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BPAT2015-0004LICENSED 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 �h, License No.: 594043 Date: Contractor. OWNER -BUILDER DECLA ATION 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 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'' compe tion, as provided for by Section 3700 of the Labor Code, for the performance ofthe, rk for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section f 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, andagree that, if I d become subject to the workers' compensation.provisions of Section 370 of the a r Code, I shall forthwith comply with those provisions. t.t —�D _ Y Date: ' ` Applicant: 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 �tp enter pon the above- mentioned property for'inspection purposes. • / /� �g-1 Date: Signature (Applicant or Agent): I 78-495 CALLE TAMPICO D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011- 77-7011COMMUNITY COMMUNITYDEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT ;1p5phication Date: 4/28/2015 Number: BPATW2015-0004 Owner: Property Address: 57611 INTERLACHEN CHARLIE KNEIP APN: 762180016 576111NTERLACHEN Application Description: PGA WEST, PATIO COVER Property 580 SF LA QUIN RTA, CA 92253 Zoning: Application Valuation: $13,000.00 ^ o CD CTS i Applicant: Contractor: op , AGIIVI RADONILARRY COIA JR DBA 7 SCO STR24 L Ij `76527 CALIFORNIA DR 48-236 VISTA DE NOP � Cif w PALM DESERT, CA 92211 LA QUINTA, CA 92253 Q , z (760)564-5811 a M. Llc. No.: 594043 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 �h, License No.: 594043 Date: Contractor. OWNER -BUILDER DECLA ATION 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 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'' compe tion, as provided for by Section 3700 of the Labor Code, for the performance ofthe, rk for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section f 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, andagree that, if I d become subject to the workers' compensation.provisions of Section 370 of the a r Code, I shall forthwith comply with those provisions. t.t —�D _ Y Date: ' ` Applicant: 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 �tp enter pon the above- mentioned property for'inspection purposes. • / /� �g-1 Date: Signature (Applicant or Agent): I DESCRIPTION, FINANCIAL INFORMATION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 1.75 $122.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY. Total Paid forBLDG CITY STAFF - PER HOUR: $122.50 $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 forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 .$0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK#, CLTD BY Total Paid forELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PATIO COVER, STD, OPEN 101-0000-02404 0 $97.17 $0.00 PAID BY . METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE PATIO COVER, STD, OPEN PC 101-0000-42600 0 $95.72 $0.00 PAID BY ` METHOD RECEIPT # CHECK # CLTD BY. Total Paid forPATIO COVER / COVERED PORCH'/ LATTICE $192.89 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID- PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM; 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 PAID BY - METHOD RECEIPT # CHECK #' CLTD BY y'1 DESCRIPTION. ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP.PC 101-0000-42600 0 $12.09: $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY .Total Paid for PLUMBING FEES: $60.44 $0.00 DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $1.69 $0.00 PAID BY METHOD RECEIPT # CHECK # ..CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $1.69 $0.00 TOTALS: $426.86 00 } G. •.Permit Details PERMIT NUMBER ....... t City of La Quinta BPAT2o1�5'0004 Description: PGA WEST, PATIO COVER 580 SF Type: PATIO COVER Subtype: Status: APPROVED Applied: 1/21/2015 MFA Approved: 3/3/2015 JJO Parcel No: 762180016 Site Address: 57611 INTERLACHEN LA QUINTA,CA 92253 Subdivision: TR 28410-2 Block: Lot: 48 Issued: Lot Sq Ft:.0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $13,000.00 Occupancy Type: Construction Type: Expired: FROM CONSULTANT KAY HENSEL No. Buildings: 0 No. Stories: 0 No. Unites: 0 STRUC RFC 2/2/2015 Details: STRUC: DESIGNED PATIO, 580 SQ. FT. INCLUDING ELEC, FANS, AND GAS FOR BBQ ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 2/2/2015 2/2/2015 STRUC RFC 2/2/2015 RECEIVED PLAN CHECK COMMENTS FROM CONSULTANT KAY HENSEL 2/27/2015 2/27/2015 STRUC APPROVABLE 2/27/2015 RECEIVED PLAN CHECK PICKED UP STEPHANIE KHATAMI 2/4/2015 2/4/2015 Agim picked up plan check items. PLAN CHECK SUBMITTAL MARY FASANO 1/21/2015 1/21/2015 RECEIVED PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 2/12/2015 2/12/2015 RECEIVED SENT TO PLAN CHECK KAY HENSEL 1/21/2015 1/21/2015 STRUC TO YOUNG - DUE 2/4/2015 CONSULTANT Printed: Tuesday, April 28, 2015 1:51:28 PM 1 of 4 l SYSTEMS Printed: Tuesday, April 28, 2015 1:51:28 PM 2 of 4 SYSTfldS FINANCIAL INFORMATION CALLED RADOM DESIGN TO INFORM HIM PLANS READY FOR TELEPHONE CALL JIM JOHNSON 2/3/2015 HOURLY PLAN CHECK - 101-0000-42600 1.75 $122.50 $0.00 2/3/2015 YES Total Paid for BLDG CITY STAFF - PER HOUR: $122.50 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 CORRECTIONS TELEPHONE CALL JIM JOHNSON 3/3/2015. 3/3/2015 BSA: CALLED AGIM RADOM THAT THE PLANS ARE READY TO. ISSUE. 101-0000-42403 0 $24.17 CONDITIONS CONTACTS DEVICES, FIRST 20 PC 101-0000-42600 NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX. EMAIL APPLICANT AGIM RADONI 76527 CALIFORNIA DR PALM DESERT CA 92211 CONTRACTOR LARRY COIA JR DBA 7 C'S CONSTR 48-236 VISTA DE NOPAL LA QUINTA CA 92253 OWNER CHARLIE KNEIP 57611 INTERLACHEN LA QUINRTA CA 92253 Printed: Tuesday, April 28, 2015 1:51:28 PM 2 of 4 SYSTfldS FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT. PAID PAID DATE RECEIPT# CHECK #- METHOD PAID BY BY HOURLY PLAN CHECK - 101-0000-42600 1.75 $122.50 $0.00 YES Total Paid for BLDG CITY STAFF - PER HOUR: $122.50 $0.00 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 - Total Paid forELECTRICAL: $48.34 $0.00 PATIO COVER, STD, 101-0000-42404 0 $97.17 $0.00 OPEN PATIO COVER, STD, 101-0000-42600 0 $95.72 $0.00 OPEN PC Total Paid for PATIO COVER / COVERED PORCH / LATTICE $192.89 $0.00 GAS SYSTEM, 1-4 101-0000-42401 07$12.09 $0.00 OUTLETS Printed: Tuesday, April 28, 2015 1:51:28 PM 2 of 4 SYSTfldS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT #.. CHECK # . METHOD PAID BY ` CLTD RETURNED STATUS REMARKS REVIEW TYPE REVIEWER - . DUE DATE BY GAS SYSTEM, 14 101-0000-42600 0 $24.17 $0.00 DATE NON-STRUCTURAL OUTLETS PC 1/21/2015 2/4/2015 2/3/2015 REVISIONS REQUIRED SEE ATTACHED IST P/C CORRECTIONS REQUIRED PLANNING WALLY NESBIT 1/21/2015 2/4/2015 WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 KATHRYN 1/21/2015 2/4/2015 2/2/2015 REVISIONS REQUIRED STRUC RFC 2/2/2015 INST/ALT/REP STRUCTURAL SAMUELS WATER SYSTEM 101-0000-42600 0 $12.09 $0.00 NON-STRUCTURAL JIM JOHNSON 2/12/2015 2/26/2015 2/17/2015 INST/ALT/REP PC APPROVED NON STRUC APPROVED PATIO COVER KATHRYN 2/12/2015 2/26/2015 2/27/2015 