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BRES2015-021078-495 CALLE TAMPIC61 LA QUINTA, CALIFORNIAt9225 Tity, 44Q„rKrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: 1 Property Address: c - APN: 'i 9053 02 TO 41l -4o cals&TG cr Application Description: DARBY ESTATES/PLAN 1X EXTENDED PATIO OPTION Property Zoning: 1 _O� /_ 6 Application Valuation: $1,423.10 1" Applicant: G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 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 Licena is in full force and effect. License la Lice No.::CONV:14 5281 1 4 347 Date: fU I Contractor: ` OWNER-BUILDE DECLARAT/ N 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 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 ynder Sec. . P.&P. . forItis reason Date: Owr.v 6 —CONSTRDING AGE I hereby affirm under penalty of peere is a co ruction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. Q. Lender's Name: Lender's Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760)777-7153 Date: 6/18/2015 Owner: ADOM VENTURES 77-682 COUNTRY CLUB DR. STE A3 PALM DESERT, CA 92211 Contractor: G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 (760)969-1400 Llc. No.::CONV:140528101254140347 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: 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 370 the Labo de, I shall forthwith comply wililh% ttfb pr visions. Date: (1/ / I �J Aoolicant: 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. 1 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 stays laws r mg to ilding construction, nd h eby aithorize representatives of this 4y toe er upon the ab ve- mention p Open I rection purposes. Date: `( ,D/ Signature (Applicant or Agent): FINANCIAL INFORMATION DESCRIPTION ACCOUNTQTY AMOUNT PAID PAID DATE HOURtY-PWN CHECK - YES 101-0000-42600 2 $140.00 $140.00 6/18/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA Total Paid for BLDG CITY STAFF - PER HOUR: $140.00 $140.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/18/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $1.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 6/18/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 6/18/15 -PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA Total Paid for ELECTRICAL: $48.34 $48.34 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $50.71 $50.71 6/18/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA Total Paid forNEW CONSTRUCTION PERMIT: $50.71 $50.71 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $70.99 $70.99 6/18/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA Total Paid forNEW CONSTRUCTION PLAN CHECK: . $70.99 $70.99 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.50 6/18/15 PAID BY METHOD RECEIPT # CHECK # CLTD BY G H A ENTERPRISES INC CHECK R7164 48371 MFA Total Paid forSTRONG MOTION INSTRUMENTATION SMI $0.50 $0.50 Description: DARBY ESTATES/PLAN 1X EXTENDED PATIO OPTION CHRONOLOGY CHRONOLOGY TYPE Type: BUILDING, RESIDENTIAL Subtype: DWELLING -SINGLE Status: APPROVED Applied: 6/3/2015 MFA NOTE FAMILY DETACHED 6/11/2015 Approved: 6/18/2015 JJO Parcel No: 609052002 Site Addres QUINTA,CA(,922�53,4 PLAN CHECK COMMENTS Subdivision: Block: Lot: 24 — 3 Q� � 7 E7 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: FiA ed: Valuation: $1,423.10 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 RECEIVED PATIO EXTENSION TO BE USED AS AN OPTION FOR Details: FIVE FOOT PATIO OPTION EXTENTION TO EXISTING PATIO PLAN 1X LOT 6. per 2013 CRC CODES MARY FASANO ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES NOTE JIM JOHNSON 6/11/2015 6/18/2015 PLAN CHECK COMMENTS FROM CONSULTANT JIM JOHNSON 6/18/2015 6/17/2015 RECEIVED RECEIVED PATIO EXTENSION TO BE USED AS AN OPTION FOR PLAN CHECK SENT TO MARY FASANO 6/3/2015 6/3/2015 PLAN 1X. SENT REVISION PLANS AND ORIGINAL PLAN 1X TO OUTSIDE PC YOUNG ENGINEERING. TELEPHONE CALL JIM JOHNSON 6/18/2015 6/18/2015 CALLED LAKEN JONES TO INFORM HIM PLANS ARE READY TO ISSUE. CONDITIONS Printed: Thursday, June 18, 2015 12:41:08 PM 1 of 3 C ........ FINANCIAL INFORMATION • CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID' PAID DATE RECEIPT # CHECK # METHOD PAID BY NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989 R7164 - CHECK G H A EN DRIVE STE C CITY 3747 CONTRACTOR G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989 DEVICES, FIRST 20 101-0000-42403 0 $24.17 DRIVE STE C CITY R7164 3747 CHECK G H A ENTECRPRISES MFA OWNER ADOM VENTURES 77-682 COUNTRY CLUB PALM DESERT CA 92211 1 (760)200-5989 IN DR. STE A3 101-0000-42600 0 $24.17 $24.17 6/18/15 R7164 FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID' PAID DATE RECEIPT # CHECK # METHOD PAID BY BY HOURLY PLAN CHECK - 101-0000-42600 2 $140.00 $140.00 6/18/15 R7164 48371 CHECK G H A ENTERPRISES MFA YES INC Total Paid for BLDG CITY STAFF - PER HOUR: $140.00 $140.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 6/18/15 R7164 48371 CHECK G H A EN MFA INECRPRISES Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 6/18/15 R7164 48371 CHECK G H A ENTECRPRISES MFA IN DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 6/18/15 R7164 48371 CHECK G H A ENTECRPRISES MFA IN Total Paid for ELECTRICAL: $48.34 $48.34 NEW CONSTRUCTION 101-0000-424000 $50.71 $50.71 6/18/15 R7164 48371 CHECK G H A ENTERPRISES MFA PERMIT INC Total Paid for NEW CONSTRUCTION PERMIT: $50.71 $50.71 NEW CONSTRUCTION 101-0000-42600 0 $70.99 $70.99 6/18/15 R7164 48371 CHECK G H A ENTERPRISES MFA PLAN CHECK INC Total Paid forNEW CONSTRUCTION PLAN CHECK: $70.99 $70.99 Printed: Thursday, June 18, 2015 12:41:08 PM 2 of 3 _••___ DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY - CLTD BY SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.50 6/18/15 R7164 48371 CHECK G H A ENTERPRISES MFA INC Total Paid forSTRONG MOTION INSTRUMENTATION SMt $0.50 $0.50 PARENTPROJECTS REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER SENT DATE DUE DATE NOTES DATE MADE NEW MOCK UP SHEET INCLUDING NON-STRUCTURAL - JIM JOHNSON 6/3/2015. 6/17/2015 6/11/2015 APPROVED NEW OPTION FOR OPTIONAL PATIO EXTENTION. OF 107 SQ. FT. PUT 2 WK PLAN 1X MOCK UP SHEET IN DARBY ESTATE MOCK UP FOLDER. YOUNG 6/3/2015 6/17/2015 6/17/2015 READY FOR APPROVAL STRUCTURAL - 2 WK ENGINEERING BOND INFORMATION Printed: Thursday, June 18, 2015 12:41:08 PM 3 of 3 AcIpw .,___.,_