BRES2015-025478-495 CALLE TAMPICO D VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Application Number:
BRES2015-0254
Owner:
c
Property Address:
53443 VIA MALLORCA
MARK ANDERSON
APN:
777390008
8014 AVALON PL
C
C7
Application Description:
ANDERSEN / REMODEL INTERIOR/EXTERIOR
MERCER ISLAND, WA 92253
O
Property Zoning:
Application Valuation:
$25,000.00
ry
gg
Applicant:
Contr
BENJAMIN HERTZ
JEHA CONSTRUCTION, MICHAEL
C
645 OLEANDER RD
'0 OUTSIDE CITY LIMITS
PALM SPRINGS, CA 92264
LA QUINTA, CA 92253
(925)250-4038
Llc. No.: AEC320
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: License No.: AEC320 y
i
Date: Contract :
OWNER -BUILDER DEC ATION
I hereby affirm under penalty of perjury that I am !.pt
from a Contractor's State
License Law for the following reason (Sec. 7031.5, Busine 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. . BAP.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'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of - e work foLwhirb tbis.permit is issued.
ave and will maintain workers' compensation insurance,.as required by
Sec 700 f the Labor Code, for the performance of the work for which this permit
is issue•. My orkers' 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 sub'
workers' compensation provisions of Section 3700 of the I shall forthwit
comply wih th a provisions.
Dat Applicant:
WA : 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 com ly with all city and county ordinances and state laws relating to building
construction, d h reby authorize representatives of this city to enter upon the above
mentionpd'pf pe* for inspection purposes.
Date: -'.4-1 M4144 Signature (Applicant or
FINANCIAL .• I.
h J'ygDESCRIPTION }
"� »
AC000NT � ¢ QTYt ';"r AMOUNV4,,p f rw t�,
PAID DATE
A¢ ,PAID
3P
BSAS SB1473 FEE
101-0000-20306 0 $1.00 $0.00
t PAID BY k r °
METHOD,; zs`,',;_ "�h °RECEIPT!# . a "` t CHECK #1 j,
CLTD BY
Y 0. _ C
s
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
`
ACCOUNT ;tg
TY
.t f PAID
PAID DATEDESCRIPTION
r .te a- mo
,,.AMOUNT,*
OTHER ELECTRICAL EQUIPMENT
101-0000-42403
0
$145.02
$0.00
PAIDtyBY$
METH0D _ �z
s;.RECEIPT.#' ""m
„<+4 CHECK #
CLTD BY i'
I
Fra DESCRIPTION Y.
`�`'� ACCOUNTs� T $
QTY':,&AMOUNT
'PAID
PAID BATE'
E" , #s
6
OTHER ELECTRICAL EQUIPMENT PC
101-0000-42600
0
$145.02
$0.00
x PAID BY '¢y +
METHOD,'...,
€ ` RECEIPTt#j4
CHECK #,
BYs*,
r f •. i
M
jCLTD
Total Paid for ELECTRICAL: $290.04 $0.00
SDESCRIPTION'
ACCOUNT s
QTY
`' AMOUNTS
PAIDMATE
{PAID
REMODEL, EA ADDITIONAL 500 SF
101-0000-42400
0
$21.75
$0.00
PAD BY :>rt
;AI
METHODS >
x� I RECEIPT #
CHECK #, ;
'"CLTD BY,
.. - �`
r
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r"�
` AMOUNTiDESCRIPO
PAID
PAID DATE
yyx4 . . q¢,
iC-
REMODEL, EA ADDITIONAL 500 SF PC
10170000-42600
0
$17.40.
$0.00
x' k fPAIDsBYMETHOD
'RECEIPT # I
,°s CHECK #I
CLTD BY-.°
,
DESCRIPTION ;Y .., ` . E
. µACCOUNT i':
QTY
AMOUNT '-;
PAID 4p
PAID DATE
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
$0.00
-_ r%.
PAID, BY':'
�
METHOD s
c''RECEIPT #
a.
CLTD BY
r
.'.
A000UNT Efi
£QTY
AMOUNT
s�' ;�PAIDI
PAID DATE
REMODEL, FIRST 500 SF PC
101-0000-42600
0
$134.88
$0.00
- 3£PAID BYE s;`Ya
METHOD
RECEIPT #
CHECK # a
CLT D -BY%`
R. ,
Y
q
Total Paid for REMODEL: .. $223.34 $0.00
DESCRIPTION
a ACCOLINT r xA
.:QTY
rt' AMOUNT"`::,x
> PAID £j'a
;PAID DATE
'r
s F
,
,
SMI - RESIDENTIAL.
101-0000-20308
0
$3.25
$0.00
PAID BYs�
METHOD ` ��`•",.'<RECEIPT
#
,�CHECK #a ''_;
CLTD BY,;:'
��.
Total Paid forSTRONG MOTION INSTRUMENTATION SMI $3.25 $0.00
'DESCRIPTION s' „
.. t ACCOU
Ig AMOUNT
s PAIDZ.r
PAID DATE
�,`,°
_
DOOR/WINDOW, REPLACE FIRST 7 _
101-0000-42400 .,
0
$60.91
$0.00 .
x' z x o
t PAID,BY ="t f
a z
' METHOD - •" `
F a
RECEIPT # x.,.
f ' CHECK #,
_, ..
CLTD BY-'
Gr
�4-r DESCRIPTION:;�
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�: 6;�•`
,
a£ OQ ACCl
AMUN-T. I
.!
. ,PAID `
ATE
PAID D
DOOR/WINDOW,
DOOR/WINDOW, REPLACE, FIRST 7 PC:
101-0000-42600
0
$110.22
$0.00•
,PAID BY.,�
:.J-
METHOD
PT,# E `"
K?s- CHECK #
TD B;Y
Total Paid forWINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 $0.00
TOTALS: 00
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Description: ANDERSEN / REMODEL INTERIOR/EXTERIOR
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED
Applied: 7/1/2015 SKH
Approved: 8/6/2015 JJO
Parcel No: 777390008 ' Site Address: 53443 VIA MALLORCA LA QUINTA,CA 92253
Subdivision: TR 29894-3 `Block: Lot: 46
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0 .Zoning:
Finaled:
Valuation: $25,000.00 y Occupancy Type: "Construction Type: LY
Expired: ;
7/14/2015
7/29/2015
No. Buildings: 0 No. Stories: 0 No. Unites: 0 _
OFFICE MEETING -
Details: NEW FRONT DOOR ASSEMBLY, REMODEL VENEER, REMOVE GARAGE DOORS AND INSTALL ONE NEW DOOR, ALTER DESIGN OF FRONT
BALCONY. PER 2013 CRC CODES
36
{ APPlied to Approved
Printed: Thursday, August 06, 2015 3:20:11 PM , 1 of 4
SYSTEMS
ADDITIONAL
CHRONOLOGY
CHRONOLOGY,TYQE r
- ACTION DATE :. COIVIP.,LETION DATE?CITE 'F
<= ..F>STAFF;NAME _
u'x- v •. -- ^. - °E;ahk::?^x:" xv ... a, e.. •x: n. v ....'x'.: .,..r :xe.....+i
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NOTE
JIM JOHNSON
7/14/2015
7/29/2015
,
OFFICE MEETING -
JIM JOHNSON
'8/6/2015
8/6/2015
PLANS WERE APPROVED OVER COUNTER BY JIM J
PLAN CHECK COMMENTS .
FROM CONSULTANT,
KAY HENSEL'
-7/20/2015
7/20/2015
STRUC BACK FROM YOUNG - RFC
RECEIVED
PLANS PICKED UP BY MIKE JEHA. ALSO HE WANTED TO SPEAK
PLAN CHECK PICKED UP,
PHILIP JUAREZ
7/28/2015
7/28/2015
-
TO JIM JOHNSON THEY WENT OVER CORRECTIONS.
PLAN CHECK SUBMITTAL
STEPHANIE KHATAMI
7/1/2015
7/1/2015
RECEIVED
'
PLANS RESUBMITTED BY MIKE JEHA AT FRONT COUNTER. HE
EXPLAINED.WHY THEY DID NOT REQUIRE A 2ND STRUCTURAL
RESUBMITTAL
KAY HENSEL
7/_29/2015
7/29/2015
PLAN CHECK. THAT'S WHY I DID NOT INCLUDE A 2ND
STRUCTURAL P/C. PER MIKE, ANY QUESTIONS WILL BE
RESOLVED BY A PHONE CALL TO KATHRYN SAMUELS.
Printed: Thursday, August 06, 2015 3:20:11 PM , 1 of 4
SYSTEMS
SENT TO PLAN CHECK
'7 4 3...
-�QT `PAID-�p
DESCRIPTION ACCOUNT.�,,��tf AMOUNTf%', �p lbD4TE;, EIP CK-#� T-,METHOD',PAID
A
BSAS SB1473 FEE
101-0000-20306
0
.
i
STEPHANIE KHATAmi
I
Total Paid for BUILDING STANDARDS ADMINISTRATION
7/1/2015
.,$0.00
BSA --
7/1/2015
I
CONSULTANT
-101-0000-42403
0
$145.02-
CONDITIONS
CONTACTS
EQUIPMENT -
hfE.TiYPE
A - S S1 STATE
ZIP -FAX,
7, V
APPLICANT
BENJAMIN HERTZ
645 OLEANDER RD.
PALM SPRINGS
CA
92264
CONTRACTOR JEHA CONSTRUCTION, MICHAEL
0 OUTSIDE C11 -i LIMITS
LA QUINTA
CA
922531
OWNER
MARK ANDERSON'
8014 AVALON PL
MERCER ISLAND
WA
92253
.. . . ........ .. . ...... . . ..... ........ ............ .... ....... .. ..... . ........ .... . . . .. ........
-jNANPAL:INr,onMA-TI0N--;,- . ... ...... ........ ..........
� , :� ... ......... ....
'7 4 3...
-�QT `PAID-�p
DESCRIPTION ACCOUNT.�,,��tf AMOUNTf%', �p lbD4TE;, EIP CK-#� T-,METHOD',PAID
A
BSAS SB1473 FEE
101-0000-20306
0
-$1.00 $0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00-
.,$0.00
BSA --
OTHER ELECTRICAL'
-101-0000-42403
0
$145.02-
$0.00
EQUIPMENT -
OTHER ELECTRICAL,
101-0000-42600*
0
$145.02
$0.60
EQUIPMENT PC
'Total Paid forELECTRICAL: $290.04 $0.00:,
REMODEL, EA
101-0000-42400
0
$21.75
$0.0-0
ADDITIONAL SOOSF
REMODEL, EA
101-0000-42600
0
$17.40
$0.00
ADDITIONAL 500 SF PC
REMODEL, FIRST 100 SF
101-0000-42400
0
$49.31
$0.00
REMODEL, FIRST SOO SF
101-0000-426000
$134.88
$0.00
Oc
."
Total Paid for REMODEL: $223.34 $0.00
Printed: Thursday, August 06, 2015 3:20:11 PM 2 of 4 CffwYSTEMS
"
mTY
•AMOUNT *
''-
'MPAID DATE
CHECK # .
•,METHOD
DESCRIP.TION
ACCOUNT• ;N -
•Y
PAID
rvRECEIPT>#
r .:. r i• [+.
sq;gs
cY y' ..- ^ j. ?'. �+ :.�:: x ?:
r r3
.:- .., �'✓
pp
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'a,. •
1W'. a �
. ? s_ Tx'"
.0 ham
§'.! Y: S '.si. Xt
SMI - RESIDENTIAL
101-0000-20308
0
$3.25
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $3.25 $0.00
DOOR/WINDOW,.
101-0000-42400
0
$60.91
$0.00 "
REPLACE FIRST 7
DOOR/WINDOW,
101-0000-42600
0'
$110.22 -
$0.00
REPLACE; FIRST 7 PC ,
Total Paid for WINDOW/SLIDING GLASS
$171.13 $0.00
DOOR/FENESTRATION:
TOTALS:00
INSPECTIONS,
SEclo - -,_ y INSPECTION;INSPECTOR SCHEDULED 4CQMPLETED RESULT.: - REMARKS � � F, NOTES �
Q� DATE s DATE g
• a
FINAL*" BLD F
• A • • • .
REVIEWS -
..STATUS REMARKS - ��; , - •`. -x ....
:,. RETURNED....
r _.,REVIEW=TYPE'; REVIEVVER� :SENT DATE'S r.:DUE'DATE.=': -NOTES-
41
.�*� • _ ,
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P�
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soNr
INFORMATION
Printed: Thursday, August 06, 2015 3:20:11 PM 3 of 4
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ATTACHMENTS
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'Attachment T e A>CREATED °
OWNER
DESCRIPTION "- .k":
�°PATHNAME
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53-443 VIA.
53-443 VIA
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DOC 7/14/2015
JIM JOHNSON
0
MALLORCA.docx
MALLORCA.docx '
1ST REVIEW -
`
BRES 2015-0254 KS
`.DOC 7/20/2015
KATHRYN SAMUELS '•
STRUCTURAL
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COMMENTS
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Bin #
City of La Quinta
Building 8i' Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
5;5,4-4 3 Building Permit Application and Tracking Sheet
Permit #
6i(k�s20I
Project Address: S 3 V 1A M
Owner's Name: Ata) P4F-V*F—, > V
A. P. Number:
Address
Legal Description:
City, ST, Zip: L-.IA 4!2?L) 11111T,A 4�4
Contractor:
I A
Telephone:
Address:
Project Description:
City, ST, Zip:
ele h
T one: Z
P S •2.S a• 4-63%
6..-4 i4 Sv u� No s be
A
State Lic. # :
City Lic.
Arch., Engr//., Designer:NJ•0
Address: l04"S ��I�.p�f1- 4 D
►6 �DD� ����i 'D-Z-AGrJ G
City:, ST, Zip pL�
AL-CON L .
Telephone: r%Gb•333 • �y7
Con structi n TY P e: Occupancy:
State i c.#: i
Project type (circle one • New Add'n 6 Repair Demo
Name of Contact Person: NLS��
Sq. Ft.: —
# Stories: 2-
# Units:
Telephone # of Contact Person: `
Estimated Value of Project: 2 �-
APPLICANT: DO NOT WRITE BELOW THIS LINE
N
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check R*nce.
Title 24 Cates.
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:-
'"' 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
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