iurlderstand as an Owner -Builder if I sell the property for which this permit is issued, I may be held -ab
leIii
financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defec
workmanship or materials.
understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
ivice, the United States• Small.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-
-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party ]egalg�, . "_� nfia�ly responsible r pr=posed construction activity at the following address:
I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
p le laws. and requirements that govern Owner -Builders as.well as employers.
12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
e 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 Contractois 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 hire 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 r wired to be presented when the permit is issued to verify the property
owner's signature. / /
Signature of property owner v Date:
Note: The following Authorization Form is required to be 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:
Address of Authorized Agent:
Tel No
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: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to be presented when the permit is issued to verify the property owners signature.
Property Owner's Signature: Date: