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BRES2016-017378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&'�t440" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2016-0173 Property Address: 76925 AVENIDA FERNANDO APN: 658240029 Application Description: MCGREE / 22SF ADDITION TO DINING ROOM ONLY Property Zoning: Application Valuation: $5,000.00 Applicant: G L SCRIVENS CONSTRUCTION INC P 0 BOX 13302 PALM DESERT, CA 92255 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 License No.: 807645 C7—I . -- D�s ate Zi/—IContrac�roC� : 'L SLrt�/ �"�S 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, 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 lendingagency 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 Date: 7/14/2016 Owner: TIMOTHY• MCGREE Contractor: JUL 14 2016 G L SCRIVENS CONSTRUCTION INC P O BOX 133021 U IYOFLAuUINTA COMMUNITY DEVELOPMENT DEPARTMENT PALM, DESERT,LCA-92253— (760)837-9918 Lic. No.: 807645 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 th r for which this permit is issued. e and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, forthe performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: _ Polity 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 o the Labor Code, I shall forthwith comply with those provisions. Date: z Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPEN ATION 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 thiscityiaentef upon above-mentioned property for inspection purposes. 7 % Date: 1( "'gnature (Applicant or Agent) DESCRIPTION FINANCIAL ACCOUNT QTY AMOUNT PAID PAID DATE ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $120.83 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE ADDITION, FIRST 100 SF PC 101-0000-42600 0 $171.14 $171.14 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE Total Paid for ADDITION: $291.97 $291.97 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY CHARGE - YES .ADMINISTRATIVE STAFF 101-0000-42600 0.25 $10.00 $10.00 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY CHARGE - YES STRUCTURAL PLAN REVIEW ENGINEER 101-0000-42600 1 $95.00 $95.00 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE Total Paid for BLDG CITY STAFF - PER HOUR: $105.00 $105.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 $145.03 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 $47.86 7/14/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK R17090 3693 RSE Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $192.89 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.65 $0.65 7/14/16 .PAID BY METHOD RECEIPT # CHECK # CLTD BY G L SCRIVENS CONSTRUCTION INC CHECK 1117090 3693 RSE .Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65 $0.65 . Description: MCGREE / 22SF ADDITION TO DINING ROOM ONLY Type: BUILDING, RESIDENTIAL Subtype: ADDITION Status: APPROVED Applied: 6/21/2016 RSE Approved: 7/14/2016 RSE Parcel No: 658240029 Site Address: 76925 AVENIDA FERNANDO LA QUINTA,CA 92253 Subdivision: TR 23813 Block: Lot: 29 Issued: Lot Scl 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 7/7/2016 Details: 22SF ADDITION TO EXISTING DINING ROOM AREA [ENGINEERED] THIS PERMIT DOES NOT INCLUDE REMODEL OR ALTERATION TO THE REST OF THE DWELLING. 2013 CALIFORNIA BUILDING CODES Printed: Thursday, July 14, 2016.9:51:55 AM 1 of 3 %'w�• • �LJ 1..1 SYS TEMS CHRONOLOGY. CHRONOLOGY TYPE STAFF NAME ACTION BATE COMPLETION DATE NOTES NOTE MARY FASANO 7/7/2016 7/7/2016 RECEIVED PLANS FROM YOUNG. APPROVABLE PLAN CHECK SENT TO RAMSES SEVILLA 6/21/2016 6/21/2016 OUTSIDE PC PLAN CHECK SUBMITTAL RAMSES SEVILLA 6/21/2016 6/21/2016 RECEIVED INFORMED GARY (760-831-7439) THAT PLANS ARE TELEPHONE CALL AJ ORTEGA 7/12/2016 7/12/2016 APPROVED AND PERMIT IS READY TO ISSUE WITH SCHOOL FEE FORM AND WASTE MANAGEMENT PLAN. CONDITIONS ,.. 'lllll ll' _. CONN DATE DATE DATE E6N CONTACT STATUS REMARKS NOTES ADDED REQUIRED SATISFIED READY TO ISSUE AJ ORTEGA 7/12/2016- COMPLETE SEE USER DEFINED FIELDS CHECKLIST Printed: Thursday, July 14, 2016.9:51:55 AM 1 of 3 %'w�• • �LJ 1..1 SYS TEMS Printed: Thursday, July 14, 2016 9:51:55'AM 2 of 3 SYSTr/viS FINANCIAL INFORMATION 'METHOD CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # PAID BY BY ADDITION, FIRST 100 SF 101-0000-42400 0 $120.83 $120.83 7/14/16 R17090 3693 CHECK G L SCRIVENS RSE CONSTRUCTION INC ADDITION, FIRST 100 SF 101-0000-42600 0 I $171.14 I $171.14 I 7/14/16 I R17090 I 3693 CHECK G L SCRIVENS I RSE PC CONSTRUCTION INC Total Paid for ADDITION: $291.97 $291.97 HOURLY CHARGE - YES 101-0000-42600 0.25 $10.00 $10.00 7/14/16 R17090 3693 CHECK G L SCRIVENS RSE ADMINISTRATIVE STAFF CONSTRUCTION INC HOURLY CHARGE - YES STRUCTURAL PLAN 101-0000-42600 1 $95.00 $95.00 7/14/16 1117090 369) CHECK G C SCRIVENS RSE CONSTRUCTION INC REVIEW ENGINEER Total Paid for BLDG CITY STAFF - PER HOUR: $105.00 $105.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 7/14/16 1117090 3693 CHECK G L SCRIVENS RSE .. CONSTRUCTION INC Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: RESIDENTIAL, FIRST 101-0000-42403 0 •$145.03 $145.03 7/14/16 R17090 3693 CHECK G L SCRIVENS RSE 1,000SF CONSTRUCTION INC RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $47.86 7/14/16 R17090 3693 CHECK G L SCRIVENS RSE 1,000SF, PC CONSTRUCTION INC Total Paid for ELECTRICAL - NEW CONSTRUCTION: $192.89 $192.89 Printed: Thursday, July 14, 2016 9:51:55'AM 2 of 3 SYSTr/viS DESCRIPTION: ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY IST BLDG NS (2 WK) AJ ORTEGA 6/21/2016 7/6/2016 7/12/2016 APPROVED SCHOOL FEE 1ST BLDG STR (2 WK) BRONZ 6/21/2016 7/6/2016 YOUNG 7/6/2016 G L SCRIVENS AJ ORTEGA SMI - RESIDENTIAL 101-0000-20308 0 $0.65 $0.65 7/14/16 R17090 3693 CHECK RSE BUILDING AREA BUILDING AREA.pdf 1ST CHECK - 1ST CHECK - CONSTRUCTION INC DOC Total Paid for STRONG MOTION INSTRUMENTATION SMI: $0.65 $0.65 TOTALS: INFORMATIONkivw ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME NOTES REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE REVIEWS STATUS REMARKS IST BLDG NS (2 WK) AJ ORTEGA 6/21/2016 7/6/2016 7/12/2016 APPROVED SCHOOL FEE 1ST BLDG STR (2 WK) BRONZ 6/21/2016 7/6/2016 YOUNG 7/6/2016 READY FOR APPROVAL AJ ORTEGA CERTIFICATION OF SCHOOL FEE INFORMATIONkivw ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED BRES2016-0173 - SCHOOL FEE DOC 7/12/2016 AJ ORTEGA CERTIFICATION OF SCHOOL FEE 1 CERTIFICATION OF BUILDING AREA BUILDING AREA.pdf 1ST CHECK - 1ST CHECK - DOC 7/6/2016 BRONZ YOUNG STRUCTURAL STRUCTURAL 0 TRANSMITTAL.pdf TRANSMITTAL.pdf Printed: Thursday, July 14, 2016 9:51:55 AM 3 of 3 CN?WsYSTEMS in City Cif La Quin to ' r h •, Building 8t Safety Division - 78-495 Calle Tampico ` Quinta, CA 92253 - (760) 777-7012 ' Building Permit -Ap' fication and Tracking Sheet • ' Permit # Project Address:2 Wner's Name: _rMay A. P. Number: Legal Description: ess 7 6 7 Z vC✓��/J �e r,M�� . City, ST, Zip: 9 ZZJ Contra t c . or (.S.L ivc N f .7 T leP hone: e _1S' 'Address:s! Se7. u o� r ✓ ¢� Project Description: ` 7_>� City, ST, Zip: � Cn '7Z7� + p^ -r ele h Tone: o . State Lie. # : City Lie. Arch., Engr., Designer: ' Address: - r City., ST, Zip: Telephone: one: %r' j State Lie. #D%6 r Canstruefton Type:,. t la Project Pe ne New Add'n Alter Repair Demo Name of Contact Person: ------ Sq. Ft.: 2 # Stories: —TO -Units: Telephone # of Contact Person: Estimated Value of Project: a.•,�, APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Catcs. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan. Check Balance Title 24 Cates. Plans picked up Construction Floodplain plan Plans resubmitted Mechanical Grading plan 2"d Review, ready for-corrections/issue Electrical Sub cont actor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"! Review, ready for, correctionstissue Developer Impact Fee Planning Approval Called Contact Person " A.I.P.P. Pub. Wks. Appr Date of permit issue School*Fecs, , Total Permit Fees f CERTIFICATE. OF COMPLIANCE JN�F'en s y C1 4. Desert Sands Unified School District e 47950 Dune Palms Road �•e om o f 'INDIAN IWEms a • Date: 7/13/2016 La Qunita, CA 92253 `�a�' a I TA, csY • �o IN�w y' No.: 16-00267-1 (760)771-8515 Owner: McGree Email:. Address: 76-925 Avenida Fernando Jurisdiction: to Quinta City: La Quinta Tract #: Type: Residential Addition < 500 sq ft Lot # Street No. Street Name Sq. Feet APN Permit No. 76925 Avenida Fernando 22 658-240-029 j "D Comments: 3',1 iL. dumTA ITY*Of LA At the present time, the'Desert Sands Unified School District does not collect fees on a r o wed $afLb�s�a�IkEWr'esidential additions under 500 square feet; detached accessory'structures (spaces that do not contain facilitielr �eeping, 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'22 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 - Greg Scrivens . Check No.: Telephone:, Bank. Name/Recipient of Certificate Funding: Exempt By Dr. Gary Rutherford Superintendent Fee Collected/ Exempted by: Sha r n McGif rey Amount Due: $0.00 Original Payrient(s) Rec'd: $0.00 New Pai.rnent R�c`d: $0.00 Quer/Linder: $0.00 NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90-6y approval period in which you may'omtest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to,collect them on the District('s) behalf, whichever is earlier. Notice to Building Department: THIS DOCUMENT VALID ONLY IF.IMPRINT•ED WITH EMBOSSED SEAL. But Iding Permit Number. �. shs Project Description: SFR Exempt o, (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan Plan Submittal Date t Job Site Address 76925 Avenida;femando, ` : La. Quinta, CA 92253. owners Name Timothy McGree & Patncia Curtner Number; street :or' 06 Box , Owners Phone'Number Owners E-MaIl'Address Project Managers Name : Greg SCrivens."RECEIV-n Project Managers Phone Numher 760-831-7439 ProjectManageesE-maiiAddress areoCdlolscnvens:cam! J�_i 1 4 2016 Builder/ Contractor : G.L. Scrivens Construction /Greg _$ Number,:Street orPo Box . P.0: '13ox 133Q2 �+ ®F L QUIN`iTj4 City, state, Postal r 661 Palm; Desert, CA 92255. C®MMUN�'�'1(DEVELOPMENT Project Square :Footage 22 sq ft. CitY.APProval By7P11 1 �n yu,AA V1b . Date of City Approval Materials To Be Discarcled: Product Tons' Trash 0:00 Not recyclable Product Tons Asphalt. 0.00 Recyclable : Masonry (broken) 0:00 Recyclable BnckBlock0.00 Recyclable:. Plaster : 0.00 Recyclable Cardboard 0:00 Recyclable scrap Metal 0;00 recyclable Commingled 0.00'R, Tile(floor) 0.00 Recyclable Concrete 0:00 Recyciable. Tile (root) 0.00 Recyclable Drywall 000 Recyclable Wood0.00 Recyclable Donated / Reuse 0:00 Recyclable Landscape Debns. : 0.00 Recyclable . "Desc hbe Items Totals:Rec cie Trash' Projected biversion I. understand it is the property owners res pons submit copies of weight tickets. or recelpts to the District :Environmental Coordinator as these hauls occur:a hereby certify that completion; implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 50% of the jobsite: waste is diverted from landfilling. The remaining matertai will.be recycled or reusWA will divert, forrecycling or re -use, remaining materials generated from the first day of the project through the completion of the project in accordance with this plan. This . DMP is issued In the name of the property. owners) ;and shall remain their property_throughout the construction and/or demolition.project.'A*contrador serving'as agent of the pwner may obtain a DMP for{he:owner. However, the.DMP is still issued tri the name of the property owners) and the owner retains legal responsibility for ensuring that the provisions of the ..',DMP are adhered to. Therope s p p rty.owner(s) and general, be kept informed 'of the diversion progress through bi-monthly reports. if §elf -hauling; all refuse material from this project site must betaken to an approved recyGer or transfer Owner / Developer/ Project Manager / Superintendent Date t