12946 (AR)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-137 Oakhill LA QUINTA, CALIFORNIA 92253
''Owner Darlene Nichols
Mailing
Address Same
City Zip Tel.
La Quinta:, CAJ92253 1 564-1676
Contractor
Sunrose Properites, Inc.
AYtze b50 asraera Road
CityZip Tela
Pala Desert, C:A 9226.0 346-2941
State Lic. City
& Classif. B 533674 Lia # 1137
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm 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.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed, pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars (5500).
❑ I, as owner of the property, or my employees with wages as their sale compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, auisness and
Professions 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 through his 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (S100) valuation
or less.)
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.
Date Owner
NOTICE TO APPLICANT: It, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
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 the above-.
mentioned property for inspection purposes.^ _
�i a
Signature of applicant :--"�.x.:.anr:.��aC" w__/" Date
Mailing Address f
City,' State, Zip
BUILDING: TYPE CONST
.P. Number
Legal Descript
Description
No' 1.2949
_OCC. GRP.
Room Addition Remodel
Sq. Ft. 16 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter O Repair ❑ Demolition ❑
Estimated Valuation $10184.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
29.15
Const.
45.€30
Mech.
Electrical
Plumbing
.S.M.I.
.50
Grading
Driveway Enc.
Infrastructure
TOTAL
74,65
REMARKS
i
ZONE: BY:
%[ I1
Minimum Setback Distances: J `
Front Setback from Center Line
Rear Setback from Rear Prop. Line i
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $ ' '
UNITS
A.C. UNIT
COLL. AREA
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
BONDING
MOBILEHOME SVC.
BAR SINK
POR. gp, FT. ®
FORMS
SEWER OR SEPTIC TANK
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
/
W(/FOUND. REINF. VVV/C/ �G
L I
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT. ®
WALL SQ. FT. ®
OTHER APPJEQUIP.
DRINKING FOUNTAIN
GAS (FINAL)
URINAL
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
L INSP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
VENTILATION
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
FIREPLACE
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
/
W(/FOUND. REINF. VVV/C/ �G
L I
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
L INSP.
AMING R U
FINAL INSP. _
ROOFING �"
.-s
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
SULATION/SOUND
FINISH GRADING
n
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
ARCHITECTURAL/ LANDSCAPE VARIANCE APPLICATION
PGA WEST RESIDENTIAL ASSOCIATION° -,INC.
.Please complete and include this request fo'rn along with four (4)
sets of your prop.gaed -home. improvement plans to:
PGA WEST RESIDENTIAL ASSOCIATION, INC.
P.O. Bos 1060
La Q.uinta,,CA:92253
or, 55-940 PGA Boulevard
La Quint,a, CA 92253.
r ;
Attn: Property. Manager
NAME 'J r !L /l/ l G. L S DATE
r ADDRESS S l L
PHONE: — ! (o UNIT: fa%�io /
PROPOSED ST ING DA t Z. -1 - 3.
APPROXIMATE CO PLFiTT DALE ,., /TLS - �/ 3.
Homeowner'&,..,6ignature
The following appropriate information should accompany your
completed application:
I. Four (4) sets of complete plans to include:
a. Improvements and/demolitions
b. Plot plan
C. All dimensions proposed
d. Relationship to neighboring units.
e'. Material and color scheme..
f. Planned modifications of all -external- systems (land-
scape, sprinklers, gas lines, electrical, etc.)
2. Agreement and Covemant Running with the Land 'completed
and ,notarized. Two (2) original.
3. Conditions of Approval, and Disclaimer form (signed)
4. Facing and Adjacent 'Neighbor form (if applicable)
5. Construction Regulations form (signed)
ELECTRICAL [ ] Approved [ ] Disapproved
Signature C/ Date
LANDSCAPE Approved ] z is; pproved
Sig at rDate
ARCH TTEE [Y� Approved [ ] Disapproved
Signature Dater-
ARC:?/Rev 5/93 -1-
e
CONDITIONS OR APPROVAL AND DISCLADMER
1. Unless specifically agreed otherwise in writing b'y the Board
of Directors, approval o:f,,the submit -ted plans. is expressly
conditioned upon the owner.agree inq to assume the cost for
any additional" maintenance directly or indirectly caused by
the proposed modificia'ion(p.), addit_on(s.) or improvement(s).
2. During the approval process, the Association may require that
its architect, landscape consultant, attorney, contractor,
etc, review the proposed plans... SUCH REVIEWS) ARE VERY
LIMITED IN SCOPE .AND MAY NOT BEM RELIED UPON BY THE OWNER TO
ENSURE CORRECTNESS OF PLANS FROM•EITHER A LEGAL,
ARCHITECTURAL, STRUCTURAL, ENGINEEQING, LANDSCAPING, ETC.
STANDPOINT.
3. The applicant FURTHER AGREES AND REPRESENTS that, as a
condition of submittal, they have independently reviewed
and can firmed.that the pr.o,paied plans are correct from a
legal, structural, architectural, engineering, and/or
landscaping standpoint and wild not in anylway, other
than that. which. has been disclosed in. the application,
negatively impact the Assbciation or cause damage or
additional maintenance -to Association -owned and/or
maintained p'ro'perty.
4. The applicant FURTHER AGREES AND REPRESENTS that the applicant
has complied with al -1 applicable Federal, State, County and
City Iaws.and ordinances and has :obtained all necessary
permits in connection with the proposed plans. Applicant
further agrees to send copies of all permits to the
Association prior to the actual implementation of the
proposed plans.
PLEASE NOTE THAT APPROVAL OF THE PROPOSED PLANS BY THE
ASSOCIATION DOES NOT CHANGE! OR -ABROGATE THE APPLICANT'S
OBLIGATION TO OBTAIN ALL NECESSARY PERMITS AND/OR COMPLY
WITH ALL APPLICABLE GOVERNMENTAL REGULATIONS.
lZ
Dated:_ d — Accepted
ARCH/Rev 5193 -4-
b yI...,
pb cant'+s s-' gnature
J� N (b �lle,4el_6
Printed apolicant''s name
CONSTRUCTION REGULATIONS
1. Any damage done to common area facilities as a result of this
construction must be repaired prior to the completion of
project. Return of deposit check wil'_ be held up until work is
satisfactorily completed.
2. No dirt, debris or other related construction material is to be
dumped on the PGA West site. All excess materials are to be
dumped off-site.
3. No material is to be.delivered and placed in street. It will
be required to place all pallets, cement and other materials in
homeowner's driveway, yard or garage.
4. Any material stockpiled in the driveway is to be left in such
a manner that it will not be an annoyance or a visual
distraction to surrounding homeowners. Do not block mailbox
access or the postal service will not deliver.
5. Do not stockpile material on adjacent lots.
6. All trash and debris are to be picked up daily and the street
cleaned as needed.
7. When your company has created a safety hazard, such as an open
trench, hole, exposed wires, etc., it must be barricaded in
such a manner necessary to prevent injuries and accidents.
8. Each unit's'irrigation and electrical. facilities are connected
with adjoining properties. When modifications are improper to
such systems, neighboring landscaping may be destroyed. Please
contact the Property Management office when modifying
irrigation or electrical systems in any way at (619) 771-1234.
-All landscape and electrical modifications must be included in
the plans and are subject to approval.
9. When entry onto golf course property is necessary in any way,
contact Golf Course Operations through Management at the
Homeowner's Association office at (619) 771-1234.
10. Do not remove PGA West construction barriers without
permission.
11. If escrow is not closed, no work shall commence.
12. Park all vehicles on the same side of the road so as not to
cause traffic congestion.
ARCH/Rev 5/93 -6-
s
13. Property lines must be verified by Homeowner/ contractor before
starting any work.
14. ALL DAM -AGES, or NON-COMPLIANCE WITH THESE CONSTRUCTION
REGULATIONS WHETHER DURING OR UPON COMPLETION OF PROJECT, IF
NOT REPAIRED WITHIN (5) DAYS WILL BE REPAIRED OR CORRECTED BY
THE ASSOCIATION AND BILLED TO THE HOMEOWNER.
15. When applying surface material to patios, walkways, etc., the
homeowner assumes risks for damages which may be caused by
mowers, edgers or other gardening equipment.
16. Drainage systems for new construction will be designed on an
individual basis. owner/ contractor to work with Architectural
Committee and Landscape Manager for approved system.
17. Construction regulations must be signed by -the pool contractor
and Homeowner.
18. If you have any further questions, please call the Association
Management office at (619) 771-1234.
Failure to comply with above regulations may result in denial of
entry to the community.
C
HOMEOWNEAigna
l6 1zD '- �—�3
ture Date
CONTRALT, Z —
gnature Date
-7-
ARCH/Rev 5/93