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BRES2017-0240
4aw 78-495 CALLS TAMPICO VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT 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: C10 33 License No.: 9076f0�0033 \ (ANA Date: '� I bA.lq—contractor. � I bIY I1A11 1 1 \ 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.). (� 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 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 Na Lender's Add WORKER'S COMPENSAT'ON 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 370C of the Labor Code, for the performance of the ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sect 00 of the Labor Code, for the performance of the work for which this permit is issu d. My workers' compensation insurance carrier and policy number are: Carrier: BENCHMARK INSURANCE COMPANY Policy Number: CST5008980 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 3'100 of the Labor Cod , I shall forthwith comply with those. provisions. Date: Applicant: 0 WARNING: AILURE TO SECURE WORKERS' OMPENSA N COVERAGE IS UNLAWFUL, WORKERS SHALL SUBJECT AN EMPLOYER TO C INAL 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 perform>d under or pursuant to any permit issued as a result of this application , the owne-, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the =ity of La Quinta, its officers, agents, and employees for any act or omission related to tl•e 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 Fissuance 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 ordirances and state laws relating to building construction, and hereby authorize representarives of this city to enter upon the above -me Toned property for inspection purposes. Date: q Signature (Applicant 3rAgent ) 1 Date: 9/28/2017 Permit Type/Subtype: Application Number: BUILDING RESIDENTIAL/REMODEL BRES2017-0240 Owner: JOHN KOSINSKI a M C-3 Property Address: 48243 CALLE FLORISTAS 48243 CALLE FLORISTAS Z APN: 646092022 LA QUINTA, CA 92253 t:7 Application Description: KOSINSKI / INTERIOR REMODEL v Cn 1 Property Zoning: �M 6 Application Valuation: $20,000.00 -TT LND -v y do Applicant:Contractor: o PRO VALENZ CONSTRUCTION & PAINTING CONTR PRO VALENZ CON6TRUCTI0.,1 &.-,PAINTIN-CONT= 29285 DESERT MOON DR 29285 DESERT MOON DR THOUSAND PALMS, CA 92276 THOUSAND. PALMS, CA 922736 �7a (760)565-1386 Llc. No.: 976003 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: C10 33 License No.: 9076f0�0033 \ (ANA Date: '� I bA.lq—contractor. � I bIY I1A11 1 1 \ 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.). (� 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 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 Na Lender's Add WORKER'S COMPENSAT'ON 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 370C of the Labor Code, for the performance of the ork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sect 00 of the Labor Code, for the performance of the work for which this permit is issu d. My workers' compensation insurance carrier and policy number are: Carrier: BENCHMARK INSURANCE COMPANY Policy Number: CST5008980 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 3'100 of the Labor Cod , I shall forthwith comply with those. provisions. Date: Applicant: 0 WARNING: AILURE TO SECURE WORKERS' OMPENSA N COVERAGE IS UNLAWFUL, WORKERS SHALL SUBJECT AN EMPLOYER TO C INAL 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 perform>d under or pursuant to any permit issued as a result of this application , the owne-, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the =ity of La Quinta, its officers, agents, and employees for any act or omission related to tl•e 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 Fissuance 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 ordirances and state laws relating to building construction, and hereby authorize representarives of this city to enter upon the above -me Toned property for inspection purposes. Date: q Signature (Applicant 3rAgent ) 1 r Date: 9/28/2017 . Application Number: BRES2017-0240 Owner:' Property Address: 48243 CALLE FLORIS TAS JOHN KOSINSKI APN: 646092022 48243 CALLE FLOF.ISTAS Application Description: KOSINSKI / INTERIOR REMODEL LA QUINTA, CA 92253 Property Zoning: Application Valuation: $20,000.00 Applicant: Contractor: PRO VALENZ CONSTRUCTION & PAINTING CONTR PRO VALENZ CONSTRUCTION & PAINTING CONTR 29285 DESERT MOON DR 29285 DESERT MOON DR THOUSAND PALMS, CA 92276. THOUSAND PALM6, CA 92276 (760)565-1386 --------------------------------------------------------------------------------------------- Llc. No.: 976003 Detail: INT. REMODEL KITCHEN,HALL BATHROOM AND MASTER BEDROOM BATH. r =..�r.•-t.,DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0' $25.33 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES/FIXTURES, ADDITIONAL 101-0000-42403 0 $103.73 DESCRIPTION ACCOUNT. QTY AMOUNT DEVICES/FIXTURES, ADDITIONAL PC 101-0000-42600 0 -$25.83 Total Paid for ELECTP.ICAL: $180.22 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD 101-0000-42402 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT EXHAUST HOOD PC 101-0000-42600 0 $5.07 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN 101-0000-42402 0 $25.34 DESCRIPTION ACCOUNT QTY AMOUNT VENT FAN PC 101-0000-42600 0 $10.14 Total Paid for MECHANICAL: $53.22 DESCRIPTION ACCOUNT QTY AMOUNT FIXTURE/TRAP 101-0000-42401 0 $101.36 DESCRIPTION ACCOUNT. QTY AMOUNT FIXTURE/TRAP PC 101-0000-42600 0 $101.36 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.67 Total Paid for PLUMBING (FEES: $228.06 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA.ADDITIONAL 500 SF 101-0000-42400. 0 $22.80 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, EA ADDITIONAL 500 SF PC 101-0000-42600 0 $18.24 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 DESCRIPTION ACCOUNT QTY AMOUNT REMODEL, FIRST 500 SF PC 101-0000-42600 0 $141.36 Total Paid for REMODEL: $234.08 DESCRIPTION ACCOUNT QTY AMOUNT SMI - RESIDENTIAL 101-0000-203081 0 I $2.60 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $2.60 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT -FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMEN- .FEE: $5.00 Birt. # . . . City. of La Quinta Building 8L Safety Division P.O. Box 1504,78-495 Calle Tampico [a.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Permit # �S 27O Project Address: 2� " Owner's Name: h S A. P. Number. Adder: L13, Legal Description: City, ST, Zip: 1, R ITy4a ' Contractor. a Telephone: (p Q — ........ Address: oJectDescription: oorj/f f1/f (S City, ST, Zip: OA I Ki Telephone: State Lic. # : Lia#: I1 ""City Arch., Engr., Designer. t S C 01-k—d e, Gi fJ Address: ° City, ST, Zip: Telephone:? a _q — C)j 21-( Construction Typ,!.&Ok Occupancy: State Lic. #: Project type (circle one): New Add'n Alter epair Demo Name of Contact Person: p b�)ra s Sq. Ft.: # Stories: t Units: Telephone # of Cantact Person: — l ip Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd 'Reed TRACKING PERMrr FE`rS Plan Sets Pian Check submitted Deal Amount Stmetural Cafes. Revlewed, ready for corrections Plan Check Deposit. . Trnss Cales. Called Contact Person Plan Check Balance _ Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°" Review, ready for correctionslissue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plaits picked up SDf.L IMAL Approval Plans resubmitted Grading IN HOUSE-, 'id Review; ready for correctionsAssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr, Date of permit issue School Fees Total Permit Fees i�/ �_ ., r � f � '. YI 1 ', 8 }� 0 '`'r. t i o L • t. t, l . � .� ,t MAW& � - .� � � a�-0� � ti'i � . ., x �. t Y �,^ } � 0 ©' n i j_ . • �.' � � ' ` i � • , , � ' I O �µ�3tt�tY OF'Cl'�w M -.: w - w° 1 t" ` . '�• • a.. '' : ? •.w: •ti - ..;..T�.ti ,,,,,�. 4�' 's `y „y4Ss .,yam` "`? �`: " - 'r: ."t x. -•a-•4 - -+Y''+' }-, Y.'. - � ;.ti. Description: KOSINSKI / INTERIOR REMODEL Type: BUILDING RESIDENTIAL Subtype: REMODEL ' Status: APPROVED Applied: 9/7/2017 SKH Approved: 9/14/2017 JJO Parcel No: 646092022 Site.Address: 48243 CALLE FLORISTAS LA QUINTA,CA 92253 Subdivision: TR 20052-2 Block: Lot: 22 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $20,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: INT. REMODEL KITCHEN,HALL BATHROOM AND MASTER BEDROOM BATH. _® .Applied to Approved , Process Summary _® .Applied to Approved , Printed: Thursday, September 14, 2017 10:57:54 AM 1 of 3 O 0 rICHRONOLOGY;TYPE "'"' .STAFF NAME . ' ACTION DATE COMPLETION DATE` L- NOTES +� PLAN CHECK SUBMITTAL STEPHANIE SWANSTROM 9/7/2017 9/7/2017 RECEIVED TELEPHONE CALL JIM JOHNSON 9/14/2017 9/14/2017 CALLED ABEL TO INFORM HIM THE PLANS ARE APPROVED xy 5 - . NAME TYPE , `'-,'NAMEr : - ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL n APPLICANT PRO VALENZ CONSTRUCTION & 29285 DESERT MOON THOUSAND CA 92276. (760)565-1386 PAINTING CONTR DR PALMS CONTRACTOR PRO VALENZ CONSTRUCTION & 29285 DESERT MOON THOUSAND . CA 92276 (760)565-1386 PAINTING CONTR DR PALMS OWNER. JOHN KOSINSKI 48243 CALLE FLORISTAS LA QUINTA CA 92253 (760)565-1386 Printed: Thursday, September 14, 2017 10:57:54 AM 1 of 3 FINANCIAL DESCRIPTION, ACCOUNT , • QTY AMOUNT PAID PAID DATE: RECEIPT # . CHECK # ~METHOD PAID BY! CLTD' - ,: BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for. BUILDING STANDARDS ADMINISTRATION 1.00 $0.00 BSA: DEVICES, FIRST 20 101-0000-42403 0 $25.33 $0.00 DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 $0.00 DEVICES/FIXTURES, 101-0000-42403 0 $103.73 $0.00 ADDITIONAL DEVICES/FIXTURES, 101-0000-42600' 0 $25.83 $0.00 ADDITIONAL PC Total Paid for ELECTRICAL:. $180.22 $0.00 EXHAUST HOOD 101-0000-42402 0 $12.67 $0.00 EXHAUST HOOD PC 101-0000-42600 0 $5.07 $0.00 VENT FAN 101-0000-42402 0 $25.34 .$0.00 VENT FAN PC 101-0000-42600 0 $10.14 $0.00 Total Paid for MECHANICAL: $53.22 $0.00 FIXTURE/TRAP 101-0000-42401 0 $101.36 $0.00 FIXTURE/TRAP PC 101-0000-42600 0 $101.36 .$0.00 WATER SYSTEM 101-0000-42401 0 $12.67 $0.00 INST/ALT/REP WATER SYSTEM _ 101-0000-42600. 0 $12.67 $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $228.06 $0.00 REMODEL,EA 101-0000-42400 0 $22.80 $0.00 ' ADDITIONAL 5000 SF REMODEL, EA 101-0000-42600 0 $18.24 $0.00 ADDITIONAL 500 SF PC - Printed: Thursday, September 14, 2017 10:57:54 AM 2 of 3 ZV�qTFM1Z - INSPECTIONS r f + _ 77-7-7 RETURNED :STATUS y GLTD'- DESCRIPTION ACCOUNT QTY AMOUNT PAID.''' PAID DATE,. RECEIPT #. CHECK # • METHOD - PAID BY, .1 .. -r _ DATE _ 1ST BLDG NS (1 WK) JIM JOHNSON 9/7/2017 - BY REMODEL, FIRST 100 SF 101-0000-42400 0 $51.68 $0.00 9/7/2017 9/14/2017 9/7/2017 READY FOR APPROVAL REMODEL, FIRST 500 SF 101-0000-42600 0' $141.36 $0.00 GRIESINGER PC Total Paid for REMODEL: $234.08 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $2.60 $0.00 Total Paid for STRONG MOTION INSTRUMENTATION SMI:. $2.60 $0.00 TECHNOLOGY 502-0000-43611 Fo $5.00 $0.00 ENHANCEMENT FEE Total Paid .for TECHNOLOGY ENHANCEMENT FEE: $5.00 $0.00 - INSPECTIONS r RETURNED :STATUS y REMARKS REVIEW TYPE _ REVIEWER r SENT DATE DUE DATE p jr NOTES ' .1 .. -r _ DATE 1ST BLDG NS (1 WK) JIM JOHNSON 9/7/2017 9/15/2017 9/14/2017 APPROVED RONALD 9/7/2017 9/14/2017 9/7/2017 READY FOR APPROVAL FIRE GRIESINGER Printed: Thursday, September 14, 2017 10:57:54 AM BOND INFORMATION ATTACHMENTS 3of3 �tii� fYC7F AAC Permit Number: BRES2017-0240 Description: KOSINSKI / INTERIOR REMODEL Applied: 9/7/2017 v Approved: Site Address: 48243 CALLE FLORISTAS Issued: Finaled:' City, State Zip Code: LA QUINTA, CA 92253 Status: UNDER REVIEW 'Applicant: PRO VALENZ CONSTRUCTION & PAINTING CONTR ` Parent Permit: Owner: JOHN KOSINSKI Parent Project: Contractor: PRO VALENZ CONSTRUCTION & PAINTING CONTR Details: