FSS2018-0038ADDITIONAL SITES
CHRONOLOGY
CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES
NOTE JACK LIMA 5/1/2020 5/1/2020
APPLICANT COULD NOT SEE PERMIT ON HIS ETRAK-IT
DASHBOARD SINCE THE PIRMIT HAD AN EXPIRATION DATE
OF 5/1/2020. I EXTEND THE PERMIT EXPIRATION DATE TO
5/15/2020 SO THE CONTRACTOR COULD SUBMIT PLANS AND
PAY PERMIT EXTENSION FEES.
CHANGED PERMIT EXPIRATION DATE OUT 60-DAYS FROM
DATE OF RESUBMITTAL.
NOTE KAYLI ALFORD 7/10/2019 7/10/2019
PERMIT EXPIRED. SPOKE TO EDGAR, AND HE APPROVED
EXTENSION OF 6 MONTHS WITH PAYMENT OF EXTENSION
FEE & LETTER EXPLANING WHY EXTENSION IS NEEDED.
NOTE KAYLI ALFORD 7/12/2019 7/12/2019 RECEIVED LETTER AND EXTENSION FEE PAYMENT. EXTENDED
PERMIT 6 MOS FROM DATE OF EXPIRATION.
Description: JACOBS RESIDENCE / FIRE SPRINKLERS
Type: FIRE SPRINKLER Subtype: RESIDENTIAL - CUSTOM
HOMES
Status: FINALED Applied: 3/8/2018 MFA
Parcel No: 767680043 Site Address: 53767 ROSS AVE LA QUINTA,CA 92253 Approved: 3/22/2018 RGR
Subdivision: TR 33076-1 Block: Lot: 38 Issued: 8/17/2018 AMA
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: 5/20/2020 crw
Valuation: $0.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details:
Printed: Thursday, January 26, 2023 4:16:31 PM 1 of 5
Permit Details
City of La Quinta
PERMIT NUMBER
FSS2018-0038
CONTACTS
NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL
APPLICANT FIRE SAFE SYSTEMS INC 1312 KINGSDALE AVE REDONDO
BEACH
CA 90278 (310)542-0585 JOSEPH@FIRESAFESYST
EMS.COM
BILL TO FIRE SAFE SYSTEMS INC 1312 KINGSDALE AVE REDONDO
BEACH
CA 90278 (310)542-0585 JOYCE@FIRESAFESYSTE
MS.COM
CONTRACTOR FIRE SAFE SYSTEMS INC 1312 KINGSDALE AVE REDONDO
BEACH
CA 90278 (310)542-0585 JOSEPH@FIRESAFESYST
EMS.COM
OWNER JEFFREY JACOBS 1299 OCEAN AVE #333 SANTA MONICA CA 90401 (310)542-0585
CONDITION
TYPE CONTACT DATE
ADDED
DATE
REQUIRED
DATE
SATISFIED STATUS REMARKS NOTES
READY TO ISSUE
CHECKLIST
RONALD
GRIESINGER 3/13/2018 3/13/2018 3/13/2018 COMPLETE APPLICATION SUBMITTED.
NOTE KAYLI ALFORD 4/30/2020 4/30/2020
OK TO EXTEND PER KOHL, WILL REQUIRE AN EXTENSION
REQUEST LETTER AND EXTENSION FEE. CONTRACTOR WILL
ALSO NEED TO SUBMIT THE REVISION PRIOR TO ANY
INSPECTIONS TAKING PLACE. REVISION FEE HAS BEEN
ADDED.
EXTENDED PERMIT TO 5/1/20 SO CONTRACTOR CAN PAY
FEES OWED VIA ETRAKIT
EXTENSION REQUEST LETTTER RECEIVED
NOTE KAYLI ALFORD 5/4/2020 5/4/2020 EXTENDED PERMIT OUT ANOTHER 4 MONTHS FOR A TOTAL
OF 6 MONTH EXTENSION.
NOTE MARY FASANO 3/8/2018 3/8/2018 THIS PLAN CHECK WAS MAILED IN
NOTE REYNA CAMARENA 8/16/2018 8/16/2018
JOSEPH EMAILED ME WITH AN UPDATED COMPLETED
APPLICATION. HE WILL BE IN TOMORROW TO PICK UP
APPROVED PLANS.
CONDITIONS
FINANCIAL INFORMATION
Printed: Thursday, January 26, 2023 4:16:31 PM 2 of 5
Permit Details
City of La Quinta
PERMIT NUMBER
FSS2018-0038
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED
DATE
COMPLETED
DATE
RESULT REMARKS NOTES
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT #CHECK #METHOD PAID BY CLTD
BY
Credit Card Fee 101-0000-43505 0 $0.72 $0.72 7/12/19 R51392 0001 CREDIT
CARD
FIRE SAFE SYSTEMS
INC AHI
Total Paid for Credit Card Fee: $0.72 $0.72
FIRE PLAN REVISION
SUBMITTALS 101-0000-42420 0 $161.00 $161.00 5/1/20 WEB5029 CREDIT FIRE SAFE SYSTEMS
INC ECON
FIRE PLAN REVISION
SUBMITTALS 101-0000-42420 0 $161.00 $161.00 5/13/20 WEB5121 CREDIT FIRE SAFE SYSTEMS
INC ECON
FIRE SPRINKLER
SYSTEMS - SINGLE
FAMILY DETACHED
101-0000-42421 0 $156.00 $156.00 3/8/18 R32931 256 CHECK FIRE SAFE SYSTEMS
INC MFA
FIRE SPRINKLER
SYSTEMS - SINGLE
FAMILY DETACHED PC
101-0000-42420 0 $234.00 $234.00 3/8/18 R32931 256 CHECK FIRE SAFE SYSTEMS
INC MFA
FIRE STAFF - PER HOUR 101-0000-42420 0.25 $40.00 $40.00 7/12/19 R51392 0001 CREDIT
CARD
FIRE SAFE SYSTEMS
INC AHI
FIRE STAFF - PER HOUR 101-0000-42420 0.25 $40.25 $40.25 5/1/20 WEB5029 CREDIT FIRE SAFE SYSTEMS
INC ECON
Total Paid for FIRE FEES: $792.25 $792.25
RECORDS
MANAGEMENT FEE 101-0000-42416 0 $10.00 $10.00 3/8/18 R32931 256 CHECK FIRE SAFE SYSTEMS
INC MFA
Total Paid for RECORDS MANAGEMENT FEE: $10.00 $10.00
TECHNOLOGY
ENHANCEMENT FEE 502-0000-43611 0 $5.00 $5.00 3/8/18 R32931 256 CHECK FIRE SAFE SYSTEMS
INC MFA
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 $5.00
TOTALS:$807.97 $807.97
Printed: Thursday, January 26, 2023 4:16:31 PM 3 of 5
Permit Details
City of La Quinta
PERMIT NUMBER
FSS2018-0038
ATTACHMENTS
Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED
DOC 7/12/2019 AARON HICKSON EXTENSION REQUEST
LETTER 2183_001.pdf 0
DOC 5/1/2020 EtrakitContractor (REVISION 1) FIRE FLOW
LETTER
53767 Ross Ave-Fire
Safe ROSS2.PDF 1
BOND INFORMATION
OVERHEAD ROUGH
PIPING EGO 10/18/2018 10/18/2018
APPROVED
W/EXCEPTIO
N
FIRE SPRINKER OH PIPING INSPECTION
APPROVED WITH THE CONDITION THAT FIRE
SPRINKLER REVISIONS/AS BUILTS BE
SUBMITTED FOR REVIEW.
OVERHEAD HYRO EGO 10/18/2018 10/18/2018 APPROVED
FIRE FINAL**KHET 5/20/2020 5/20/2020 APPROVED
RVI COULD NOT BE COMPLETED DUE TO
WEAK SIGNAL. RESCHEDULED FOR FIELD
INSPECTION.
Field inspection passed.
Field inspection passed.
