07-1587 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4&t 4 4 Q"
Application Number: <<07-00001587
Property. Address: • 81608 RANCHO SANTANA DR
APN: 767-200-999-4 -312022-
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 30000
Applicant: Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
- - - - - - - - - - - - - - --LICENSED NTRACTOR'S LA'RATION
I hereby affirm under penalty of perjury that I am li sed rider pro ' ion of Chapter 8 (commencing with
Section 7000) of Division 3 of the Business an r es onaIs my license is in full force and effect.
License Cl s: Li se 863763
/Dat 3 0? tractor:
OWNER -BUILDER DEC TION ,
I hereby affirm under penalty of perjury that I am exempt from the ontm wr'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.). -
(_) 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 contractorls) 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:
JASON NETTLETON
81608 RANCHO SANTANA DRIVE
LA QUINTA, CA 92253
(760)777-9920
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/30/07
Contractor: D bm u-iL
CHAMPION CONSTRUCTION
42331 MILLCREEK WAY MAY 3 U 2007
BERMUDA DUNES, CA 9220
(760) 835-3234 CITY OF LA QUINTA
Lic. No.: 863763 FINANCE DEPT.
------------------
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 STATE FUND Policy Number 229-0028780
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 1 should become subject to the workers' compensation provisions of Section
3 00 of the La r C I shall forthwith comply with those provisions.
D� �J % cant:
/WARN G: AlL RE 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 woro not commenced
within 180 days from date of issuance of 5iie
ation of wo for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that th is co ect/I agree to comply with all
city and county ordinances and state laws relating to bud reb'y authorize representatives
of this u to ente�r7upon theabove-mentioned groper s
ate: �% ,Sig re (Applicant or Agent):
Application Number . . . . . 07-00001587
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee 284.50 Plan Check Fee 184.93
Issue Date . . . . Valuation . . . . 30000
Expiration Date 11/26/07
Qty Unit Charge Per Extension
BASE FEE. 252.00
5.00 6.5000 THOU BLDG 25,001-50,000 32.50
----------------------------------------------------------------------------
Permit MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50
Issue Date . . . . Valuation . . 0
Expiration Date 11/26/07
Qty Unit Charge Per. Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
------------------ ---------------------------------------------------------
Permit ... . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . 45•.00• Plan Check Fee 11.25
Issue Date . . . . Valuation 0
Expiration Date 11/26/07
Qty Unit Charge Per Extension
BASE FEE 15.00
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
Expiration Date 11/26/07
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. ALARMS/BARRIERS SHALL BE IN
LQPERN11T
9
Application Number . . . . . 07-00001587
----------------------------------------------------------------------------
Special Notes and Comments
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED
Fee summary Charged -Paid Credited Due
---------------------------------------------------------
Permit Fee Total 388.50 :00 .00 388.50
Plan Check Total 210.93 00 .00 210.93
Grand Total 599.43 .00, .00 599.43
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CITY OF
LA QUINTA
1--suiLDIN
& SAFETY DEPT.
AP
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FOR CC
NSTRUCTION
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14.
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Bin #
: City'f La Quinta
Building at Safety Division
Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #P.O.
C-61.
Project Address:' t!Q T A
Owner's Name:
A. P. Number:
�� Q
Address:nWA
Legal Description: O C
City, ST, Zip:
Contractor:10 CAA.1 44,c
Telephone:
Address:
Project Description:
City, ST, Zip:
'
Telephone:
State Lic. #: City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:.
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft:
#Stories:
Units:
Telephone # of Contact Person:
Estimated Value of Project: 3 d . dv
APPLICANT: DO NOT WRITE BELOW THIS LINE
# .
Submittal
Req'd
Recd
TRACMG ,
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans. resubmitted
Mechanical
Grading.plan
2°" Review, ready for correctionsfissue
Electrical
Subcontactor List "
Called Contact Per4on
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:=
'"' Review, ready for correctionstissue
-Developer Impact Fee
Planning Approval
Called Contact Person
A,I p,p,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
05/23/2007 14:37 FAX 780 882 1210
r05i11.F2007 08.:40 FAX
o5/o8/2007 08:53FAX 780882 1210
DESERT MANAGEMENT
DESERT MANAGEMENT
(a005/007
[M 007
12 005/008 -
AF
CIIITECTURAL COMN>ix'><TFF, CERTIkFXCATE
(Exhibit "A". to the Architectural
Improvement Application and Agreement)
Tho Architectural Improvement Application and Agreement was roviewad by the
Architectural Committee on aand has been;
Approved Conditionally Approved Rejected
Subject to t'he following.
Conditioins. set forth below
Returned for Further Information
Required Modif cation$
Comments
Yes No •
Recording to be sent by owner to County Rccvrder'� oifico %r roof and/or
cxterior wall modificatiolis.
Deposit Required Deposit Amount Required $
"Q -
pat Architectural Committee
Architectural Commit a Architectural Committee
Arohitectural Carrimittee 'Architectural Committeo
NOTE: THIS APPROVAL IS VALID FOR 90.DA'YS PROM APPROVAL DATE
05/23/2007 14:36 FAX 760 862 1210 DESERT MANAGEMENT .0001/007
+0./11%2007.08:38 FAX 0003
05iJ9/2001 08:53 FAX 760 582 1210 DESERT MANAGEMENT x,003/008
EXHIBIT "ler
ARCHITECTURAL IMPROVEMENT APPLICAvw AND AGRERMtrgT
DATE v — 1 O.. '" c->7-
'NAME (s) ss, /
STREET ADDRESS _ 26 l G(o � ,4W -e Yv JA 4YA AIA
-
REQUESTED IIv1PROV2NMNT =�
Approval is requested for the above improvement according to the plans attached. We
have attached two (2) sets of plans outlining the work to be done: along with a complete
dasarlption of the materials and colors to be used. If we are using a contractor($), we .
enclose copies of the Contractor's License.
Attaobmentss
1, Two copies of the Architectural Improvement Application Q✓�� `� �y
2, Two. sets of plans with materials and color$ to be used.
Note: One set is for the management offioe; the other set to be returned to you as
"Approved".
3. Contractor's narn' a =d copy of contractor's license. (Not required if.the
Improvement is under $300,00 or if "Ownet-*Buildei'�.
4.' Brochures (2). and/or color aamples of rnanufaotured products to be used.
We have read the Architectural Committee Rules and Guidelines and have. fllxiaished
copies to all contractors to be engaged by us and we agree to comply with those Rules
and Guidelines. We also uridcrstand that.it is our responsibility to insure that our
Coritractor(s) comply with said Rules. We acknowledge that Building Permits foi home
improvements may be required by the City ifLidio, The coat ofpermits, -responsibility
for obtaining them, and the subsequent inspections will be our responsibility. In•all cases
we recognize the requirement to be in compliance with applicable building codes
including, bat not limited to, those adopted subsequent to the original completion and
aeccptance of our dwelling.
05/23/2007 14:36 FAX 760 862 1210
05/1172007 08:39 FAX
05/09/2007 09:53 FAX 780 862 1210
Page Two
DESERT MANAGEMENT
DESERT MANAQEMENT
The Association has no responsibility whatever in achieving compliance with rower
building codes; which apply as a result of Horrieowner, prompted modifications. Further,
we understand that approval will not be granted for any modification, which directly or
indirectly conflicts with the Declarations of Covenants, Conditions and Restrietkons, We
also understand we are responsible for the accurate determination of property lines and
setbacks (as applicable).
Wd also .understand that we will be responsible for all costs of this improvement and for .
costs associated with any repair to common area occurring as a result of'implerneriting
this iinprovement, laxamples include, but are not limited to, sprinkler and irrigation
systems, buildings, roofs, exterior walls, lawns, plants and drainage. Further we
recognize that any modifications to.the oommon area irrigation and larndscaping.schamo.
are subject to formal acceptance by the Association. Any required remedy to achieve the
required maintenance standard or irrigation standard are our responsibility. Additionally,,
we understand that the job Site mast be left reasonably clean at the end of each day, that
neither debris nor dirt may be dumped in'cwmmon'area or loft at job site.. Any
maintenance •or replacement of permitted improvcrrients, exeept for certain landscaping,
which are beyond "initial" improvements, shall be the homeowner's responsibility:
We agree to indemnify for ourselves, as well as for our successors and assigns, and
covenant and agree to hold Association harmless from all claims, demands or liability
arising out of or crncounrered in eonneotion with this Agrccment,..whcthcr such claims;
demands or liability are caused by Owners, Ow'ners' agents or employees, or eerittactors
or subcontractors employed on the project, their agents or employees, or caused by any
products installed on the projeot by said contractor(s) or subcontractor(s). Such
indemnification shall extend to claims, demands or liability for personal injuries and /or
property damage occurring during installation, as well as after completion, including, but
not limited to, all 0%*ners' maintenance responsibilities provided herein.
.5
We further indeninify and hold the Association harmless from all liability related to any
darnage to existing improvements (wherever located within the Subdivision) resulting
from the installation/coustruction of the Architectural Improvement.
If required by the Architectural Review Committee, we. agree to record, and .pay for the .
recording, of this improvement at the County Recorder's office.
,We further adknowledge that the Architectural Committee may require a deposit be
submitted before work is begun.
Ca 002/007
2004 •.
IA 004/00.8
05/23/2007 14:37 FAX 760 862 1210 DESERT MANAGEMENT Ij006/007
05/11/2007 08:40 FAX 1@005
05/o9/2007 09:54 FAX 760862 1210 DESERT MANAOEMENT 1006/008 '
Page Three .
We'further.agTeo that this improvement will be completed in a_raasonable and diligent
manner. e further agree that X) if wis do not correct any damage causod as a result of
implementation of this improvement or, 2) if we fait to complete this.improvement within
the allowed time frame the Sjemeowners Association may elect to complete the work
and/or repairs, and we will be responsible for the actual costs' of such work. Payment to
the Association is authorized by ua in the form of an assessment or monthly penalty
payments as approved in the Guidelines.
By signing this. agreetnent below, we agree to be bound by its terms and conditions and
any'conditions set forth by the Architectural Committoo in the Architectural Committee
Certificate, which is attached hereto as Exhibit "N' and made a part Hereof by this
reference,
Signator fa
ll w s:
(Signa ) (Signature)
9
CITE Ct= I..� QUINTA S=J8-0,0NT !C, �9S_TP -
>_' I ��n�l� IVL:,�rEl� c�n n>>a_I�_5�' �J Di✓
w
.101i A,DC t%3$: I _:��L — — N ► — (/ <rr = / /�..� BUILDEki ! r.•3 79 7t C. N
: �.,g i 51)? 54� Gang -,, ai►�es in a ccnJ,nlcucijs.2h &. Only persons appearing on this list or their employees are authorized to work N
. is l� LiVitl� �..b� bi�!;354 the 'ob �a., h ui
on this jot.. ?%ny cha-iges to this list must be appro,!ae by the Building Didis-ion prior to comr•iencerr-ent of work. Failure to comply will result in a stoppage of work and/or the voidance o
of buitr_:ny permit. for ria�i appl,cable trade, all intorwalion remust be cvint,Izted ; ap licant. "On File' is not an acceptable res onse. —
i Vradg i :'as-F6icalin�� = Csatractor gtaa"'.L nLrctoe'S tkxnse WorkersCom nsefiori risuraiice ° itY � o
1:oml-any Acme Claasiticetiera '-.ic•.ase dumber Exp. Date . Carrier Name Poficy Number Exp. Date Cleanse Number Exp. Irate
le.g. A, B, C-8; ;xxxxxxi (xx/xxixxi (e.g. State Fund. CalComp) IFatmt Varies? (xxlxx/xx) (xxxxl (xxtx :lxxi ro
- EARit --4089 {
Pt.U@ABINti ICS 361 '• �_ ____. _. , ...._
DRYWALL
1 _r
SKEET METAL
I"ULgi7ONI`.IG 21. !
SEWAGE DISP IC -421
®AUQTING IC:33) i�_ —_—••
CERAMIC 1115 JC .541
a;wi11NETSIC-bl--
f ItVNG (C-131—
LANDSCAPING IC 27)
Pol)1 IC•531`
-- -i