12-0334 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
12-00000334
Property Address:
55898 BRAE BURN
APN:
775 -280 -064 -
Application description:
PLUMBING
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
350
T4ht 4 4 Q"
Applicant: Architect or Engineer:
0 011 - . NIN
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LIC cc CO TRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licen under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of, the Business a rof onals Code, and my License is in full force and effect.
License Class: C27 License No.: 883625
Date: _/r 1► Contractor:
( OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury at I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Busine 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).:
(_) 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 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.).
I—) 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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 3/29/12
Owner:
HAYES RESIDENCE
55898 BRAE BURN
LA QUINTA, CA 92253
D I
q )
Contractor: m.AR 2012
GORDO LANDSCAPE, JAVIE
PO BOX 7123 CITY OF LA 01i11Nifl
LA QUINTA, CA 92248N,(CE
(760)619-4906
Lic. No.: 883625
-----------------------------------------------
WORKER'S 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 permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier EXEMPT Policy Nu bar EXEMPT
I certify.that, in the performance of the w r or which this permit is issued, I shall not employ any
person in any manner so as om bject to the workers' compensation laws of California,
and agree. that, if I 'ho eco a su to the workers' compensation provisions of Section
3700 of the Labor de, 1 sh fo ith comply with those provisions.
Date Applicant:
WAR ING: FAILURE TO SECUREWO KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITIO 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 sation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above ' ti6n is correct. I agree to comply with all
city and county ordinances and state laws relating to buildin ons tr of^ and hereby authorize representatives
of this my to enter upon the above-mentioned propert or ins c rposes.
Date: Signature (Applicant or Agent):
Application Number : . . . . 12-00000334
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 18.00
Plan Check Fee
4.50
Issue Date . . .
Valuation
0
Expiration Date 9/25/12
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 3.0000 EA PLB
GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
GAS LINE FROM POOL HEATER TO NEW
BBQ. 60
L.F. 3/4" PIPE 2010 CODES.
-------------------------------------------------
Other Fees . . . . . . . . BLDG
---------------------------
STDS ADMIN (SB1473)
1.00
Fee summary Charged
---
Paid Credited
--- - - - - ------ - - - - ----
Due,
-- - - - - - -
-- - - - - - - - - - - - - - ------ - - - -
Permit Fee Total 18.00
.00 .00
18.00
Plan Check Total 4.50
.00 .00
4.50
Other Fee Total 1.00
.00 .00
1.00
Grand Total 23.50
.00 .00
23.50
LQPERMIT
N
Bewd— -
MUDDING ZONE
EXISDNGHOUSE AREA SO FOOTAGE 2W2SRFL
LOT
LEGAILDEOn
the Gdita.se
CCNSTRUCRONTYPE
EXISTING GARAGE NSA 50 FOOTAGE Atwe ,JG-ge
C7RACTK
Pod Ndiun
D-1
RESURFACING
LANDSCAPELANDSCAPETOTAL
W E AREA 2872 k Ft
aTM
-u L. S.I`H"111
BIA.DIN0000E
2007CBG 20D7 CMG 2007 CPC
111-4&
Mar NEc2005,
LOTSIZE 16,552.85RFt
STATE
CA
0
62005 ENERGY STANDARDS
LOTODVERAGE
ARK
ARN
775280050
R
S
VICINITY MAP
ORIENTATION
BUILDING SUMMARY
G
SIP O
BUILDING
ANALYSIS 4
Shutes
ADD CONCRETE
TO NORTH SIDE OF INSTALL GAS LINE
HOU 3'X20" AND ELECTRIC
PROPOSEDTO
SAW CUTEASTING CUTEMSTING CONCRETE
PROPERTY LINE CONCRETE TO CREATE PLANTERS AND CRE TE CURVE
. \ ALONG SIDE H SE OR X10'
1 WITH BOGAMBILI OR OTHER COLOR �w✓ ��
ADDED
---------- —•--•--p _.
ooteQttlpmelns EXISTING GRASS
1 EXISIM WG
1
UTILITIES
UNDERGROUND PROPOSDEDTO
CATCH aASEN 2'X2' ADD PLANTER WITH MOUNT 12'HIGH
DG OR MULCH AND RIVER ROCK
FOR A (DESERT LANDSCPE LOOK
�-.�s—'�i-.r��rrrr-rr-.: rri'-•rte-�+. t.vw �--�
1' EXISTING ��
Z,
.
1 E)aSNTING CONCRETE
j PATIO
1 TO BE RESURFACE
1 - WITH STAMP OVERLAY
i •-J
j LA
1 �
r l
1
1
1 1 1
1 _ e
FIREPLACE i Z2t
1
1 ,
■ -----------
EXISTING GRASS
�t
PROPERTY LINE
7
PROPOSED TO REMOVE EXISTING GRASS
NEW AND ADD PLANTER WITH
CONCRETE LOW GROWING SHRUBS
2500 PSI
t
r
E705TING
SPA 1
Y
Flown P.t •
ll�.
EXISTING POOL -
BORDER TOBE Pots
RESURFACE W17H •
SIMULATED STONE
HEDGE
m
Site Plan Date 2/16/2012 Desert Sands Valley Builders RopertyoWn«
PO BCO! 7122 Caryn and Rd and Hayes
U 02na CA 922ae 55698 Bree Burn
PGA West CC
Approved by Date La OuMRa, CA 92253
R. -e Poh 0
GRAPHIC SCALE
SCALE IN FEET
SCALE 1t2010
DRAFTING DESIGN
DESERT SANDS VALLEY GROUP
76041949()6
DSVBUIIDERSpYAHOOCOM
WWW.OESERTSVRCOM
1/4•=1'
Scale
NOTES
PROPOSED
NOTSHOWNON
PLAN TO WIDEN EXISTING
ENTRY WAY TO HOUSE
FROM 370 5'
Bewd— -
law Vdt.9.UOhb
au«. p.hn
Lenlme
G
O
L
F
f�
C
Rdws Nedpe
0
U
R
E
Ch. --k
QUEEN PALMS
QUEEN
Shutes
R. -e Poh 0
GRAPHIC SCALE
SCALE IN FEET
SCALE 1t2010
DRAFTING DESIGN
DESERT SANDS VALLEY GROUP
76041949()6
DSVBUIIDERSpYAHOOCOM
WWW.OESERTSVRCOM
1/4•=1'
Scale
NOTES
PROPOSED
NOTSHOWNON
PLAN TO WIDEN EXISTING
ENTRY WAY TO HOUSE
FROM 370 5'
Bin.#Qt.urn�a
Buffing a. Safety Division . .
P.O. Box 1504,-78-495 Ca1fe Tampico,
La.Quinta, CA 92253 - (760) 777-7012
Permit A lication and Tracking Sheet
Perini #
ProjectAddress:C[ (.Building
(A
Owner's Name:. 1�j CuocY
A. P. Number. --(S �. S C)
Address: 4W,fC�
Legal Description:.
City, ST, Zip: CA 5-2,7&-3
✓Tel
Contractor. �O` i �� C �d�
hone: std
eP � ->r ��'•::'-'::?�::x; •
Address: _ -i cl b`
Project Description: LOinLCe.�.
City, ST, Zip: Qfi� io
/n�
moi,as �jne- Irvm.-yob4-ccti4-r-r
Telephone: " �p lcl-1d(c; r.�
State Lic. # : BE3 314, 25 City Lia #;
Arch., Engr., Designer
3
Address:
City, ST, Zip:
Telephone: v N >:'
State Lie. #:,wi� r
Name of Contact Person: �av \ �� 61l��c- v
Construction Type: 1 y0 �r.y4-r Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL:
Units:
Telephone # of Contact Person: _ .L 0
Estimated Value of Project: S b
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Rce'd
TRACK NG PERWUT FEES
Plan Sets
Plan Check submitted Item Amount
Structural Calm
Reviewed, ready for corrections Plan Check Deposit. .
truss Cates.
Called Contact Person Plan Check Balance
Title 24 Calm,
Plans picked up Construction
Flood plain plan
Pians resubmitted Mechanical
Grading plan
2' Review, ready for correctionskssue Electrical
Subeontactor 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 correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees