BRES2015-0256V,
78-495 CALLE TAMPICO Ct 0 D ��NUCl/
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2015-0256 D /L1\
Property Address: 54917 FIRESTONE
APN: 775051076
Application Description: MOORE RESIDENCE ADDITION / RE DEL JUL 3 0 2015 I
Property Zoning:
Application Valuation: $15,000.00
CITY OF LA QUINTA
Applicant:
BOB EDWARDS CONSTRUCTION INCOR
51-455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Busin ss and Professions Code,
and my License is in full force and effect.
License Clas : B, C1,6License No.: 6 85
`/
Date: t W �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).:
( ) 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.).
( )1, 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:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/29/2015
,ner:
M & RUTH ANN MOORE
I17 FIRESTONE
QUINTA, CA 92253
BOB EDWARDS CONSTRUCTION INCOR
51-455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
(760)777-8202
Llc. No.: 684857
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 tlilt, if I should become subject to the
workers' comp nsation provisions of Se ' n 700 f e•L or Code, I shall forthwith
comply w h thtse provisions.
Date%
: ` ?Q - 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 larel g to building
construction, and hereby authorize representatives of th' it t e t �on the above.
mentioned �rjoypee4yrfor inspection purposes. '
Date: �1'�! 1� Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION
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 forADDITION: $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
Total Paid for BLDG CITY STAFF - PER HOUR: $87.50 $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
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 1,0005F, 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
APPLIANCE REPAIR/ALTERATION
101-0000-42402
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
' ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
APPLIANCE REPAIR/ALTERATION PC
101-0000-42600
0
$4.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for MECHANICAL: $16.92 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
ROOF DRAIN
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
ROOF DRAIN PC
101-0000-42600
0
$12.09
$0.00
- PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $24.18 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SMI - RESIDENTIAL
101-0000-20308
0
$1.95
$0.00
PAID BY
METHOD.
RECEIPT #
CHECK #
CLTD BY
Total Paid forSTRONG MOTION INSTRUMENTATION SMt $1.95 $0.00
TOTALS:00
Permit Dexaiis PERMIT NUMBER
r � BRES2015 00256
City of La Quinta
Description: MOORE RESIDENCE ADDITION / REMODEL
f' t
_d 0 A.' a,+y.. 9 ,gym . }� .:., .P$ ! p v -
a^s- _ .}� >� J-, •' T} , s'Ek
Type: BUILDING, RESIDENTIAL
Subtype: ADDITION
Status: APPROVED
Applied: 7/6/2015 EVA
Approved: 7/29/2015 JJO
Parcel No: 775051076 Site Address: 54917 FIRESTONE LA QUINTA,CA 92253
Subdivision: TR 21846-1
Block: Lot: 1
NOTE
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0
Zoning:
Finaled:
Valuation: $15,000.00
Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0
No. Unites: 0
7/21/2015
Details: ENCLOSE ATRIUM 128 SQ. FT. ADDITIONPER 2013 CRC CODES
RECEIVED
__j Applied to Approved
x n _
-. z( .'t' kf+ •{.l -`�" C "'! .:•-' - ti -RK 57 w.;.> ' ,. t+ t i. Y+�,'�, F+y, ,:Y 5, += . „ i' K ,r}�s S'yt%' i."k `'
-&-&N
f' t
_d 0 A.' a,+y.. 9 ,gym . }� .:., .P$ ! p v -
a^s- _ .}� >� J-, •' T} , s'Ek
t •{:.,
CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES
NOTE
JIM JOHNSON
7/15/2015
7/21/2015
NOTE
KAY HENSEL
7/27/2015
7/27/2015
PLANS PULLED FROM JIM'S DESK AND PROCESSED
PLAN CHECK COMMENTS
FROM CONSULTANT
MARY FASANO
7/20/2015
7/21/2015
RETURNED FROM YOUNG STRUCTUAL APPROVED
RECEIVED
PLAN CHECK PICKED UP
PHILIP JUAREZ
7/23/2015
7/23/2015
PLANS PICKED UP BY GABRIEL RIOS.
