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Home My WebLink About2022-861t' „:„ City of Palm SpringsIII A-, „,„.,,,BUILDING PERMIT 4i- .0,, Building Address: 3760 Camino San Simeon Date 03/07/2022 Case No.: " Permit Reynaldo Bermudez Submitted Technician Owner Address Phone Jay Rokni 708 Westmount Dr 424 285 5578 West Hollywood CA Contractor Address Phone Lic.Number Coachella Valley Lighting& 67765 Tamara Rd 760 578 1700 1059305 Electric Cathedral City CA Architect Address Phone Engineer Address Phone Lot# Block# Tract Parcel Number 39 VISTADELCIELO 680-061-009 Lot Size Zone Occupancy 10209 Building Sq.Ft. Garage/Carport Roofed Patio/Porch Remodeled Area New Use of building Permit Type Const.Type Fixture Units sfd Electric Service Upgrade Fire Sprinkler Units Valuation Permit Fees Paid 4600.00 180.84 Describe work in detail: MPU 200A solar ready Special Conditions: DO NOT CONCEAL OR COVER ANY CONSTRUCTION UNTIL THE WORK IS INSPECTED IMPORTANT The issuance of this permit shall not be held to be an approval of the violation of any provisions of any city or county ordinance or state law. Inspections of work are subject to an approved set of plans being on the job. Changes to plans are not to be made without permission of the Building and Safety Divisions. The owner and/or contractor is responsible for establishing all property lines. All utilities must be underground. This permit will expire if work is not started in 180 days or if more than 180 days elapses between inspections. I certify that I am familiar with all requirements of the City of Palm Springs as they apply to this permit and understand that these requirements must be completed prior to final inspection and that no certification of occupancy will be issued until such time as these requirements are met. I certify that I have read this application and state that the information is true and correct. Z. OWNER/CONTRACTOR/AGE JY DAT ISSUED BY Finaled 31'102 74-' This is a building permit when properly filled out,signed and validated,and is not transferable. PERMIT NUMBER 2022-861 INSPECTION INFORMATION o L 44.7 No work shall be concealed without a signature by the inspector.4'. The approved plans and this card must always be available to the inspector. Preserve this record. Every permit issued shall become invalid after 180 CARDunlessarequiredinspectionhasbeenapproved. JOB CARD Furthermore, permits expire when more than 180 days has elapsed from the date of the last approved Project address: 3760 Camino San Simeon required inspection. Permit #: 2022-861 Inspection hours 8AM -4PM Monday-Thursday CONSTRUCTION HOURS Inspection request line(760)323-8243 Weekdays 7am to 7pm Building Department(760)323-8242 Saturdays 8am to 5pm Building Department Fax(760)322-8342 Sundays & Holidays Not Permitted ELECTRIC SERVICE UPGRADE INSPECTIONS JOB NOTES: Meter Release ct (2- J =' Final S% 2 ZLA-- CITY OF PALM SPRINGS BUILDING PERMIT APPLICATION Date : 1 LZ- Plan Check Deposit Fees: Building:Fire: Project Address 3'-7(€,t G. . (' cac.,,,N- n,NAssessor's Parcel # Owner's Name ---SC, 5 5 e Phone#3 2-S53-SS SOwner's Address "3"7 6 C tv.e Contractor's Name SR, p Cr-- v,r Phone#7(00 S-tg-VZpt d# k,0 `k'S OSContractor's Address In-7-7 dos - V"<c6, ,r C c azsLiArchitect's Name Phone#Lic.# Architect's Address CONTACT PERSON •KU,2.J\ . Cr Address 4071 PHONE-7 SZ8- no. FAX EMAIL2_0.-NE) r , Q Business License.#200 631 Exp. Date0A l3‘ ,2.t.Lot Size (sf.) Building`Clsei Type of Const. Occupancy Group(s)Sprin led MAR 0 a 707 Project SQ Ft:Building 2_,2_6,cal Garage V Carportl cm o=v.L+i s'kila(type) ) Project Description -fie Total Valu ° P All submittals of New Construction (Sinale Family Residence), and Additions (Includina Casitas) are subject toPublicWorksandEngineerin, Conditions of Approval. All required Conditions of Arproval for the project must besubmittedand/or addressed[directly to Engineering and Public Works by the Amollcant for review, aissuanceofallgradingandencroachmentPermits.pproval and WHERE INDICATED BY A CHECK, SUBMIT 4 SETSMinimumsizeofplans *18 x 24" Minimum scale '/4" =1';Maximum size of plans 40" x 36") ErComplete Application 0 Mech. Plan I Duct Schematic, Equipment LocationOPlotPlanwithlotsquarefootage. 