15053 (RPL)4.4
�t B• P.O. BOX 1504 No. 15053
Building 3 78-495 CALLE TAMPICO
Address 54^-atl Oak HI11 LA OUINTA, CALIFORNIA 92253
Owner
Asher
Mailing
Address Same
City
La. Quinta,
Zip
. 9.3253
CalifonniA ftdls & Spas
Address
.41910 Boardwalk A--2
Valor, Desert, ,Zip 92211
State Lic.
& Classif.. C-53 556128
Designer
Address
334-X4.861
Tel. 340-9000
City
Lic. # 355
Tel.
City Zip State
s
Lic. #
(LICENSED CONTRACTOR'S DECLARATION
I herebyy affirm that•I am Iicense"nder provisions of Chapter 9 (commencing with Section
7000)pf'Division 3_of the Business``s'and Professions Code, and -my license is In full force and
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description
Sq. Ft. No. No. Dw.
Size - Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ .
's\N,I-,I-m4ha-perf6gnance•of thp.work for v�rfirch this permit is issued, 1 shall '
employ any rn in manner�so as to become subject to the Workers' Compensation
Laws of Cal ifpeorniaso��� �� (� ,�; 1h,
Date Owner
NOTICE TO APPLICANT:. H, after makfng. this. 'Certificate of. Exemption you should become. ZONE' Rte'
subject to the Workers' Compensation provisions of the ^Labor Code, you must forthwith- '
comply with such provisions or this permit shall be deemed revoked.. M IP mU m S ck DISCBS ,.
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.
Tt4 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 car lly that 1 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.
Slgnature of applicant Date
Mailing Address
City, %State, Zip
F t Se k from Center Line
Rear Set a from Rear Prop. Line
ttie�tr etback'from Center Line
IN 45vIli
- •--r =— ` fS de Set k from.Property Line
..
FIN rA,}L,DATE' INSPECTOR
CYC—
Issued by:Date Permit
Validated by:
Validation:
'IGNATURE DATE
-
OWNER -BUILDER DECLARATION
hereby for following
ES1lmated ValUatlOn,
1 affirm that I am exempt from the Contractors License Law the
reason: (Sec. 7031.5,Business and Professions -Code: Any city or counfy_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
PERMIT
AMOUNT
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 Any Section 7031.5 'any for
Plan De '
p
alleged exemption. violation of by. applicant a permit
subjects the applicant to a civil penally of not more than five.hundred dollars ($500).
.Chk.
Plan Chk. BBI.
G ppt�
s:S atii
❑ 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
Const.
®e00
�
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,
Mech.24.00
'
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
'
Electrical
45.00
of proving that he didnot build or improve for the purpose of sale.) . .
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
27.00
-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
S.M.I.
such projects with contractors) (caned pursuant to the Contractor's. License Law.) -
Grading
❑ 1 am exempt under Sec. B. & P.C. for this -reason
Driveway Enc.
o e owner
Infrastructure
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 Co J filed w't the c�lty, Certi�leedd is her y furnished.
�\t�\
\ 1=, y
4.%..CERTiACTE O E TION
TOTAL244#-50
,ROM
WORKERS'
REMARKS
SC�OMPENSATION'INSURANCE
\��l,Tils�sei:7un nem nbt-be Q0�d I1�tliis�pe -a one hundred dollars ($100)valuation.
'
or less.l .�
's\N,I-,I-m4ha-perf6gnance•of thp.work for v�rfirch this permit is issued, 1 shall '
employ any rn in manner�so as to become subject to the Workers' Compensation
Laws of Cal ifpeorniaso��� �� (� ,�; 1h,
Date Owner
NOTICE TO APPLICANT:. H, after makfng. this. 'Certificate of. Exemption you should become. ZONE' Rte'
subject to the Workers' Compensation provisions of the ^Labor Code, you must forthwith- '
comply with such provisions or this permit shall be deemed revoked.. M IP mU m S ck DISCBS ,.
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.
Tt4 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 car lly that 1 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.
Slgnature of applicant Date
Mailing Address
City, %State, Zip
F t Se k from Center Line
Rear Set a from Rear Prop. Line
ttie�tr etback'from Center Line
IN 45vIli
- •--r =— ` fS de Set k from.Property Line
..
FIN rA,}L,DATE' INSPECTOR
CYC—
Issued by:Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
Y
ARD SPKLR SYSTEM
2ND FL. SQ. FT. p
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (FINAL)
TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN.
SO FT ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
x$
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
REMARKS:
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
FINISH GRADING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION
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 APPJEQUIP.
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
wa_
i
N
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITU►LS
GARDEN WALL FINAL
Architectural Committee Worksheet`
�- = � - 9: •s, vJ; 4.l �� ate; �: �
Date Recezved Owners Name' P;:G.g. Re t L,ocatioa
Received By Type of Request [j C. e e acomplete
Checks Recieved .oa 9'S
Ri.versid'e Couaty:'Recorders office: Check $ l:o,et_b9 .'Amount 5
PGA..West Residential Assoc-iat:ioa Inc. (Non Refuada'ble)
Check $ ID !o': Amount 405-ik � Deposited on
PGA West Residential Associitioa Inc: (Re,fundable)
Check.$ eog I Amount $ Dom Deposited on, Refunded
Approval Application$ [j Complete [] Incamplete
Agreement Covenant $ [] Complete... [j Incomplete
Notarized [] Yes [ ]:. No - Number of P.,lans
Contractor Naive. - Contractor License $ Proof of Ins.
C.
PCL
Submitted t o.:=n1,._ =" ' 2 . 5
_.
Arc r, ect 'alCommittee Mettber In_tials . Date
Reviewed BY:
:a�y i� 1r
A=chitectu" a1 Corm L*` tte .Member ' nitials+ Date
Approved.
Denied ['j Arc=itectur-a` Coaiaiittee_. Member I�i"tials Date
41-910 Boardwalk, Suite A-3 Bus:J619) 3a9-9uuu 3
Fax
'Palm Desert, CA 92211
(619 346-5407
PAT CATTARINI yj
DIRECTOR OF MARKETING
CA UC No. 185102 1�.� : vtfowlQN v���•F q 7•
t.
�fWIFU![Oltt Cuuu� a� arn�
=
SP R
ARCHITECTURAL/LANDSCAPE VARIANCE APPLICATION
PGA VEST RESIDENTIAL.ASSOCIATION.
INC.
form,, 'to:- along* with
Please complete and, include , thi's .. request -
four (4-) sets, ,.of. your proposed , home ;improvement
plto :
ans
PGA WEST :RESIDENTIAL: AS.SOCIATION.,
. INC
La Quinta', CA 9 22 5.3
or , 55 -'940 • P'GA ;Boulevard
La. Qu Ata.,-, CA 92253
-At t Property Manager:
l `
��J/'LL
N _
NAME: syr) • /
DATE :�.j
r
ADDRESS : ' q
5+133 OAv�-.��
;UNIT :
PHONE: / ..-_ / ;c�y�sb`1430
PROPOSED. SJARTING`� kNTE - •
APPROXIMATE CO PLETION T Swag F.fscr:. S -r -z
Homeownefli6 SighAture
The following appropriate information ..should accompany your
completed application:
1. Four 14) sets of ' complete•�'plans,.,;to' include :
a. Improvements and%demolitions
b. Plot:,., plan
C. All -6dimensions proposed
0069 d. Relationship to neighboring; unit's'
e. Material and color scheme,
ok �
�Pf. Planned mod_=ifications .of all :external .systems (landscape,
sprinklers, gas lines, electrical, etc.)
c 2. Agreement- and Covenant Running 'with.. the' Land completed and
notarized;. Two (2), original
f
3. Conditions of Approval.:and` ,tiiscl.aimer ,f'orm. (signed)
tJ /A
4. Facing and 'Adj acent Neighbor torin (.if applic,able)
J 5. Construction Reguatiors form Asigned).
ELECTRICAL [ 7 Approved [ ]'Disapproved
Signature Date.
LANDSCAPE [ ] Approved [ ] Disapproved
Signature Date s
i
Mei
ARCHITECTURAL COMMITTEE [.,]Approved I ] Disapproved
Signature Date
ARCH/Rev 6/94 I
4