PLAN CHECK SUBMITTAL
ED VASQUEZ
7/6/2015
7/6/2015
RECEIVED
RESUBMITTAL
PHILIP JUAREZ
7/24/2015
7/24/2015
SENT TO PLAN CHECK
KAY HENSEL
7/6/2015
7/6/2015
STRUC TO YOUNG - DUE BACK 7/20/2015
CONSULTANT
Printed: Wednesday, July 29, 2015 2:17:09 PM 1 of 4
CL U U IJ SYSTEMS
Permit Detail�
City of la Qui— a
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CLTD
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY
BY
PERMIT
NUMBER
0
CALLED GABRIEL RIOS TO INFORM HIM PLANS ARE READY
TELEPHONE CALL
JIM JOHNSON
7/21/2015
B R ES�2015-025b
7/21/2015
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CLTD
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY
BY
ADDITION, EA
101-0000-42400
0
CALLED GABRIEL RIOS TO INFORM HIM PLANS ARE READY
TELEPHONE CALL
JIM JOHNSON
7/21/2015
ADDITIONAL 500 SF
7/21/2015
ADDITION, EA
FOR CORRECTIONS
TELEPHONE
$17.40 $0.00
JIM JOHNSON
7/29/201{5
7/29/2015
CALLED JOE TO INFORM HIM PLANS ARE READY TO ISSUE
SCALL
?� ti 2'i�.•':�'��r. ;:,.$
�£'}'ir,`N1 1!.. Y'
C.i '�:: Ztt.+ 4�'S,
0 � 0
'a'
fi`n;t.s-.,x,•.� .:fir-"� p� ..;":
L.
„rl�.
CONDITION
0
DATE DATE
CONTACT
DATE ADDED
STATUS
REMARKS NOTES
TYPE
- REQUIRED SATISFIED
$171.14 $0.00
READY TO ISSUE
PC
7/23/2015
PENDING
HOURLY PLAN CHECK -
101-0000-42600
CHECKLIST
$87.50
$0.00
;. .r L '.''
6 m . ,r• �'�n y fray` s. .!
! fj � j 7; wsYs
Y ' a `M1I, (Y;'^ ) -eG f ^ri �. �S £. 'wi : �jP j�•� t
-,eA4�,
..
'1�`- N`Y .'x'4• .M ,4,r ,/t :.Y
NAME TYPE
NAME
ADDRESSI
CITY
STATE ZIP PHONE, FAX EMAIL
APPLICANT
BOB EDWARDS CONSTRUCTION
517455 DESERT CLUB
LA QUINTA
CA
92253
INCOR
DRIVE
CONTRACTOR
BOB EDWARDS CONSTRUCTION
51-455 DESERT CLUB
LA QUINTA
CA
92253
INCOR
DRIVE
OWNER
TOM & RUTH ANN MOORE
54917 FIRESTONE
LA QUINTA
I CA
1 92253
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. 6.. ,,;`j 'i ••n' r ter" �" �„'= •r :-{i : . ? r
CLTD
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY
BY
ADDITION, EA
101-0000-42400
0
$62.36 $0.00
ADDITIONAL 500 SF
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 forADDITION: $371.73 $0.00
HOURLY PLAN CHECK -
101-0000-42600
1.25
$87.50
$0.00
YES
Total Paid for BLDG CITY STAFF - PER HOUR: $87.50 $0.00
Printed: Wednesday, July 29, 2015 2:17:09 PM 2 of 4
FU LJ SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
FINAL" BLD
PARENT PROJECTS
Printed: Wednesday, July 29, 2015 2:17:09 PM 3 of 4
SYSTEMS
MMETHOD
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $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 forELECTRICAL - NEW CONSTRUCTION: $192.89 $0.00
APPLIANCE
101-0000-42402
0
$12.09
$0.00
REPAIR/ALTERATION
APPLIANCE
101-0000-42600
0
$4.83
$0.00
REPAIR/ALTERATION PC
Total Paid forMECHANICAL: $16.92 $0.00
ROOF DRAIN
101-0000-42401
0
$12.09
$0.00
ROOF DRAIN PC
101-0000-42600
0
$12.09
$0.00
Total Paid for PLUMBING FEES: $24.18 $0.00
SMI -RESIDENTIAL
101-0000-20308
0
$1.95
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SM! $1.95 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
FINAL" BLD
PARENT PROJECTS
Printed: Wednesday, July 29, 2015 2:17:09 PM 3 of 4
SYSTEMS
Permit Details PERMIT NUMBER
BRES2015-0256
City of La Quinta
'REVIEW'TYPE—
TREVIEWEK—
-SENT-DATE-
—DUE'DATE
DATE
"- STATUS—
REMARKS:
NOTES
NON-STRUCTURAL -
JIM JOHNSON
7/6/2015
7/20/2015
7/15/2015
REVISIONS REQUIRED
0
2 WK
NEW CITY TRANSMITTAL
DOC 7/20/2015
KATHRYN SAMUELS STRUCTURAL
BRES 2015-0256
I
0
STRUCTURAL - 2 WK
YOUNG
7/6/2015
7/20/2015
7/20/2015
READY FOR APPROVAL
ENGINEERING
NON-STRUCTURAL -
JIM JOHNSON
7/24/2015
8/7/2015
7/29/2015
APPROVED
JIM TOLD ME TO PUT ON HIS DESK
2 WK
.•; ,R, ..f T k�{ LS' ""�-`�' + y } '�� a71 i 1 -.. •ro X_ �.!'� of 1, 'Q ..s :: f
Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED
DOC 7/15/2015
JIM JOHNSON 54-917 FIRESTONE.docx
54-917 FIRESTONE.docx
0
BRES2015-0256 SCHOOL
BRES2015-0256 SCHOOL
DOC 7/29/2015
JIM JOHNSON
FEES.pdf
FEES.pdf
0
1ST REVIEW -
NEW CITY TRANSMITTAL
DOC 7/20/2015
KATHRYN SAMUELS STRUCTURAL
BRES 2015-0256
I
0
TRANSMITTAL
(ist).pdf
Printed: Wednesday, July 29, 2015 2:17:09 PM 4 of 4
ti7Ll L.1 IJV SYSTEMS
Bin #
City Of La Quint?