APPROVED Total Paid forPLUMBING FEES: $60.44 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $1.69 SAMUELS Total Paid forSTRONG MOTION INSTRUMENTATION SMI $1.69 $0.00 TOTALS:•i INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES FINAL" Printed: Tuesday, April 28, 2015 1:51:28 PM 3 of 4 V? SYSTF.lv1S REVIEWS RETURNED STATUS REMARKS REVIEW TYPE REVIEWER - SENT DATE DUE DATE NOTES DATE NON-STRUCTURAL JIM JOHNSON 1/21/2015 2/4/2015 2/3/2015 REVISIONS REQUIRED SEE ATTACHED IST P/C CORRECTIONS REQUIRED PLANNING WALLY NESBIT 1/21/2015 2/4/2015 2/2/2015 1 READY FOR APPROVAL SETBACKS / HT OK ASSIGNED TO WALLY NESBIT. KATHRYN 1/21/2015 2/4/2015 2/2/2015 REVISIONS REQUIRED STRUC RFC 2/2/2015 STRUCTURAL SAMUELS NON-STRUCTURAL JIM JOHNSON 2/12/2015 2/26/2015 2/17/2015 APPROVED APPROVED NON STRUC APPROVED PATIO COVER KATHRYN 2/12/2015 2/26/2015 2/27/2015 APPROVED STRUCTURAL SAMUELS Printed: Tuesday, April 28, 2015 1:51:28 PM 3 of 4 V? SYSTF.lv1S Printed: Tuesday, April 28, 2015 1:51:28 PM 4 of 4 SYSTEMS Bin # City of La Quin to . ' Building &r Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Project Address:.5-7_9,11 %4,rEX_C,4CH C �Lr Owner's Name: Q'r 4 ICl/ C' ( f A. P. Number: .76.2 -- )80 —of6 —f Address: S77-611 /41 7_U_ 44 CA -e-- Legal Description: N6. 'c;7/ 6-T 7-R, MYO—? C 4'-P City, ST, Zip: t,,4 Contractor: CS CO�JT/crc �7C,li • telephone:h ne: Address: Project Description: City, ST, Zip: Telephone: 7C0 -�'�I � .i-Z%'Z <<',;.:::...::..:�•.::;.;.;;r.::::..�:::a.. r State Lie. # : City Lie. #: Arch., Engr., Designer: �OOLlr pC-f(G . 'Address: City,, ST, Zip: f1141-1 D611647 Telephone: '760_dJ6F.7- Z(-4` Construction Type: Occupancy: State Lie.<:..;;.;:.,.: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: ACf!`i 6 Oktl Sq. Ft•: S80 # Stories: T/Units: Telephone #,of Contact Person: 7670 - % e Estimated Value of Project: 11©O o - APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets PIan Check submittc v p2/ Item Amount Structural Calcs. p< Reviewed, read for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance, Title 24 Calcs. Plans picked up Aez-1 AA Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°' Review, ready for corrections/issue Electrical Subcontactor 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 ------------------- Se11061 Fees Total Permit Fees 7-;l3". )��s :SCS IaP oU YOUNG' x .: ENGINEERING �. a o a Q a F R V i .•, £. a • 4S £� i `9,.'" �r NZ x WIOWW°W tt Letter of Transmittal To: City of La Quinta 'Today's Date: 2-27-15 78-495 Calle Tampico City Due Date: 2-26-15 La Quinta, CA 92253 Project Address: 57-611 Interlachen Attn: Kay Plan Check.#: BPAT 2015-0004 Submittal: ® 1St ❑ 4th ❑ 2nd ❑ 5th - ❑ 31 ❑ Other: Weare forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Descriptions: Includes: # Of Descriptions: Copies: Copies: ❑ Structural Plans ® 1 Revised Structural Plans ® 2 Structural Calculations ❑ Revised Struct. Calcs Truss Calculations floor ® 1 ❑ Revised Truss and Roof ❑ Soils Report ❑ Revised Soils Report ®, 1 Structural Comment List/ Responses ElApproved Structural Plans ® 1- Redlined Structural Plans ❑ Approved Structural Calcs ❑ Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ OheH rr� Ra — Comments: _, Structuraln co tent is approvable. FEB 7 Z W If you have any questions, please call. ,LA CITY OF QUINTA Time = 0.75 HR cOMMUNIM ThisMaterial Sent for: ❑ _ Your Files ® Per Your Request ❑ Your Review ❑ Approval ❑ Checking ❑ At the request of: Other: ❑ 'BY: Kathryn Samuels Palm Desert Office: ® (760) 772=5107 . Other: ❑. .