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FSS2019-0004ADDITIONAL SITES CHRONOLOGY CONTACTS NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL APPLICANT JD MECHANICAL FIRE INC. - BRIAN SLOAN 82579 FLEMING WAY LA QUINTA CA 92253 KATHY@JDMENCHANI CAL.COM CONTRACTOR J D MECHANICAL FIRE INC 82579 FLEMING WAY SUITE D INDIO CA 92201 JD@JDMECHANICAL.C O OWNER MELDMAN FAMILY, LTD.53525 HUMBOLDT BLVD LA QUINTA CA 92253 CONDITION TYPE CONTACT DATE ADDED DATE REQUIRED DATE SATISFIED STATUS REMARKS NOTES READY TO ISSUE CHECKLIST EDGAR GONZALEZ 5/10/2019 PENDING AS BUILT DRAWINGS REQUIRED BEFORE FINAL IS APPROVED. CONDITIONS Description: MENLDMAN / FIRE SPRINKLERS FOR GARAGE CONVERSION Type: FIRE SPRINKLER Subtype: RESIDENTIAL - CUSTOM HOMES Status: FINALED Applied: 1/29/2019 JLIM Parcel No: 767700018 Site Address: 53525 HUMBOLDT BLVD LA QUINTA,CA 92253 Approved: 2/5/2019 EGO Subdivision: TR 33076-2 Block: Lot: 66 Issued: 2/7/2019 AHI Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: 10/7/2019 crw Valuation: $0.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 4/30/2019 - FSS E GONZALEZ - "Submit as-built drawings along with field set with markups prior to final inspection request." Printed: Friday, January 27, 2023 10:46:05 AM 1 of 3 Permit Details City of La Quinta PERMIT NUMBER FSS2019-0004 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED DATE COMPLETED DATE RESULT REMARKS NOTES OVERHEAD HYRO EGO 4/30/2019 5/10/2019 APPROVED OVERHEAD ROUGH PIPING EGO 4/30/2019 5/10/2019 APPROVED AS BUILT DRAWINGS REQUIRED BEFORE FINAL IS APPROVED. FIRE FINAL**KHET 9/12/2019 9/12/2019 DISAPPROVE D Replace faulty pressure gauge. FIRE FINAL**KHET 10/3/2019 10/3/2019 DISAPPROVE D Replaced gauge, still reading below required static pressure. Contractor is opting for a bucket test. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT #CHECK #METHOD PAID BY CLTD BY FIRE PLAN REVISION SUBMITTALS 101-0000-42420 0 $161.00 $161.00 10/2/19 R54152 1670 CHECK JD MECHANICAL FIRE INC.AMA FIRE SPRINKLER SYSTEMS - SINGLE FAMILY DETACHED 101-0000-42421 0 $160.00 $160.00 1/29/19 R43954 1473 CHECK LEONARD TWETEN JLIM FIRE SPRINKLER SYSTEMS - SINGLE FAMILY DETACHED PC 101-0000-42420 0 $240.00 $240.00 1/29/19 R43954 1473 CHECK LEONARD TWETEN JLIM Total Paid for FIRE FEES: $561.00 $561.00 RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 $10.00 1/29/19 R43954 1473 CHECK LEONARD TWETEN JLIM Total Paid for RECORDS MANAGEMENT FEE: $10.00 $10.00 TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 $5.00 1/29/19 R43954 1473 CHECK LEONARD TWETEN JLIM Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 $5.00 TOTALS:$576.00 $576.00 Printed: Friday, January 27, 2023 10:46:05 AM 2 of 3 Permit Details City of La Quinta PERMIT NUMBER FSS2019-0004 ATTACHMENTS Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED DOC 2/7/2019 AARON HICKSON FIRE JOB CARD FIRE JOB CARD.doc DOC 2/5/2019 EDGAR GONZALEZ FSS2019-0004 - MADISON CLUB LOT 66B - 53-525 HUMBOLDT BLVD. - FIRE SPRINKLER SYSTEM TI (COA).docx FSS2019-0004 - MADISON CLUB LOT 66B - 53-525 HUMBOLDT BLVD. - FIRE SPRINKLER SYSTEM TI (COA).docx 1 DOC 10/1/2019 KOHL HETRICK FSS2019-0004 - 1-HEAD RECALC.pdf FSS2019-0004 - 1-HEAD RECALC.pdf 1 DOC 10/1/2019 KOHL HETRICK FSS2019-0004 - 2-HEAD RECALC.pdf FSS2019-0004 - 2-HEAD RECALC.pdf 1 DOC 10/1/2019 KOHL HETRICK FSS2019-0004 - AS- BUILTS - PLANS.pdf FSS2019-0004 - AS- BUILTS - PLANS.pdf 1 IMAGE 9/12/2019 KOHL HETRICK Existing PRV affecting riser supply.JPG Existing PRV affecting riser supply.JPG 0 IMAGE 9/12/2019 KOHL HETRICK Static pressure affected by PRV.JPG Static pressure affected by PRV.JPG 0 BOND INFORMATION FIRE FINAL**KHET 10/7/2019 10/7/2019 APPROVED With Bucket Test Bucket test performed to satisfaction. REVIEWS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE STATUS REMARKS NOTES 1ST PERMIT TECH (1 DAY) JACK LIMA 1/29/2019 1/30/2019 1/29/2019 COMPLETE 1ST FIRE (2 WK)EDGAR GONZALEZ 1/29/2019 2/12/2019 2/5/2019 APPROVED- CONDITIONS 2ND FIRE (1 DAY)KOHL HETRICK 10/1/2019 10/2/2019 10/1/2019 APPROVED AS-BUILTS SEE ATTACHMENTS FOR DOCUMENTS PARENT PROJECTS Printed: Friday, January 27, 2023 10:46:05 AM 3 of 3 Permit Details City of La Quinta PERMIT NUMBER FSS2019-0004 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: 1/27/2023 Permit Type/Subtype: Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: FIRE SPRINKLER/RESIDENTIAL - CUSTOM HOMES FSS2019-0004 53525 HUMBOLDT BLVD 767700018 MENLDMAN / FIRE SPRINKLERS FOR GARAGE CONVERSION Owner: MELDMAN FAMILY, LTD. 53525 HUMBOLDT BLVD LA QUINTA, CA 92253 Applicant: JD MECHANICAL FIRE INC. - BRIAN SLOAN 82579 FLEMING WAY LA QUINTA, CA 92253 Contractor: J D MECHANICAL FIRE INC 82579 FLEMING WAY SUITE D INDIO, CA 92201 (760)775-6220 LIc. No.: 1020141 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 License No.: 1020141 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: ACCREDITED SURETY AND CASUALTY COMPANY INC Policy Number: 1ATCA16000224 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: 1/27/2023 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: FSS2019-0004 53525 HUMBOLDT BLVD 767700018 MENLDMAN / FIRE SPRINKLERS FOR GARAGE CONVERSION Owner: MELDMAN FAMILY, LTD. 53525 HUMBOLDT BLVD LA QUINTA, CA 92253 Applicant: JD MECHANICAL FIRE INC. - BRIAN SLOAN 82579 FLEMING WAY LA QUINTA, CA 92253 Contractor: J D MECHANICAL FIRE INC 82579 FLEMING WAY SUITE D INDIO, CA 92201 (760)775-6220 LIc. No.: 1020141 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Detail: 4/30/2019 - FSS E GONZALEZ - "Submit as-built drawings along with field set with markups prior to final inspection request." FINANCIAL INFORMATION 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 $160.00 DESCRIPTION ACCOUNT QTY AMOUNT FIRE SPRINKLER SYSTEMS - SINGLE FAMILY DETACHED PC 101-0000-42420 0 $240.00 Total Paid for FIRE FEES: $561.00 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:$576.00