9993 (AR)P.O. BOX 1504
Building 5��25 �� 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Carlene Smith
Mailing
BUILDING: TYPE CONST
Address same A.P. Number
City,Zip Tel.
a Quinta 92253 771-1176 Legal Description
r..
Contractor I
Geretette Construction
Address
55888 Yucca Trail.
Yucca Vly '92284 365'3889
State Lic. City
& Classif. 280103 iLic.# 1{201
Arch., Engr.,
Designer
Address Tel.
City j IZjp' (State
! Lic. #
I am licensed under provision'saf,Chapter9 (commencing with Section
the Business.and Professions Code, and my license is in full force and
� .
' OWNER -BUILDER DECLARATION
I hereby affirmethat I am exempt from the Contractor's License law for the following
reason: (Sec. 703)1.5, 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 rile 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 that. he 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, Buisness 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
❑ Copy Is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICAYE OF EXEMPTION FROM
WORKERS' COMPENSATION'INSURANCE
(This section need not be completed i!. -the permit istfor one hundred dollars ($100) -valuation
or less.) S
I certify that in the performance ofrthg work for which _thL�;pe mit 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: If, after malnng this Cer ilibate 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 if 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 ordinancesand state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant— Date
Mailing Address
City, State, Zip
No.
OCC: GRP.:
Description Add 0 clear fire place to
living rant
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation
4�o0.®a
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
46.80
Const.
72.00
Mech.
Electrical
Plumbing
S.M.I.
.50
Grading
Driveway Enc. ,
Infrastructure
fTrte .ai"b %rl A"14 d fi0_r1C_%_f4 44
TOTAL
i () _ miw I `17MIAU i 119'* Q 30
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date f�'� Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. a $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. S0. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® V4c
HOUSE SEWER
LATHING
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
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
Vk,FINAI- INSPECTIOAGt:)T4571t
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
PGA WEST. RESIDENTIAL,`ASSOCIATION,-INC.
August 12, 1991
Robert and Carlene Smith
38 Balboa Coves
Newport Beach, CA 92663
R . 54-325OakHi
Dear Mr. and Mrs. Smith:
Thank you for your Architectural Variance request to add a
fireplace, dry bar and entertainment center to your home.
Your plans, have been approved as submitted, with, the following
conditions:
H
1. The attached "Construction Regulations" must be
adhered to:
2. Any roof damages ;and future. water entry due to the
installation; of the - fireplace are the
responsibility of'the-homeowner.
3. Any -roof tiles..that are. walked on 'causing damage,
or -:damaged because: ,of sheetmetal and ,plastering
work are to'be:repaired by the homeowner or
homeowners contractor.,
If you have any questions,' please contactt,he Management office.
Thank you, ,
Bruce F ,azier, Property Manager
on Beha.f of the PGA West
Architectural%tand cape Committee
Encls.
P.O. Box 12710, Palm Desert, California 92255; Telephone. 619-341-0393 FAX 619-346-5632
REQUEST NO.
ARCHITECTURAL/LANDSCAPE VARIANCE REQUEST„
DATE:
OWNERS NAME(S)
PROPERTY ADDRESS 54 5 0A Y_ i 'UNIT/LOT #
LOCAL PHONE 6/9- ?-71 - //7� OTHE,R'PHONE
MAILING ADDRESS 3,R BA I -130A: 'CO tJIF-5 N'6_)f6kr13gpAc_4 CA
(If d,!.ffet6nt.f±omi.'p3:�cipibrty address)':
The following modif ication.. is , prop'q's ed and approval,is requested
for an Arc hitecturdl /ri"andsc aipo Vwriance in. accordance with the
procedure outlined in our C,. C. & R. '8.
We have attached the necessary," d
oduments -,as outlined in the
procedures sheAt. We -also understand -that, approval is gran
ted,
we will'be responsible for the c-'O"s;"-ts'-Of:-sa�i!i'mod,3*-f-3*.ca,'t'ion and any
and'' all '!damage -:may` occur,**' 'to any common '
area property
including but not limi"ted to-' sprinkler systems,' utilities,
F
buildings, lawns and - plants. We,, further.. understand that all
building modifications -t9 approval
- require h of ...the City of La
Quinta and building Permits as may be required. "-The cost of these
approvals and permits .will 'be. bothe* byJ'us...:,Wefur'ther agree that,
if approved, thd.modificatIons will --be --,mad6'- in 'strict compliance
with the plans submitted with this application'.
The modification we proposed is _F i gt 5:-PL_),,+,-ce=-
(Please I p 11 rovide a complete
lete'
E-Aj i lvm c --/VT- CA- p
13 A/FTS. -r.3 /,'S
narrative description Of. 'the,pr6p6'sed7 modifti--atIon).
7 -RE oNL-y n t\j DM
OWNERS SIGNATURE(S)
ppp�
REQUEST NO.
ARCHITECTURAL/LANDSCAPE VARIANCE REQUEST„
DATE:
OWNERS NAME(S)
PROPERTY ADDRESS 54 5 0A Y_ i 'UNIT/LOT #
LOCAL PHONE 6/9- ?-71 - //7� OTHE,R'PHONE
MAILING ADDRESS 3,R BA I -130A: 'CO tJIF-5 N'6_)f6kr13gpAc_4 CA
(If d,!.ffet6nt.f±omi.'p3:�cipibrty address)':
The following modif ication.. is , prop'q's ed and approval,is requested
for an Arc hitecturdl /ri"andsc aipo Vwriance in. accordance with the
procedure outlined in our C,. C. & R. '8.
We have attached the necessary," d
oduments -,as outlined in the
procedures sheAt. We -also understand -that, approval is gran
ted,
we will'be responsible for the c-'O"s;"-ts'-Of:-sa�i!i'mod,3*-f-3*.ca,'t'ion and any
and'' all '!damage -:may` occur,**' 'to any common '
area property
including but not limi"ted to-' sprinkler systems,' utilities,
F
buildings, lawns and - plants. We,, further.. understand that all
building modifications -t9 approval
- require h of ...the City of La
Quinta and building Permits as may be required. "-The cost of these
approvals and permits .will 'be. bothe* byJ'us...:,Wefur'ther agree that,
if approved, thd.modificatIons will --be --,mad6'- in 'strict compliance
with the plans submitted with this application'.
The modification we proposed is _F i gt 5:-PL_),,+,-ce=-
(Please I p 11 rovide a complete
lete'
E-Aj i lvm c --/VT- CA- p
13 A/FTS. -r.3 /,'S
narrative description Of. 'the,pr6p6'sed7 modifti--atIon).
7 -RE oNL-y n t\j DM
OWNERS SIGNATURE(S)