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SOTB (12-0860)R r i P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 c&t!t 4 4 Q" Application Number: 12-00000860 Property Address: 81095 MUIRFIELD VILLAGE APN: 762-400-011- - - Application description: STRUCTURES OTHER THAN BUILDINGS Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5800 Applicant: -e Architect or Engineer: BUILDING & SAFETY0EPARTMENT BUILDING PERMIT 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. Ze�E-nseClass: B -C LicenseNo.: 493470 053 te: Contractor: RST V A 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 ($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. , B.&P.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 Owner: DORIN FAMILY TRUST 6245 PASEO ALTA PICO SKY VALLEY, CA 92209 Contractor: HILLWOOD 76280 VIA CHIANTI INDIAN WELLS, CA 92210 (760)200-3046 Lic. No.: 493470 VOICE (70) _ 0 2 FAX (7 7-7 1 INSPECTIONS (760) - 153 I Date: 8/14/12 SEP 1 q 2012 --- CITY-10E-LADUNTA - _ WORKER'S COMPENSATION DECLARATION rmMr��.c armor r. I 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 TOWNER INS Policy Number WCCO01087202 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 M 37the Labor Code, forthwi/with those provisions. Date: 1` Applicant: 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 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 and state laws relating to building construction, and hereby authorize representatives ckthis cc/o/unt Ito enter pon the above-mentioned property for inspection purposes. Date: /f/81Z- Signature (Applicant or Agent): Application Number . . . . . 12-00000860 Permit . . . IBUILDING PERMIT Additional desc . Permit Fee . . . . 81.00 Plan Check Fee 52.65 Issue Date . . . . Valuation 5800 Expiration Date 2/10/13 Qty Unit Charge Per Extension BASE FEE 45.00 4.,00 9.0000 THOU BLDG 2,001-25,000 36.00 --------------------7------------------------------------------------------- Special Notes and Comments OUTDOOR FIREPLACE PER ENGINEERED DESIGN. 7FT HGT. 5'-0" MIN SIDEYARD SETBACK. 2010 CODES. ENGINEER BRIAN GOTLIEB C33047. ------------------------7--------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 5.27 HOURLY PLAN CHECK 70.00 STRONG MOTION (SMI) - RES .58 Fee summary Charged Paid Credited Due Permit Fee Total 81.00 .00 .00 81.00 Plan Check Total 52.65 .00 .00 52.65 Other Fee Total 76.85 .00 .00 76.85 Grand Total 210.50 .00 00 210.50 LQPERMIT Bin.# City ta'd uin La Q ih Building &r Safety Division P.O. Box 1504,*79-49S Calle Tampico L4-Quinta, CA 92253 -:(760) 777-7012 Building Permit Application'and Tracking Sheet peliwt # Project Address: 14VIAF1C1.&> VIL&.46 E Owner's Name:. J>0jg /A) A. P. Number. Address: )wV1RF/e&0 vfL(.46e- Legal Description: Contractor- 11,Lwoob City. ST, Zip: 44 WIIJTA C 10"M Telephoae:71,4--102- 99-80 11 01, Address: 16-7-80 V/h CHMAITI Project Description: City, ST, Zip: 1.,IJP(AA) kJCLLS ,Ch 92210. P&C -s 7-Ao A1,G FtOPLAC-C Telephone: 760 State Lic.#: -4q5470 City LiL M. Arch, Engr., Designer 8S 57RVCrVRA1- Address: 43 /10o C-OOK - ST - City, ST, Zip: pAJ. " VC S;&97-1 C,$ 422 11 Telephone: 70 5-1, 8.3 rs 3C State Lic.#: Name of Contact Person: Construction T . ype:, Occupancy: Project type (circle one): Now Add'n Alter Repair Demo Sq. . Ft: 9 Stories: ff Units: Telephone # of Contact Person: '7 (PC) M9 -c 3 6 5 J Estimated Vahie of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE Sub mittal Rcq'd 'Rec'd lrl:r— PERMrrFEES- J cm Amount Plan Seft Plan Check submitted Structural Cafes. 4 Reviewed, ready IAWO'dr. Plan Check Deposit. Truss Cafes. Called Contact Person Plan check Balance. Tide 24 Cafes. 7— Plans pia"- Construction: Flood plain plan Plans resubmitted. Mechwilcal Grading plan eeti 2'4 Review, ready for correctio*7. Electrical Subcontactor List Called Contact Person Plumbing Great Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for correctionslissue Developer Impact Fee Planning Approval. Called Contact Person A.LP.P*. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees 1 91 z ' PGA WEST FAIRWAYS ASSOCIATION September 13, 2012 Greg and Denise Dorin 6245 Paseo Alta Rico Carlsbad, CA 92009 Re: Architectural Application — 81095 Muirfield Village Dear Greg and Denise Dorin: The Architectural Committee has reviewed your request for the installation of a fire place in your courtyard. I am pleased to inform you that the Architectural Committee has approved your application as submitted Enclosed is Exhibit C — the Compliance Review Request form. Please complete this form after the work is completed and return it by mail or fax to the address below so the completed project can be inspected. If you have any questions, please contact Cassie Gertz, Operations Manager at 760-776-5100 Ext. 345 or email: Cassie.Gert�a_Mannementtrust.com. Sincerely, For lite Architectural Committee PtGA WEST Fairways Association aald, CCAM, PCAM Manager Exhibit C — Compliance Review Request cc: Lot File Architectural Committee Post Office Box 1690 - La Quints,. California 92247 - Phone (760).776-5 100 - Fax (760) 776-5111 b" `�. 71-.780 San Jacinto Dr. Ste. E2; Rancho Mirage,, Ca. 92270 ph. (760) 834-8860 fax (760) 834-8861 Letter of Transmittal To: City of La Quinta Today's Date: 8-9-12 78-495 Calle Tampico City Due Date: 8-9-12 La Quinta, CA 92253 Project Address: 81-095 Muirfield Village Attn: Kay Plan Check #: 12-860 Submittal: ® 15t ❑ 4th ❑ 2nd ❑ 5th ❑ 3`d ❑ Other: We are forwarding: ® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup Includes: # Of Descriptions: Includes: # Of Descriptions: Copies: Copies: ® 1 Structural Plans ❑ Revised Struct. Plans ® 1 Structural Calculations ❑ Revised Struct. Calcs ❑ Truss Calcs ❑ Revised Truss w/Ltr. ❑ Soils Report ❑ Revised Soils Report ❑ Structural P/C Comments ❑ Approved Structural Plans ❑ Redlined Structural Plans ❑ Approved Structural Calcs ❑ Redlined Structural Calcs ❑ Approved Truss Calcs ❑ Redlined Truss Calcs ❑ Approved Soils Report ❑ Redlined Soils Reports ❑ Other: Comments: Structural content is approvable. Structural Plan Review Time =1.0 Hrs. This Material Sent for: ❑ Your Files ® Per Your Request ❑ Your Review ❑ Approval ❑ Checking ❑ At the request of: Other: ❑ By: John W. Thompson Rancho Mirage Office: ® (760) 834-8860 Other. ❑ Bin # City of La Quinia Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: Owner's Name: 5TON14 i,'� A. P. Number: Address: g cp%MV k ax> v` Legal Description: City, ST, Zip: L,.&v 4r-,41t- � Contractor: Contractor: elephone:%(pry ��,� %�� n. > VISION. Address: joW #&t Project Description: City, ST, Zip. Telephone- ��/') r •:fid NYi' /mss' �*. :^s:�r�. �;G /� W" t> � - State Lie. # C {� CityLic. #:� �1 Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lie. u•'.{ ryyr< c,:.11FF:: Construction Type: Occupancy: Project type circle one) New Add'n Alter Repair Demo Sq. Ft.: # Stories: # Units: Name of Contact Person: Telephone # of Contact Person: Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Ree'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cales. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21' Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN 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 r , CITY OF LA QUINTA ° BUILDING & SAFETY DEPARTMENT (760) 777-7012 INSPECTION REQUEST LINE (760) 777-7153 Owner STEVE RAFAEL Contractor PLACENCIA MIRROR & GLASS Permit Number COURTESY POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 81-095 MUIRFIELD VILLAGE 2 COURTESY INSPECTIONS TO CHECK THE RE- INSTALLATION OF EAST ELEVATION GUEST LEAKA[(€EPF INSPECTION DATE INSP. TEMPORARY POWER SETBACKS U/G PLUMBING / WASTE U/G ELECTRICAL/ GROUNDING FOOTINGS / STEEL CONCRETE SLAB I I m• DO NOT POUR CONCRETE UNTIL ABOVE SIGNED ROOF NAIL / PRE -ROOF OKAY TO WRAP FRAMING COMBINATION ROUGH ELECTRIC ROUGH PLUMBING ROUGH MECHANICAL INSULATION COVER NO WORK UNTIL ABOVE SIGNED INTERIOR GYP. BD. DRYWALL EXTERIOR LATH GAS TEST SEPTIC ABANDONMENT SEWER CONNECTION SEPTIC / GREASE INTERCEPTOR MASONRY INSPECTIONS FOOTINGS / STEEL BOND BEAM POOL / SPA / WATER FEATURE INSPECTIONS PRE-GUNITE / SETBACKS U/G PLUMBING U/G GAS U/G ELECTRICAL PRE -PLASTER ALARMS / BARRIERS DECK BONDING FINAL INSPECTIONS TEMP. USE OF PERMANENT POWER ELECTRICAL PLUMBING MECHANICAL PUBLIC WORKS DEPARTMENT COMMUNITY DEVELOPMENT DEPT. FINAL / JOB COMPLETED ABOVE APPROVALS DO NOT INCLUDE RIGHT TO TURN ON UTILITIES OR OCCUPY BUILDING