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9602-044 (PAT)LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with SeGtioA 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. 42404$ B I2/3105 License # ' Lic. Class Exp. Date Date r?Signature ofContractor G it OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner 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 & policy no. are: Carrier ; �,: Policy No. W/A (This section need not be completed if the permit valuation is for $100.00 or less). ( ) 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 shill forthwith comply with those provisions. Date: Applicant �r Warning: Failure to secure Workers' Compensati6en overage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 agrees to, & shall, indemnify & hold harmless the City of Indian Wells, its officers, agents and employees. 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. IOcertify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property�'foor/r inspection purposes. Signature (Owner/Ag ent)'�,a.x Daae % ALCM BUILDING PERMIT ERMITx�� DATE Zy 7'/% VALUATION St�T TRACT JOB SITE ADDRESS 49-609 PASCO TRASZA) APN 646-082-00S OWNERCONTRACTOR >j LARRY G(il ITZ I) & M MjlLIEK '%365 RWY 111, #148 4809 .PASEO TARAW LA QUIKA CA 92253 LA QUINI'A 0A 92253 (619).5ti4-69r27 C'HI.# 2789 DESIGNEWENGINEER USE OF PERMIVA 1'1V FEE DESCRIPTION FEES HiR(1..6-PAY10 408.00 Sl., I.S`! IMitTE i COST OF CONST RUCTION 5.426.40 PI:Hli41.'I' FIE,C 8 U M MARY Pi. AN <.*JHZt: K FlC. 1,01.00t'} 439-3181 &52.65 r' !NS' RU(:1ric.)N FEE 101-000.418-000 sal.00 :3'T(jN(i A40110N FEL - R1 SID 104-000-2414)00 1.54 CO C pa)j C\2 QC m LL- SUB -TOTAL C'ONSIRUC710N AND 1 l -,\N CHECK $134 t9 I.E'SS 11RI I'.AIU FEES $0.00 TOT,A 1, PERMIT 1a F EST UE, NOW $134.119 RECEIPT DATE By DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs aUnderground Ducts Forms & Footings alDucts Slab Grade Ll~ Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath 02 Final Final BLOCKWALL PPR VALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: { • —, LICENSED CONTRACTOR DECLARATION I hereby affirm 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. 404;3 $ i 1f95 License # U Class Exp. Date ,bate Signatureof Contractor OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: ( ) 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 & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner 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 & policy no. are: Carrier Policy No. (This secti n�need not be completed if the permit valuationig'for $100.00 or less). ( 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 comply with those provisions. nnfo• OnnlirAnf Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $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. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his 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 agrees to, & shall, indemnify • & hold harmless the City of Indian Wells, its officers, agents and employees. 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.wcrk 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 State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection' purposes. (Owner/Agent) ' Date A`°"BUILDING PERMIT PERM IT9601 059 DATE m6m IVALUATION S400.0C LOT TRACT JOB SITE ADDRESS APN OWNER CONTRACTOR LARRY GUMIZ is ' DEAN MILLM 79-165 i-IWY t! 1, fft48 SAT: LA t1if NTA CA 92253 LA QMWA CA 92253 (610'15&1 6927 DESIGNER/ENGINEER � (619)771-931 S USE OF PERMIT -.1, PAL BUILD114G 1NKYALL 32" x 40" GLASS BLOCK WINDOW IN MATFIk 13ti'I H FEE DESCRIPTION FEES CONTRACT Ah MOULT" 400.00 LS ES'f[MM;> D COSai OF CON&FR'11C' IM14 X31111.111'; 1 F.kMI'1' 1414 ti; SUMMARY CONSTRUCTION FEE. 1.1(.1.4 0-418-000 355.000 SLTC3=MTAi. CONSMUMON AND PLAN CHECK $.13.00 ._n USS PRE -PAW FEES $0.00 "a, , PERIMI la Elva MU NONV $15.00 ,IAN 16.1996 ! ! By RECEIPT DATE—ZZZ- BV DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS yet Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation / Vents :,Fireplace P.L. 1,, Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING PROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final t4 COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures r Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 9253 - (619) 777-7000 FAX (619) 777-7101 February 8., 1996 Larry Gumtz Construction 15320 Patronella Avenue Gardena, California 92049 SUBJECT: SETBACK ADJUSTMENT 96-392 LOCATION: 48-609. PASEO TARAZO (LAGUNA DE LA PAZ) Dear Mr. Gumtz: This letter is to report approval of your setback adjustment application pursuant to Chapter 9.188 of the City of La Quinta Planning and Zoning regulations, subject to conditions and in accordance.with attached exhibits. SETBACK ADJUSTMENT REQUEST: To reduce the rear yard setback from 10 -feet to 4 -feet for a private patio cover. CONDITIONS: a. Obtain a building permit from the Building & Safety Department. b.' Comply with Laguna de la Paz architectural requirements. C. The structural support posts for the patio cover shall be no :,loser than 5'. to rear property line. However, the.patio cover eave can encroach as shown on the attached exhibit. After review it was determined that: 1. This adjustment is consistent with the intent and purpos of the Zoning. Ordinance. 2. There are special circumstances applicable to the property, including such factors as size, shape, topography, location or surroundings. that justify approval of the adjustment. sba96-392 MAILING ADDRESS P.O. BOX 1504 - LA QUINTA, CALIFORNIA' 92253 i These special circumstances are (a) small.rear yard, and (b) common open space atrear of property. 3. This adjustment will not be detrimental to the health,, safety, and general welfare of the community. 4. The Laguna de la Paz Architectural Committee has granted approval of the requested adjustment. If you have any question, please contact me at 619-777-7067. Very truly yours, JE Y H N CO UN T DEVELOPMENT DIRECTOR R SDELL ssoci anner GT. Attachments c: Kelly Tropple, Building & Safety Department r CASE NO: CITY OF LA'QUINTA FEE: $100..0.0 PLANNING & DEVELOPMENT DEPARTMENT APPLICATION FOR SETBACK ADJUSTMENT APPLICANT: Submit this form with two copies of a scaled site plan, drawn to adequately 'depict the nature. of the request. A, nonrefundable fee of $100 is required"when the Application tis submitted.' Check must be make payable to the "City of La Quinta". If. the Applicant is not. the owner, of the property, a letter must be' submitted' by the owner authorizing the Applicant to execute this document in his behalf. PLEASE PRINT OR TYPE J APPLICANT/CONTRACTOR: DATE Z _6 - /q6 CONTACT PERSON (IF DIFFERENT) PHONE MAILING ADDRESS: /5 3Z O L272v (Address) ty) (State) (Zip) OWNER'S NAME : L E- A-/VPHONE 17/ -/53 % MAILING ADDRESS: - 6 0 . (Address STREET ADDRESS OF PROPERTY: LEGAL'DESCRIPTION OF PROPERTY:C ASSESSOR'S PARCEL NUMBER: ?LS -3 (City) (S_ i CAM 2e - LOT # � TRAlI ADJUSTMENT REQUESTED:- P/- Tl a U UL K to . 101Z p 7-2:2' Cv Lr -z1) � EAS AdO`�r% (/V�- c> 05 . 7 REASON FOR REQUEST:' 71y o i2 D e e 7-v 111 A �� C) JUSTIFICATION:, No request for a Setback Adjustment shall -be granted unless'it is determined that itis consistent with the intend and purpose of this Ordinance; that there are .special circumstances applicable to the property,, including such, factors as, size, shape, topography, location'or surroundings that justify the approval of the adjustment'cf the setback requirement, and that the adjustment will not 'be detrimental to, the health, safety, and general welfare of the, community or be detrimental to_ property in the.area of the parcel for which the adjustment'is'requested. FORM . 013 / CS Ex t 14. rILIT v �- v P IT Mi �' ,-1-�•1, t 14. rILIT v �- v P Paa..e One cjv, _ LAGUNA DE LA PAZ HOMEOWNERS ASSOCIATION ARCHITECTURAL IMPROVEMENT APPLICATION 1 LOT# DATE 7 NAME.( s ) STREET ADDRESS %//Z O LOCAL PHONE 7 OTHER PHONE REQUESTED IMPROVEMENT A" R,,�tLo C en,16 &e2/r% pproval is requested for .the -above improvement %according to -the lans attached. We have attached two (2) sets of plans cutlining- th work to be done .along with a complete description of the �a rials to be used. Upon approval of this application and to commencement of the improvement, the 'certificate of bility insurance, will be provided, naming the Association as n additional insured. We have read the Architectural Committee Rules and/or Guidelines and have furnished copies to all contractors to be engaged by us. We. agree to comply with. those Rules. We also understand that it is our responsibility. to ensure that our Contractor(s) comply. 1317 We acknowledge that Building 'permits for home improvements are required by the City of La, Quinta including any modifications to bearing walls. The .cost of permits, 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, but not limited to, those" adopted .subsequent to the original complet=on .and acceptance of our dwelling. The Association has no responsibility what so ever in achieving compliance with newer building codes which apply as a result.. of Homeowner -)rompted modifications: Further, we 'understand that approval will not be granted for any modifications which directly or indirectly conflicts with the Declarations. of Covenants, Conditions, and Restrictions. We.also understand we. are responsible for the., accurate determination of property Lines and set=backs (as .applicable).- As-.Revised pplicable). As-Revised January 1:9.96. Page Two We also understand that we will be'responsible for all costs of this improvement and for costs associated with any repair to the common area occurring as a result of implementing this improvement. Examples include, but are not limited to, sprinkler and irrigation systems, utilities, buildings, lawns, plants, and drainage. Further we recognize that any modifications to the common area irrigation and landscaping scheme are subject to formal acceptance by the Association. Any required remedy to ...achieve the required maintenance standard or irrigation standard is our responsibility. Additionally, we understand that the job site must be left reasonably clean at the end of each day and , that no debris nor dirt may be dumped on the project. We acknowledge that walls that have to be removed or partially removed to permit digging equipment access must have prior permission and must be replaced the same as wall removed Any maintenance or replacement of permitted improvements, except for certain landscaping, which are beyond "initial" improvements shall be the homeowner's responsibility. W.eto pay the Association an application fee of $_a(if required) to defer administration costs and expenses in t e Commi.ttee'.s.review.of the plans and specifications., We further agree that this improvement will be completed in a reasonable and diligent manner (but no longer than six (6) months). We further agree that •1) if we do not :correct any damage caused as a result of implementation of this improvement or, 2) if we fail to complete this improvement within the allowed time frame, the Homeowners Association may elect to complete the work and/or repair, and we will be responsible for the actual costs of such work. We authorize the use of our deposit, if any, held by the Homeowners Association to be used as partial payment for this purpose. We understand that when the work is complete and has been accepted by the Homeowners Association, we may request:azrefund of .our deposit if one has been given. Signature of all Owners: (Signature) `W - :�f,& (Signature As Revised January 1996 LAGUNA DE'�A PAZ HOMEOWNERS ASSOCIATION ARCHITECTURAL COMMITTEE CERTIFICATE This�la 1' ion was revie on % altnd has been: Approved Rejected 3 by the Architectural Committee Conditionally Approved with required.modif-cations set forth below Returned for Further Information Required Modifications��,� Comments. �%Gl5 it �U c/�/ ��f�✓'7� f'� `i r�/G — ps2 Signed: ' Date.': W Arch. u Committee COMPLETION INSPECTION Completed work inspected and approved: Deposit return authorized (if applicable)*: Comments: Signed: Date:. * Less any reimbursement to the Association for .costs incurred to bring homeowner.into compliance with the governing documents. As'Revised January 1996 . L--'.---_ '- _- _ � . - Page One LAGUNA DE LA PAZ'. HOMEOWNERS • ASSOCIATION. ARCHITECTURAL IMPROVEMENT APPLICATION t LOT#, �� DATE_ 3A)V On ey NAME (s)_Ale. MR.S 'VLL eg :.. STREET ADDRES S �p Q (' LOCAL PHONEIq�77� -/ �% �r�' rr-. °`OTHER' PHONE .4! •r,. './ - REQUESTED . T,`- N IMPROVEMENSA'%!9- L L � o[ X ' ��}D (� A.SS •�/Q G/�C t..r 0. 10011�'7"o��+,��:4;41e,e y G ui� 7-zx• `� :, + � f. .. �yy,., �.r +� a"`7 i"+r`�'u .+� vs ia. # ^'.. �; t.,.. -ter wt Y Xi1 �'• �i'S� °'�;;-t» t {y f✓ . .�, to ".;FIS,+, yr" 1 �'i M•f .,f �! ':,!'i'+ ! ° • '' •�..r. a_,il i`' • � +;T� + ''.� h. i Ms iii ,3'` ' vr'� •i, �`-/, ;- •'' ' � � �� .t S � � 'i�+ ,y X��.tii �i •yr- � y. 3- �. r � o.a«x �, ..�..c x�� a�,�'�'7i ??��:: �'� � w ,try . / s e �. • ,�• .. , � � -� of lu a tet?, 'y/y- � - 1. •} '- M l �...�. i=rAppr6val is requestedl;,,for�'ethe? above }improvement.=accoird aris 'attached S;twoy` (2) sets- of °.plins*joutl ! e°', work to,be .donea oziq%�sath .''a,Jcomplete 'description'rof ; F'materials , to, 'be,;Yused. t pou,F; a°pp ti o `�-thi s._ 'Acat ` nd,4 .•prior_._to--roencemezrtt rt rv: '` M±= - er of� ; �,ility -°:insurance . w 11yTb��povided ons; s�"��; i A �''... . `r.. I'a-":1 yyb d• iian i 2 i�F i..•.f 11J` 'i 'at' :� a�. 'k .�Y� z•jp �_, f ,yam. �v 1gf ��Y��}+'Y �� _ 2a , {.:a .. S.� 4fi(,r. �t4 � � �+,�-��,�., rid' -. •'"•, f haverreai �r.•cC«.3� .,. t..?e. e ;v;R;�l, es.'-:;,ar. nd/;or r.z .Gu�yi x, A. 4 z.and have furnished,"1copies-:.to; all contractors; to -be .,e ngaged3�p:us,~7 �. agree , to ; comply.,.with biose Rules We.,'also:"'iinderstandrtthatVit ,� ibis �4our responsibilityr�tol�ensure,;.*tt at;r;our 'Contractor (s ) comply .acknowledge that; Building Permits for. •rhomeA i,inprovements.iar.e'��; of t'- ,} by the CityofLa,Quiritancludng Jany modifications bearing .walls. ^-.The cost:�of_`pe'rmts' responsibilitys;forobtaining them, and "the•-subsequent�i'rispect�ion§,;will, .be our "re's.ponsibi-pity:',: � ' In all cases, we, recognize'. the . requirement : to� • be •'in •compliance., a., with applicable' building codes.'including, but` not` limitedto,'' those adopted subsequent to the original completion , and, ^ acceptance of our dwelling. The Association - has' -'no,-.' responsibility what so ever in achieving compliance with newer building codes which apply as a result... of Homeowner prompted modifications. Further, we understand that approval will not be granted for any modifications which directly or indirectly conflicts with the Declarations of Covenants, Conditions, and Restrictions. We also understand we are responsible for the accurate determination of $roperty lines and set -backs ;(as. applicable): As'•Revised January 1996 4, ., Page Two We also understand that we will be responsible for all costs of this improvement and for costs associated with any repair to the common area occurring as a result of implementing this improvement. Examples include, but are not limited to, sprinkler and irrigation 'systems, utilities, - buildings, lawns, .plants, and drainage., Further we recognize that any modifications to the common area irrigation 'and landscaping scheme are subject to' formal acceptance by the Association. Any. required .remedy to — ....achieve -the required maintenance standard or irrigation standard is our responsibility. Additionally, we understand ',that the job. site must be left reasonably clean at the end of each day and , that no debris -nor dirt may be. dumped on .theproject. We acknowledge that walls that have- to -be'.-removed or partially removed to permit digging equipment access mush have: prior permission and must be replaced the same as wall removed.. - Any maintenance or replacement of permitted improvements, except for.. certain landscaping, which are beyond "initial" improvements' shall be the homeowner's responsibility. $-a ree toq Ppay the Association an application fee. $ (if re uirefl. to defer administration costs and ex enses int.0 .ommi;ttee'.s .review .of the plans and specifications.; - We further agree that this: -improvement will be, completed in a _ reasonable and er (but no longer than six (6) months): We further agree that 1) if we do not 'correct 'any_ damage caused as a result of implementation of this -improvement or, 2) if we fail to complete this improvement within'the allowed time frame, the Homeowners Association *may elect -to complete -the* work and/or repair, and we will be responsible for the actual -costs of .such work. We authorize ,the -use of our deposit, if any, held by the Homeowners Association to be used as -partial payment for. this purpose. We understand "that when the .work is complete and has been accepted. by the Homeowners Association, we may request:a refund of .our deposit if one has.been given. Signature of all owners (Signature) ( ignatur As Revised January 19.96 Thi t�' on LAGUNA DE LA:PAZ.'HOMEOWNERS ASSOCIATION ARCHITECTURAL COMMITTEE CERTIFICATE ion was reviewed by the Architectural Committee d has been: .Approved Rejected Conditionally Approved with required modifications. set forth below ..Returned for.Further Information, Required Modifications Comments Signed: JAb bwl-'k ;+ -I&+ v A Yl r R m m i, fl, 4e e COMPLETION INSPECTION, pom'pleted-work inspected and approvedr Deposit returnauthorized(if.'applicable)*.: .Comments: Signed: Date: Less any reimbursement to the Association.for costs incurred to bring homeowner into'compliance with the governing -documents. As Revised January -19:9:6