PAT (10-0559)61194 Living Stone Dr
10-0559
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT •
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. ,
LicenseClass: C54-DO3 L' License No.: 842535
te: O V401 ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury 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 1$5001.:
(_ 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. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
A) 1 f l
Lender's Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/23/10
Owner:
DAVID SHEVCHUK
61194 LIVING STONE DRIVE
LA QUINTA, CA 92253
Contractor:
ACROPOLIS MARBLE STONt TILE ,
41230 AETNA SPRINGS R 1
BERMUDA DUNES, CA 9220 r �� 1.� R
(760) 880-8009. CC, ()'f
11010 '-�
LiC. No.: 842535
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
_ Ihave 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.
t 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 1932386-2010
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,
-and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith
hccomply
ywwith those provisions.
-16'ate*"— scant:
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.
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 pursuantto 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 180days 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 and tate laws relating to building construction, and hereby authorize repr
of thi bunty to enter upo e -above-mentioned property for inspection urposes.
ate: i% ignature (Applicant or Agent):
LQPERMIT - '
. t
Application Number:
10-00000559
Property Address:.
61194 LIVING STONE DR
APN:
764-280-999-200 -300236-
Application description:
PATIO COVER RESIDENTIAL
Property Zoning:
MEDIUM HIGH DENSITY RES
Application valuation:
2554 1
c&ht
4.4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT •
Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. ,
LicenseClass: C54-DO3 L' License No.: 842535
te: O V401 ntractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury 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 1$5001.:
(_ 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. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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:
A) 1 f l
Lender's Address:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/23/10
Owner:
DAVID SHEVCHUK
61194 LIVING STONE DRIVE
LA QUINTA, CA 92253
Contractor:
ACROPOLIS MARBLE STONt TILE ,
41230 AETNA SPRINGS R 1
BERMUDA DUNES, CA 9220 r �� 1.� R
(760) 880-8009. CC, ()'f
11010 '-�
LiC. No.: 842535
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
_ Ihave 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.
t 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 1932386-2010
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,
-and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith
hccomply
ywwith those provisions.
-16'ate*"— scant:
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.
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 pursuantto 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 180days 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 and tate laws relating to building construction, and hereby authorize repr
of thi bunty to enter upo e -above-mentioned property for inspection urposes.
ate: i% ignature (Applicant or Agent):
LQPERMIT - '
. t
Application Number . . . . ." 10-00000559
Permit PATIO COVER PERMIT
Additional desc .
Permit Fee' 54.00 Plan Check.
Fee
35.10
Issue Date . . . Valuation
2554.
Expiration. Date 12/20/10
Qty !Unit Charge Per
Extension `
BASE FEE
45.00 "
1.00 9.0000 THOU BLDG 2,001-25,000
9.00
--------
Special Notes and Comments
192 S.F. OPEN LATTICE SHADE'STRUCTURE
ATTACHED TO'CASITA AND SFD: NO POSTS, NO
`
FOOTINGS.. 2007 CODES.
-------------------_----------------------------
Other Fees . . : . . . . BLDG"STDS ADMIN (SB1473)
1:00
STRONG MOTION (SMI)
- RES
..50
` Fee summary Charged Paid Credited
--------
Due
-----------------
Permit Fee Total 54.00 .00
.00
•54.00
Plan Check Total 35.10 .00
.00
35.10
Other Fee Total 1.50 .00
.00
1.50
-Grand Total 90.60 .00
.00
90.60
LQPERMIT -
,
David J. Shevchuk
Patricia Shevchuk
13-760 Highpointe Drive
Kelowna, BC V 1 V2Y-3000
Property Address: 61194 Living Stone Drive
CONDITIONAL APPROVAL
Dear Mr. & Mrs. Shevchuk:
We are pleased to inform you that your plans for installation of BBQ, low voltage lights, drainage, rear yard
landscaping, attached patio cover, water feature, irrigation, fire pit, seat wall, received on 05/25/2010, have
been approved by the Design Review Committee per your submittal [with the following condition(s): 1, 2, 39
5, 8, 9,11,12,13,14,15,,16,17,19, 20, 23 and 24 (see attached copy).
Please note: Any damages caused by contractor due to construction shall need to be repaired, all:
- -- -irrigation and landscape shall be restored to original condtion.
This approval does not constitute. -consent by the Association for the applicant to encroach, trespass, or build
on any property other than that of the applicant. This approval 'is related solely to the items reserved for
approval by the CC&R's in accordance with the Architectural Guidelines. The approval does not extend to the.
quality of work done by your architect, or contractor, or to any structural engineering,, soils engineering, or site
grading and drainage, design. You are urged to obtain the. services of a state licensed professional for
consultation as needed.
The Design Review Committee is composed of volunteers. As such, .it does not review applications to ensure
compliance with building codes, or other local or state laws. Please be advised that this approval does not
relieve you from obtaining any necessary building permits from the governmental agencies involved to ensure
compliance with these codes. Any violations of these ordinances will be your responsibility to correct. Thank
you for your patience in this matter and for complying with the Association's policies and standards.
Si rely, -
F rt e De 'gn eview Committee
-Barry Sterett,.CCAM, CMCA
Association Business Manager
Enclosures
cc: Board of Directors
Design. Review Committee
Professionally Managed by Action Property Management, Inc.
60-750 Trilogy Parkway, La Quinta, CA 92253-7717
760-777-6059 .800-400-2284 760-777-6097 fax
www. actionlife. com
1'
n
Bin #
City of La Quints
Building 8t Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
(�
ProAddress: r
1 IQ2
Owner's Nati% VG
A. P. Number:
Address:
Legal Description:
Contractor:
City, ST, Zip:
xssv
Telephone:ig
Address: �
Project Description:
City, ST, Zip: D:
U
}'..
V. .. ..Tele
Stale Lic. # : City Lic. Cvo
'
Arch., Engr:, Designer-.
Address:
City. ST, Zip:
Telephone -
State Lie. /. rl>ii%; y }° .:•
,H
Name okontact Person:
Construction Type: an
Occap cy:
pm' circle one): New Add'n Alter Repair Demo
7 type )"
Sq. Ft.:#Stories:
.
' # Units:
Telephone,# of Contact Person:
Estimated Value of Project: -
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Plan Sets
Pian Check submitted
Item
Amount
Structural Cale&
Reviewed, ready for corrections
Plan Check Deposit
Truss Ctics.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Griding
M HOUSE:-
Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.p,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees