12-0219 (CONR)81309 Amundson Ave
12-0219
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P.O. BOX 1504 — -- - -- - - ---- _ ..-_
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:]
2-00000219
Property Address: -_81309—AMUNDSEN AVE
APN: 767-200-998-0 -330761-
Application description: NEW COMML OTHER NON-RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 15518
Applicant: A ) Architect or Engineer:
0'
--------------------------------------------------
LICSe CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I a icensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 6essProfessionals Code, and my License is in full force and effect.
Lice se Class: BLicense No.: 848057
Date: .Z> = L ontr
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perju 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).:
(_ 1 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.).
(_ 1 1, 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.).
1 _ ) I am exempt under Sec. , BAP.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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/25/12
Owner:
EAST OF MADISON LLC
PO BOX 1482
LA QUINTA, CA 922 8 0
2912
Contractor: _
BRADSHAW CONSTRgCTION(°, (' QVINT
46248 ROUDEL LN,d R A
LA QUINTA, CA 92253
(760)347-4246
Lia. No.: 848057
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
1 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 STATE FUND Policy Number 71950202311
I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if Ishould beco subject to the workers' compensation provisions of Section
3700 of the Labor Code, I sh forthwith comply with those provisions.
ate: •'E- IL plicant: l
WARNING: FAII-150RE 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 Director of Building and Safety 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 an state laws relating to building construction, and hereby authorize representatives
of th' courttty``to Aennter upo a above-mentioned property for inspection purposes.
OeOate: •Lr i'L nature (Applicant or Agent):
Application Number . . . . . 12-00000219
------ Structure Information 699SF STORAGE FACILITY/VB/S-2/CL7A [ENG] -----
Other struct info . . . . . CODE EDITION 2010
FIRE SPRINKLERS NO
MIXED-USE OCCUPANCY S-2
OCCUPANT LOAD 3.00
1ST FLOOR SQUARE FOOTAGE 699.00
----------------------------------------------------------------------------
Permit . . . BUILDING PERMIT
Additional desc
Permit Fee . . . 171.00 Plan Check Fee 111.15
Issue Date . . Valuation 15518
Expiration.Date . . 1/21/13
Qty Unit Charge Per. Extension
BASE FEE 45.00
14.00 9.0000 THOU BLDG 2,001-25,000 126.00
----------7-----------------------------------------------------------------
Special Notes and Comments
699SF STORAGE FACILITY/VB/S-2/CLASS A -FR
[ENGINEERED] 469SF COVERED AND 230SF OF
OPEN STORAGE AREA. THIS PERMIT DOES NOT
INCLUDE PLUMBING, ELECTRICAL, OR
MECHANICAL INSTALLATIONS OR STORAGE OF
HAZARDOUS MATERIAL - RESIDENTIAL
LANDSCAPE MAINTENANCE EQUIPMENT ONLY.
2010 CALIFORNIA BUILDING CODES.
July 19, 2012 11:09:03 AM AORTEGA
----------------------------------------------------7-----------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
STRONG MOTION (SMI) - COM 3.26
Fee summary Charged Paid
----------------- ---------- ----------
.Permit Fee Total •171.00 .00
Plan Check'Total 111.15 .00
Other Fee Total 4.26 .00
Grand Total 286.41 .00
LQPERMIT
Credited Due
.00 171.00
.00 111.15
.00 4.26
.00 286.41
r
7
I II I VIII III VIII IIII 34
Bin.
P.O. Box. 1504,:78.49S.Calle -Tampico'
LQ CA 92253 - (760) 777-7012
Building Permit Application' and Tracking Sheet '
Permit t ' _
qq `
. lT
17-
Project Address``
Ownees Name: .
A. P. Number. .. 1.3 M*t&4 AQa
Addrcss:
Legal Description: 1.(p • led • 00.1 . fl • -41616
City, Sl•, Zip: w r4 -%A
Contractor. 8 4 OJ {
Telephone: q', m — C1100
Address: q (p cs-'aiij— tMi,%
Project Description:
City, ST, Zip: N'f1/ fit' 41 22S
tr.tt_D n►C
Telephone: -7GQ, 3`(7.4( Z•,( ;
State Lic. #: INo$1 City Lic #<
dan
Arc ,Bagr.,Designer.1vA-brr'!tt(a t
Address:
-wu or coup, -i -
City, ST. Zip: P11L-4, ru5 !
Telephone: -7" -:914 {• - Sts -01 Construction Type:. ' Occupancy:
State Lic. #: Z 100Project type (circle one): New Add'n Alter Repair Demo
Name of Conracx Parson:1 Y 1f' •SL, J Sq. Ft : # Stories: I # Units:
Telephone # of Cotttact Person: (.4 S-15% 6, M I Estimated Value of Proj OOa
APPLICANT: DO NOT WRITE BELOW THIS. UNE
M
Submittal Req'd Reed
TRACK NG PERMIT. Fi;ES
Plan Sets 3
Pian Cheek submitted Item Amount
Structural Cales.
Reviewed, ready for corrections g Plan Check Deposit. .
Truss Calcs.
Called Contact Person a3 tan Check Balance.
Title 24 Cales.