Building &r Safety Division
P.O. Box 1504, 78-495 Calfe Tampico
La Qulnta, CA 92253 - (760) 777-7012
02 � Building Permit Application and Tracking Sheet
Permit #
_
"IFIGS�-D l�>—
Proj6et Address:
Owner's Name:
bb
A. P. Number: ] _ ��
Address:
Legal Description:
City, ST, Zip. L-1, 1'
Contractor:
4 }y,
Telephone; ?c'a%" • ,' �a?"�3 #
Address: �j- �-
Project Description: 2�
City, ST, Zip:
v
Telephone: G — 1 ��
<<Y +"a" r .1'`
,.
State Lie. # : ^ 1
City Lie. !,:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lie. #: --
""::z2s�%
c' r
3Q:
z`"
ConstructionType: Occupancy: '3.
. Project type circle one New dd' Alter Repair Demo
Name of Contact Person: �u
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project: 5
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Z
Plan Check submitted
No
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
'Called Contact Person
Plan Check Balance,
Title 24 Cafes.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"d 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:-
''d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
1
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 fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $0.00 X 128 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 this proposed project may now be issued.
Fees Paid By Exempt/ Robert Edwards Check No.
Bank Name/Recipient of Certificate Telephone
Funding Exempt
BY Dr. Gary Rutherford
Superintendent
1 f
Fee collected /exempted by Kelly Jones Payment Recd
,,:Over/Und-_r
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest 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: This Document NOT VALID without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy -Accounting
YOUNG .
.X x ENGINEERING
zi'd^m" /
,?2Y _Wi
5111
Letter of Transmittal
To: City of La Quinta Today's Date:
7-20-15
78-495 Calle Tampico City Due Date:
7-20-15
La Quinta, CA 92253 Project Address:
54-917 Firestone
Attn: Kay Plan Check #:
BRES 2015-0256
Submittal: ® 1st
❑
4th
❑ 2nd
❑
55th
❑ 3'd
❑
Other:
We are forwarding: ® By Messenger ❑ By
Mail (Fed Ex or UPS)
❑ Your Pickup
Includes: # Of Descriptions: Includes:
# Of
Descriptions:
Copies:
Copies:
® 1 Structural Plans
❑
Revised Structural Plans
® 1 Structural Calculations
❑
Revised Struct. Calcs
❑ Truss Calculations Floor
❑
Revised Truss
and Roof
❑ Soils Report
❑
Revised Soils Report
❑ Structural Comment List
❑
Approved Structural Plans
❑ Redlined Structural Plans
❑
Approved Structural Calcs
❑ Redlined Structural Calcs
❑
Approved Truss Calcs
❑ Redlined Truss Calcs
❑
Approved Soils Report
❑ Redlined Soils Reports
❑
Other:
Comments: Structural content is approvable.
—
If you have any questions, please call.
Time = 1.25 HR
This Material Sent for:
UNITYDEVELOPMEI
❑ Your Files
®
Per Your Request
❑ Your Review
❑
Approval
❑ Checking
❑
At the request of:
Other: ❑
BY: Kathryn Sarriuels
Palm Desert Office: ® (760) 772-5107
Other: ❑