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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 n- LL_o a U O 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 <: ? 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 ® 1 Supplemental Struct. Calcs ❑ Truss Calcs ❑ Revised Truss Calcs ❑ Soils Report Update ❑ Revised Soils Report ® 1 Structural P/C Comments ❑ Approved Structural Plans ® 1 Redlined Structural Plans ❑ Approved Structural Calcs ® 1 Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ 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 This Material Sent for: ❑ Your Files ® Per Your Request ❑ Your Review ❑ Approval ❑ Checking ❑ At the request of: Other: ❑ . BY: John W. Thompson t : ® (760) 772-5107 RECEIVEDOffice • Other: ❑ 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: