04-5821 (RPL)T4hf 4 4 a"
P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
Application Number . . .
Property Address . . . .
APN:
Application description
Property Zoning . . . . .
Application valuation . .
Owner
CRV LA QUINTA 70 LP
C/O CAPSTONE ADVISORS
9255 TOWNE CENTER DR 520
SAN DIEGO CA 92121
BUILDING & SAFETY DEPARTMENT
(760).777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-�Jr 3
04-00005821
80773 BELLERIVE
775 -360 -024 -
POOL - RESIDENTIAL
LOW DENSITY RESIDENT
29000
Contractor
Date u�3V
TOPMAN BUILDERS
P.O. BOX 10202
PALM DESERT CA 92255
(760) 772-7296
WCC: VIRGINIA SURETY
WC: 00500019402 01/01/05
CSLB: 455121 11/30/05-
CCC:
1/30/05CCC: B -C29
---------------------------------------- ------------------------------------
Permit . . . . . . MECH POOL
Additional desc
Permit Fee 24.00 Plan Check Fee 6.00
Issue Date . . . . Valuation . . . . 0
Qty Unit Charge Per Extension
BASE FEE -15.00
1.00 9.0000 EA MECH FURNACE -<=100K 9.00
----------------------------------------------------------------------------
Permit . . . . . . BLDG POOL PERMIT
Additional desc
Permit Fee . . . . 291.00 Plan Check Fee 189.15
Issue Date . . . . Valuation . . . . 31000
Qty Unit Charge 'Per Extension
BASE FEE 252.00
6.00 6.5000 THOU BLDG 25,001-50,000 39.00
----------------------------------------------------------------------------
Permit . . . . . . ELEC POOL PERMIT -RES
Additional desc..
Permit Fee . . . . 45.00 Plan Check Fee 11.25
Issue Date . . . . Valuation . . . . . 0
Qty Unit Charge Per Extension
BASE FEE '15.00
P.O. Box 1504�� VOICE (760) 777-7012
T-Vf
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: C�[ o Date:
Applicant:
Applicant's Mailing Address:
Architect or Engineer:
Architect or
Lic. No..
BUILDING PERMIT DECLARATIONS
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 Licen is i fTrce and effect. - - - ( 1
License Class- `S n . ALicense No. :1 512, l
Date t Contractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury th I am xempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and. Professions Code: Any
city or county that requires a permit to const Iter, 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 Contractors' 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).):
U 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 or 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.).
U I, 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner.
WORKERS' COMPENSATION DECLARATION
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 pen -nit is
_C
1) 1 �� ed:t My w r4 +� s' comp 5ation insurance carri and lacy numbgr e:
Carrier 'U V Pte► x)14 6 "[ Policy Number1+
_ I certify that, in the perfonhance of he work for which this permit is issue , 1 shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those prc on /f
, —&7%!&L& 4 , AppdORKER
----------------------------
WARNING: FAILURE TO SECUOMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UPTO ONE HUNDDOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of pa 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
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, indemnity and hold harmless the City of La Ouinta, 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 infopa n is corect. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county toe err pont bove-mentioned property for inspection purposes.
Signatures (Applicant or Agent):
Page 2
Application Number. . . . . . 04-00005821 ..Date
8/03/04
Qty Unit Charge Per
Extension
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL
30.00
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING
Additional desc
Permit Fee 33.00 Plan Check Fee..
8.25
Issue Date . . . . Valuation . .
. . 0
Qty Unit Charge Per
Extension
BASE FEE
15.00
2.00 6.0000 EA PLB FIXTURE
12.00
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
---- -----------------------------------------------------------------------
Special Notes and Comments
POOL & SPA. ANSI Z21-58-1998.
---BBQ
FIREPt}{%9(a!QIO�ALARMS/BARRIERS
SHALL BE IN PLACE PRIOR TO PREPLASTER
INSPECTION.
Fee summary Charged Paid Credited
-----------------
Due
------------------------------
Permit Fee Total 393.00 .00 .00
----------
393.00
Plan Check Total 214.65 .00 .00
214.65
Grand Total 607.65 .00 .00
607.65
July 21, 2004
Architectural Committee
PGA WEST Fairways Association
P O Box 1658
La Quinta, California 92253
Re: 80321 Merion La Qumta - PGA WESTT" - Property Owner: Houck/Webb
Dear Sir/Madam:
CNL Desert Resort, LP, formerly known prior to statutory conversion as KSL Desert
Resorts, Inc., ("Desert Resorts') is the owner of the golf course property immediately adjacent to the
rear property line of the above referenced residential property. Desert Resorts is the holder of a five
(5) foot easement along the rear property line (the "Setback Area') of all of the residential lots
located in the Hermitage project at PGA WEST M, however Desert Resorts is willing to grant its
limited consent to a property owner's encroachment and construction of pool improvements within
the Setback Area subject to the property owner's compliance with certain terms and conditions.
The Property Owner and the pool contractor have requested Desert Resorts' approval: of the
encroachment of the pool within the Setback Area. This letter shall serve as your notice that Desert
Resorts approves of the pool's installation subject to certain teams and conditions including, but not.
limited to, the following:
1. Property Owner agrees to construct and maintain a solid, continuous twenty-four
inch (24') wide mow strip which shall be located along the entire length of the
Setback Area abutting the rear property line;
2. Property Owner agrees to construct a solid buffer wall along the length of the pool
improvements a minimum height of twenty four inches (24');
3. The pool and related improvements (excluding the mow strip) must be set back a
minimum of 24" from the golf course property line; and
4. The mow strip, consisting or turf or concrete, shall not extend above the ground
elevation, or may be a shrub bed at the discretion of Desert Resorts golf course
superintendent.
If you have any questions, please contact Barbara Larsh at (760) 5648023 or me at (407)
418-6804. _ .
Cc: Carol McKnight
Barbara Larsh
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