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED
DATE
STATUS REMARKS NOTES
1ST PERMIT TECH (1
DAY)
MARY
FASANO
3/8/2018 3/9/2018 3/8/2018 COMPLETE
1ST FIRE (2 WK)RONALD
GRIESINGER
3/8/2018 3/22/2018 3/13/2018 APPROVED Complete Proper Fire Permit Application
1ST FIRE (1 WK)KOHL
HETRICK 5/4/2020 5/11/2020 5/6/2020 REVISIONS REQUIRED SEE ATTACHMENTS
FOR CORR PLEASE SEE REVISED PLAN SET IN ATTACHMENTS.
2ND FIRE (1 WK)KOHL
HETRICK
5/8/2020 5/15/2020 5/11/2020 APPROVED SEE ATTACHMENTS
PARENT PROJECTS
Printed: Thursday, January 26, 2023 4:16:31 PM 4 of 5
Permit Details
City of La Quinta
PERMIT NUMBER
FSS2018-0038
ATTACHMENTS
Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED
DOC 4/30/2020 KAYLI ALFORD Extension Request
FSS2018-0038.pdf
Extension Request
FSS2018-0038.pdf 0
DOC 5/6/2020 KOHL HETRICK
FSS2018-0038 -
REVISION 1 - LETTER OF
CORRECTIONS.pdf
FSS2018-0038 -
REVISION 1 - LETTER OF
CORRECTIONS.pdf
1
DOC 5/11/2020 KOHL HETRICK
FSS2018-0038 - REV 1 -
APPROVED PLANS AND
CALCS.pdf
FSS2018-0038 - REV 1 -
APPROVED PLANS AND
CALCS.pdf
1
DOC 8/16/2018 REYNA CAMARENA UPDATED APPLICATION FSS2018-0038
APPLICATION.PDF 0
Printed: Thursday, January 26, 2023 4:16:31 PM 5 of 5
Permit Details
City of La Quinta
PERMIT NUMBER
FSS2018-0038
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/26/2023
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
FIRE SPRINKLER/RESIDENTIAL - CUSTOM HOMES
FSS2018-0038
53767 ROSS AVE
767680043
JACOBS RESIDENCE / FIRE SPRINKLERS
Owner:
JEFFREY JACOBS
1299 OCEAN AVE #333
SANTA MONICA, CA 90401
Applicant:
FIRE SAFE SYSTEMS INC
1312 KINGSDALE AVE
REDONDO BEACH, CA 90278
Contractor:
FIRE SAFE SYSTEMS INC
1312 KINGSDALE AVE
REDONDO BEACH, CA 90278
(310)542-0585
LIc. No.: 745383
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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: C16, C36 License No.: 745383
Date: 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.).
(___) 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 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 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: INSURANCE COMPANY OF THE WEST Policy Number: WSD5035115
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 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 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 laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Date: 1/26/2023
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
FSS2018-0038
53767 ROSS AVE
767680043
JACOBS RESIDENCE / FIRE SPRINKLERS
Owner:
JEFFREY JACOBS
1299 OCEAN AVE #333
SANTA MONICA, CA 90401
Applicant:
FIRE SAFE SYSTEMS INC
1312 KINGSDALE AVE
REDONDO BEACH, CA 90278
Contractor:
FIRE SAFE SYSTEMS INC
1312 KINGSDALE AVE
REDONDO BEACH, CA 90278
(310)542-0585
LIc. No.: 745383
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- - - - - - - - - - - - - - - - - - - - - - - - -Detail:
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
Credit Card Fee 101-0000-43505 0 $0.72
Total Paid for Credit Card Fee: $0.72
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE PLAN REVISION SUBMITTALS 101-0000-42420 0 $161.00
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE PLAN REVISION SUBMITTALS 101-0000-42420 0 $161.00
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE SPRINKLER SYSTEMS - SINGLE FAMILY DETACHED 101-0000-42421 0 $156.00
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE SPRINKLER SYSTEMS - SINGLE FAMILY DETACHED PC 101-0000-42420 0 $234.00
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE STAFF - PER HOUR 101-0000-42420 0.25 $40.00
DESCRIPTION ACCOUNT QTY AMOUNT
FIRE STAFF - PER HOUR 101-0000-42420 0.25 $40.25
Total Paid for FIRE FEES: $792.25
DESCRIPTION ACCOUNT QTY AMOUNT
RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION ACCOUNT QTY AMOUNT
TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:$807.97