Plans picked up astruction
Floodplain Pw plan
Plans resubmitted.'. /• Mecharikal
Grading plan
Z'! Review, radyf rrtictio. Issue 6
(• 9 , Electrical 411 .40V
Subeontaetor List
Called Contact Person24
ion Plumbing l..
Grant Deed
Plans picked up SALL r!
H.O.A. Approval
Plans resubmitted ( Grading
IN HOUSE:-
Review, ready for correctio a Developer Impact Fee
.Planning Approval
Called Contact Person a .P.
Pub. Wks. Appr '
Date of permit issue
School Fees
01
nips U
Total Permit Fees Lit
4 P
nom. `,➢ ; .lr/ /' iZ %7i i9?!l
3,626 d5c lt: Fc, —v v•
P
&xf
.
IIIIIIIIIIIIIIIIIIIIIIIII
35
IE
T. H F. —
MADISON
CLUB
February 24, 2012
Mr. and Mrs. Mike Gray
Gray Investments, Inc..
1131 Dolphin Terrace
Corona Del Mar, CA 92625
MGra,,"U;LraylnyestnlZnts i nc.coall
RE: Gray/Lots 28B & 29B at 8.1307/81325 Amundsen Avenue
Maintenance Building
Dear Mr. and Mrs. Gray:
Tile Madison Club Design Review Committee (DRC) reviewed and approved the drawings submitted for
the maintenance facility adjacent to your home. Please review the following stipulations:
1. Doug Siebold should be contacted relative to a Lot .Line Adjustment which is necessary to
separate this piece of land from the Golf Course property.
2. Al colors and materials are to blend with your existing home.
3. As previously noted, there is a main drainage pipe in this area which could potentially need to be
I•epaired, Maintained or otherwise accessed in the future. In the event any access to this drainage
pipe causes damage to your maintenance facility the cost to repair will be borne by you or any
future owner.
Please contact Jeff Prevost at (760) 391-5072 or Brook Marshall at (760) 219-8057 or by email at
Brook@dc.rr.com with any questions.
Sincerely,
Madison Club Design Review Committee
cc: Andrea Rodriguez
Doug Siebnrd
Mark Bradshaw
Jeri Prevost
DRC file
. -4 • 1I'[{- phi A.' .st r R [ . - ." _ j ., v' ti
• j ; xti l 6 r /r ,: • rTM . ,,' .P `'`' S _^w•"!^' 4 t. R`r 'w
53035 Mxaiwe'riiac WAY, Ln QmxrA. CA92251 TEL 760 391-4500 Fax 760 391-4599
Mark Bradshaw 4 IIIIIIIIIIIIIIIIIIIIIIIII 36 j
From: Brook Marshall <brook@dc.rr.com>
Sent: Monday, November 14,20116:28 PM
To: Mark Bradshaw
Subject: FW:
'November 14, 2011
Mr. and Mrs. Mike Gray
Gray Investments, Inc.
1131 Dolphin Terrace
Corona Del Mar, CA 92625
MGray(@Izrayinvestmentsinc.com
RE:. Gray/Lots 28B & 29B at 81307/81325 Amundsen Avenue
Utility Equipment Building
Dear Mr. and Mrs. Gray & Ms. Hanson:
The Madison Club* Design Review Committee has approved the location of the proposed Utility Building on the Madison
Club golf course (Lot `B") adjacent to your lot subject to the Golf Club approving the request. Please be advised of the
following additional conditions of approval:
• Based on the city approved "Phase I, On -Site Storm Drain Plan", prepared by RCE Consultants; there is a 26'
wide storm drain easement that runs parallel to your property line. The proposed structure will occur over this
easement.
• Within this easement there is a 24" storm drain pipe (Line "8A") which is maintained by the Madison Club
HOA. If for any reason the HOA must enter the easement for maintenance and/or repair to the pipe resulting in
L_ the structure becoming damaged and/or removed; the replacement and/or repair to the structure will be your
responsibility.
• The proposed structure will be low in height and located so not to be seen from the street or the golf
course. Materials shall complement the residence. As discussed, additional landscaping will be installed to
screen the structure from the street and the golf course.
Please contact Jeff Prevost with any questions at (760) 391-5072 with any questions regarding this matter.
\
Sincerely,
Madison Club Design Review Committee
cc: Doug Seibold
DRC File
"I
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
IIININIII III 37
IE
WCV
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
To: Greg Butler, Director - Building & Safety To Planning: June 01, 2012
From: Les Johnson, Director -Planning Due Date: June 08, 2012
Permit #: 12-219 Status: 2nd Review
Attn: Jay Wuu
Building Plans Approval
(This is an approval to issue a Building Permit)
The Planning Department has reviewed the Building Plans for the following
project:
Description:
Address or General Location
Applicant Contact:
Storage Facility
81-307 Amundsen Ave
Mark Bradshaw (760)275-6891
The Planning Department finds that:
❑ ..,these Building Plans do not require Planning Department approval.
...these Building Plans are approved by the Planning Department.
❑ ...these Building Plans require corrections. Please forward a copy of the
atta hed cor ections to the applicant. When the corrections are made
pie a retur them to the Planning Department for reviewC.
Les J nson Di tor -Planning Date
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