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13-1568 (RER)78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: Applicant: A & M CONSTRUCTION 78070 CALLE CADIZ LA QUINTA, CA 92253 T-iht 4 XP Qubtz COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT RER-13-1568 54711 EISENHOWER DR 774284041 HENDERSON / INSTALLATION OF NEW WINDOW IN 1ST FLOOR CMU WALL $2,500.00 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 a Business and Professions Code, and my License is in full force and effect. License Class: B. C10 License No.: 746198 K Date l45 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 ($500).: (_) 1, 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.). (1 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 I am exempt under Sec. . B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY 1 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: Owner: TERRY HENDERSON VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 54711 EISENHOWER DR LA QUINTA, CA 92253 Contractor: A & M CONSTRUCTI( PO BOX 366 LA QUINTA, CA 9225 (760)564-4832 Llc. No.: 746198 Date: 6/11/2015 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' compens , as provided for by Section 3700 of the Labor Code, for the performance of the r r 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 polity 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, Y I should become subject to the workers' compensation provisions of Section 37 0 of the Labor Code, I shall forthwith comply with those provisions. Datei(D 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 sta aws rter upon elating to building construction, and hereby authorize representatives of this ci o enthe above- mentioned property for inspection purposes. Date: I Signature (Applicant or Agent): ` C� FINANCIAL .• l• DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE HOURLY PLAN CHECK - YES 101-0000-42600 3 $210.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BLDG CITY STAFF - PER HOUR: $210.00 $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. SMI - RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI $0.50 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, NEW, FIRST 1 101-0000-42400 0 $60.91 $0.00 PAID BY METHOD RECEIPT # CHECK # 'CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DOOR/WINDOW, NEW, FIRST 1 PC 101-0000-42600 .0 $59.46 $0.00 .PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $120.37 $0.00 TOTALS:00 Description: HENDERSON / INSTALLATION OF NEW WINDOW IN 1ST FLOOR CMU WALL Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED Applied: 12/5/2013 Approved: 6/10/2015 AOR Parcel No: 774284041 Site Address: 54711 EISENHOWER DR LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: Lot: 12 Issued: UNIT 28 EXTENSION GRANTED - PERMIT FEE CHANGED TO REFLECT Lot Sq Ft: Building Sq Ft: Zoning: Finaled: Valuation: $2,500.00 Occupancy Type: Construction Type: Expired: No. Buildings: No. Stories: No. Unites: Details: INSTALLATION OF NEW TWO (2) FOOT BY THREE (3) FOOT WINDOW IN CMU WALL AT 1ST FLOOR ROOM. THIS PERMIT DOES NOT INCLUDE REVIEW OR APPROVAL FOR BEDROOM EMERGENCY ESCAPE AND RESCUE OPENING. 2013 CALIFORNIA RESIDENTIAL CODE. ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES.` EXTENSION GRANTED - PERMIT FEE CHANGED TO REFLECT PLAN CHECK/PERMIT UPDATED SCHEDULE AND REVISED ENGINEERED DETAILING A) ORTEGA 6/9/2015 6/10/2015 APPROVED BASED ON ENGINEERS RECOMMENDATION AND EXTENSION NO CHANGE TO REFERENCED STANDARDS BETWEEN 2010 AND 2013 CALIFORNIA RESIDENTIAL CODE. SITE VISIT TOM HARTUNG 11/24/2014 11/24/2014 visited site to discuss window project with Terry Henderson Called Terry Henderson to inform her that permit application extended to 2/6/2015 and that plans were approved and TELEPHONE CALL TOM HARTUNG 11/24/2014 11/24/2014 ready to go. All the City needs is contractor info prior.to issuance CONDITIONS Printed: Thursday, lune 11, 2015 2:20:01 PM 1 of 3 CRSYSTEMS FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY - BY HOURLY PLAN CHECK - 101-0000-42600 3 $210.00 $0.00 YES Total Paid for BLDG CITY STAFF - PER HOUR: $210.00 $0.00 BSAS SB1473 FEE 1 101-0000-20306 1 0 1 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: SMI -RESIDENTIAL 101-0000-20308 0 $0.50 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMt $0.50 $0.00 DOOR/WINDOW, NEW, 101-0000-42400 0 $60.91 $0.00 FIRST 1 DOOR/WINDOW, NEW, 101-0000-42600 0 $59.46 $0.00 FIRST 1 PC Total Paid for WINDOW/SLIDING GLASS $120.37 $0.00 DOOR/FENESTRATION: TOTALSi. $331.87 06 INSPECTIONS __. PARENT'PROJECI'S'-' Printed: Thursday, June 11, 2015 2:20:01 PM 2 of 3 CRsysiEMs _KEVIEWTYPE—'"REVIEWER— -SENT'DATE'—DUE"DATE"` DATE —STATUS "'""REMARKS'""`"'" NOTE REVISION 1: CONSTRUCTION MATERIAL CHANGE, REVISED DETAIL PROVIDED AND REVIEWED NON-STRUCTURAL - REVISION 1: FRAME AGAINST PREVIOUSLY APPROVED STRUCTURAL AJ ORTEGA 6/9/2015 6/10/2015 6/10/2015 APPROVED 1 WK MATERIAL CALCULATIONS FOR CHANGE OF PROPOSED STEEL ' FRAME TO WOOD WITH WOOD HEADER„ DESIGN ACCEPTED PER ENGINEER RECOMMENDATIONS. Printed: Thursday, lune 11, 2015 2:20:01 PM 3 of 3 CM SYS7Eti1S I Bin # Qty of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777 -7012 - Building Permit Application and Tracking Sheet mit # Project Address: -Owner's Name: A. P. Number: Address: 519(2& Legal Description: City, ST, Zip: adlym zg-3 Contractor: Address: Telephone: - Project Description: AuleT,- City, ST, Zip: dim -Wjkj�— -M "ZM4 Telephone: State Lie. # City Lie. Arch., Engr., Designer: Address: E. Rob i9d A 4 City, ST, Zip: meo2 gr Telephone: q (4-4 State Lic. #: C. '7 Li - 111 Construction Type: AWMr Occupancy: Oter Project type (circle one): New Add'n Repair Demo Name of Contact Person: Sq. Ft.: # Stories: # Units: Telephone #,of Contact Person:e Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Rcq'd Rcc'd TRACKING PERMIT FEES Plan Sets Plan Check submitted 12-141 ntem Amount Structural CaIcs. Reviewed, ready for corrections filly Plan Check Deposit Truss Cales. Called Contact Person Iz.jj Plan Check Balance Title 24 Calcs. Plans picked up ---D�l `IOU (Cl Construction Flood plain plan Plan's resubmitted" Mechanical Grading plan .2"! Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted 04�, i2gk A, Grading IN HOUSE:- Review, ready for correction!0/is ue Developer Impact Fee .Planning Approval Called Contact Person, AN A.I.P.P. Pub. Wks. Appr Date of permit issue Schodi Fees Total Permit Fee's 4Wt3 ---t -� ro