BRES2015-017578-495 CALLE TAMPICO
VOICE (760) 777-7125FAX
LA QUINTA, CALIFORNIA 92253
(760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/2/2015
Application Number:
BRES2015-0175
Owner:
Property Address:
55900 PEBBLE BEACH
ROBERT MOORE
APN:
775130019
184 SAND HILL CIR
Application Description:
Property Zoning:
MOORE RESIDENCE/REMODEL
MENLO PARK, CA 92253
Application Valuation:
$5,000.00
j17
Applicant:
Contractor:
=� ea , G
ROB PITCHFORD
RAWLINGS CUSTOM CONTRACTING IN
77622 COUNTRY CLUB DR
PO BOX 3216
_
PALM DESERT, CA 92211
PALM SPRINGS, CA
92263 N t�
(760)322-8788
.y
Lic. No.: 746930
---------------------------------------------------------------------------------------------
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: 8 License No.: 746930
Date: Contractor:
i%
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
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.).
(_) 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 lendingagency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's
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 tion, as provided for by Section 3700 of the labor Code, for the performance
of the rk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Secti 700 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 that, if I should become subject to the
workers' compensation provisions of Section 3700 o e Labor Code, I shall forthwith
comply with/dos provisions.
Date: G 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 ab�e�,*Vinno
n ' correct.
I agree to comply with all city and county ordinances and stag building
construction, and hereby authorize representatives of this ci the above-
mentioned prop rty for inspection purposes.
Date:Signature (Applicant or Ag
FINANCIAL INFORMATION
DESCRIPTION- ACCOUNT.' ;QTY AMOUNT-, ...: PAID. PAID DATE
HOURLY PLAN CHECK - YES 101-0000-42600 0.75 $52.50 $0.00
d PAID BY METHOD �, '' '' ° . ` RECEIPT # CHECK # CLTD BY
Total Paid for BLDG CITY STAFF - PER HOUR: $52.50 $0.00
„ DESCRIPTION
-ACCOUNT
QTY-'
, • AMOUNT
PAID
4PAID 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 BYY,
,METHOD
RECEIPT # ..
CHECK #
CLTD BY
DESCRIPTION'
ACCOUNTQTY'
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 for ELECTRICAL: $48.34 $0.00
DESCRIPTION'
ACCOUNT .
QTY1
AMOUNT!_ -
PAID
PAID DATE'
SMI - RESIDENTIAL
101-0000-20308
0
$0.65
$0.00
PAID BY'` -;
,6. 'METHOD
-RE CEIPT#
CHECK #
CLTD BY
Total Paid forSTRONG MOTION INSTRUMENTATION SMI: $0.65 $0.00
DESCRIPTION
...ACCOUNTQTY°
'AMOUNT
PAID
PAID DATE
DOOR/WINDOW, REPLACE FIRST 7
101-0000-42400
0
$60.91
$0.00
PAID BY' . '7
YMETHOD .._
RECEIPT #"
CHECK #
:.CLTD BY
'' :• DESCRIPTION - ,
ACCOUNT.` Y M _
QTY
AMOUNT
PAID .: , ••
PAID DATE
DOOR/WINDOW, REPLACE, FIRST 7 PC
101-0000-42600
0
$110.22
$0.00
-PAID BY
xe ° METHOD r
RECEIPT,#'•CHECK
#
CLTD BY
Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $171.13 $0.00
TOTALS:0i
J
Pe' em t Details PERMIT NUMBER
_
City of La Q uinta�
' BRE5263:1 y75
.::.
Description: MOORE RESIDENCE/REMODEL
Type: BUILDING, RESIDENTIAL Subtype: REMODEL Status: APPROVED
Applied: 4/29/2015 MFA
Approved: 5/15/2015 JJO
Parcel No: 775130019 Site Address: 55900 PEBBLE BEACH LA QUINTA,CA 92253
Subdivision: TR 20717-2 SEE ASSR MB 769 PGS 3134 Block: Lot: 27
Issued:
3536
CHRONOLOGYzTYPE.;
Lot Scl Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $5,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites:.0
KAY HENSEL
Details: REMOVE SLIDING DOOR AND REPLACE WITH ACCORDIAN DOORS. 2013 CALIFORNIA BUILDING CODE.
ADDITIONAL
CHRONOLOGY
CHRONOLOGYzTYPE.;
<' STAFF NAME -
__
'� ACTION DATE
.... _.. _ tin
COMPLETION DATE
°NOTES E 1,
NOTE
KAY HENSEL
4/29/2015
4/29/2015
PLAN CHECK COMMENTS
FROM CONSULTANT
RECEIVED -
KAY HENSEL
5/15/2015
5/15/2015
STRUC APPROVABLE 5/14/2015
PLAN CHECK SUBMITTAL
RECEIVED
MARY FASANO
4/29/2015
4/29/2015
SENT TO PLAN CHECK
-- COONSULTANT
KAY HENSEL • r
4/29/2015
4/29/2015
STRUC TO YOUNG - DUE BACK 5/13/2015
TELEPHONE CALL
JIM JOHNSON
5/15/2015
5/15/2015
CALLED DENISE FROM THE FLYING BUTTRESS TO INFORM HER
PERMIT IS READY TO ISSUE
CONDITIONS
Printed:. Tuesday, June 02, 2015 11:26:14 AM r 1 of 3 C }
SYS rEMS
a `T�•G
'�OF'Ftn'
Printed: Tuesday, June 02, 2015.11:26:14 AM 2 of 3
COTWsYSTEMS
FINANCIAL
INFORMATION
f
CLTO
'METHOD. y 'PAID
DESCRIPTION ` ACCOUNT QTY
AMOUNT
CONTACTS
PAID DATE RECEIPT # CHECK # BY' -��.
�.
NAME�TYPE
"; '' _ �T`NAME °'
ADDRESS1
CITY
^STATE
ZIP
PHONE ..
FAX . .
EMAIL • -
,
$52.50
$0.00
BSAS SB1473 FEE
101-0000-20306
0
$1.00
,a..
APPLICANT
ROB PITCHFORD
77622 COUNTRY CLUB
PALM DESERT
CA
92211
Total Paid forBUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
DR
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
CONTRACTOR
RAWLINGS CUSTOM CONTRACTING
PO BOX 3216
PALM SPRINGS
CA
92263
101-0000-42600
0
$24.17
$0.00
IN
Total Paid forELECTRICAL:
$48.34
OWNER
ROBERT MOORE
184 SAND HILL CIR I
MENLO PARK
CA
92253
Printed: Tuesday, June 02, 2015.11:26:14 AM 2 of 3
COTWsYSTEMS
FINANCIAL
INFORMATION
f
CLTO
'METHOD. y 'PAID
DESCRIPTION ` ACCOUNT QTY
AMOUNT
PAID
PAID DATE RECEIPT # CHECK # BY' -��.
�.
By
HOURLY PLAN CHECK - 101-0000-42600 0.75
$52.50
$0.00
YES
Total Paid for BLDG CITY STAFF -.PER HOUR:
$52.50
$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 '
SMI - RESIDENTIAL
101-0000-20308
0
$0.6S
$0.00
Total Paid forSTRONG MOTION INSTRUMENTATION SMI:
$0.65
$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
Printed: Tuesday, June 02, 2015.11:26:14 AM 2 of 3
COTWsYSTEMS
Permit Details PERMIT NUMBER
_
City of La Quinta BRES20115�
1'�1 �1lr�►Ii. A6 •i
Bin # a
City. of La Quinta
Building 8i Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: ^5-(�M
Owner's Name: P)��0
A. P. Number: Z7� ( c) D (
Address: Lj -Doo T—
Legal Description: (,'07- 7i 20717—Z
City, ST, Zip: c,44.
Contractor: �U`-' 1
Telephone: � �
P ��
.......................:.................
Address:
Project Description:
City, ST, Zip:
Q E- e5,c—i c-�x6.i7 &7c..AU
h
Telephone:
one:
State Lic. #:.�7 1 q (0- l 3-(D
City Lic.
lC "r
Designer: ��
���
CC
Address: -627
City., ST, ZiPT- /� i�
Tel h
e one: 20 6`
.. ...
Con tructi
s on Type: ccu
P Occupancy:
P Y:
Lic. #.
Pr
Project nPa (circle one):: New Add'n Alter Repairair Demo
Name of Contact Person: Q55 TT::t
Sq. Ft.:#
Stories: I
# Units:
Telephone # of Contact Person b O �-46 2 ��
Estimated Value of Projec DD
APPLICANT: DO NOT WRITE BELOW THIS LINE
It
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
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 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�3.��
If you have Any questions, please call. q`
ciF LA _nfur_N
Time = .75 HR
This Material Sent for?
-❑ Your Files ® Per Your Request
d ❑ '• Your Review ❑ Approval •'
❑ Checking ❑ At the request of:
Other: ❑ .
BY: Kathryn Samuels
Palm Desert Office; ® - (760) 772-5107
Other ❑
' F'
4
YOUNG tig
ENGINEERING °`y
° ° a W.
A"', 0
-
' Letter of Transmittal
To: City of La Quinta Today's Date:
5-14-15
78-495.Calle Tampico City Due Date:
5-13-15 .
La Quinta, CA 92253 Project Address: 55-900 Pebble Beach
Attn: Kay Plan Check #:
a,
BRES 2015-0175
Submittal: tai,
4 t
-
❑ 2nd
❑ •5th
M
aro
❑ Other.
z
We are forwarding: ® By Messenger' ❑ By Mail (Fed Ex or UPS)
❑ ` Your Pickup
Includes: # Of Descriptions: Includes: `' # Of
Desc-iptions; ,
Copies: ,�.
' Copies:
® 1 Structural Plans
❑
Revised Structural Plans
® 1 Structural Calculations
❑
Revised Struct. Calcs
'El Truss Calculations Floor
El
Revised Truss
and Roof
❑ Soils Report
❑
Revised Soils Report
. ❑ Structural Comment List
❑ -
Approved Structural Plans
❑ Redlined Structural Plans
E],
Approved Structural Calcs
❑ Redlined Structural Calcs
❑
Approved Truss Calcs
❑ Redlined Truss Calcs
❑
Approved Soils Report '
El Redlined Soils Reports
❑ _ �. 6, 0fher:
Comments: Structural content is approvable.
If you have Any questions, please call. q`
ciF LA _nfur_N
Time = .75 HR
This Material Sent for?
-❑ Your Files ® Per Your Request
d ❑ '• Your Review ❑ Approval •'
❑ Checking ❑ At the request of:
Other: ❑ .
BY: Kathryn Samuels
Palm Desert Office; ® - (760) 772-5107
Other ❑
' F'