0 Fireplace Specifications, if applicableDrainagePlan: show lot corner elevations, Planning/Fire approval/Engineering ApprovalOStructuralCalculations, if applicable Fire Sprinkler plans (required at time of submittal)wet-stamped and signed) O FloorPlan, dimensioned. Door&Window Schedule Submit the following directly to the EngineeringFramingPlanwithsectionsandelevationsDepartment:O Truss Calculations and layout as applicable ENGINEERING SERVICES: Min Requirements,wet-stamped and signed) project maybe subject to additional conditions ofFoundationPlan approval (Submit 1 copy of the following ).13Electrical Plan/Load Calculations RI Site Plan with the following Finish Floor ElevationsOHealthDepartmentapprovalof: Existing, Proposed and Immediate Adjacent HomesWaste, Drain &Vent Isometric Q Title report or Grant Deed with a Tax Bill showingGaslWaterPipingIsometric (dimensioned layout) current ownershipDetailsshowingcompliancewithaccessibilityQRIFA(Red Imported Fire Ant Certificate)for anyrequirements export of soil from the siteSitePlanshowingparkingforpersonswithElPM-10 (Dust Control) for projects of more than 5000disabilitiesandpathoftraveltobuildingentrancesquarefeetofsoildisturbanceOTitle24(Energy)-2 sets/Lighting Compliance Forms RI Tribal Clearance Letter for all New ConstructionManufacture's brochure for HVAC equipment not required for additions or Casitas) Bldg.Plan Check# Planning Case# Signature i OWNER/ BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason(Section 70 31.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any Structure prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law Chapter 9 commencing with Sec.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 hundreddollars($500).) Please check one of the following: 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 of the Business and Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such 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 of the Business and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) I am exempt under Sec. of the Business and Professions Code for this reason: Owner Signature: Date: LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under the 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.The following applies to B contractors only: I understand the limitations of Section 7057 related to my ability to take prime contracts or subcontracts involving specialty trades. License Class: C- I(' State Lic. No : \CI S C130 S City Bus. Lic. No. ZOO 7 &, S 3 1 Print Name on License:Zv o CY U-C c to c 3r Phone: 7 5"lg—Vi co Address: (D 7 7(p C f C S 2.2 Every county or city which requires the issuance of a permit as a condition precedent to the construction,alteration,improvement,demolition or repair of any building or structure shall require that each applicant for the permit sign a declaration under penalty of perjury verifying workers'compensation coverage or exemption from coverage as required by Section 19825 of the Health and Safety Code. I,hereby affirm under penalty of penury one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE TO SELF INSURE for worker's 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: Policy No. I CERTIFY that in the performance of work for which this permit is issued, I SHALL NOT EMPLOY ANY PERSON, in any manner so as to become subject to the worker's compensation laws of California, and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall for with comply with those provisions. Contractor or Agents Signature:r Date: J )ZZ Disclosure Form City of Palm Springs,CA Page 1 II r ,..., , City of Palm Springs Paid Receipt Summary11.A 3200 East Tahquitz Canyon Way Palm Springs, CA 92262 Page 1 of 1 4iIF , ,DATE 3/7/2022 Phone: Bldg: 760-323-8242 Eng: 760-323-8253 Fax: See Below ACCOUNT : Coachella Valley Lighting & Electric PERMIT NUMBER 2022-861 67765 Tamara Rd Cathedral City CA 92234 3760 Camino San Simeon Palm Springs, CA Phone: 760 578 1700 Date Reference Number Invoice Number FeeCat Description Status Amount 3/7/2022 2022-861 22-1139 100-34420 Microfilm Paid 4.15 3/7/2022 2022-861 22-1139 100-37035 SMIP 1 Paid 0.50 3/7/2022 2022-861 22-1139 100-32005 RESIDENTIALMEPFEES Paid 124.60 3/7/2022 2022-861 22-1139 100-32020 PERMITPROCESSINGFEE Paid 43.14 3/7/2022 2022-861 22-1139 100-32075 S.B.1473 Paid 1.00 3/7/2022 2022-861 22-1139 261-32130 Technology Fee Paid 7.45 Date InvoiceNum Status Payment Amount 3/7/2022 22-1139 Original Due 180.84 3/7/2022 22-1139 Paid CreditCard paid 3/7/22 Gutierrez 180.84 Total Paid 180.84 Building Fax#: 760-322-8342 Engineering Fax#: 760-322-8325 3/7/22, 12:57 PM Palm Springs City Hall I Online Ref trAtht so gtir0048.t" Palm Springs City I Ail 3200 E TAHQUITZ CYN WY Jacob Azar, Audit & Rev Supervisor PALM SPRINGS, CA 92262 1 760-323-8229 Jacob.Azar@palmspringsca.gov Invoice Number: 2022861 Subtotal 180.84 Total Taxes 0.00 Total PAYMENT ID: NZH4QV7TP2ZN6 Hide Details Card: Visa 1021 March 07, 2022, 12:57 PM Method: INTERNET TRANSACTION Auth ID: 01571 5 Reference ID: 206600533165 Authorizing Network: VISA DATE VISA March 07, 2022 VISA 12:57 pm 1021 https://www.clover.com/tx/p/NZH4QV7TP2ZN6 1/2