05-4544 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
TdY 4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 05-00004544_
Property Address: 81196 RED ROCK RD
APN: 764-270-999-149 -300233-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 2000
Applicant: Architect or Engineer:
------------------
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.
License Class: License No.:
Date: Co ractor:
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).:.
( ) 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.).
( 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
VOICE (760) 777-7012
FAX (760) 777-7011 `
INSPECTIONS (760) 777-7153
Date: 10/10/05
Owner:
DRYER
81-196 RED ROCK ROAD D
LA QUINTA, CA 92253 d Q
1005
Contractor: OCT 10
OROS BROS MASONRY CITyOFLA
WCC: STATE FUND F�N��CE��'4
WC: 1744804 10/01/06
CSLB: 826241 ,10/31/05
-----------------------------------------------
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 C29 Policy Number - - - - - - - - - - - - ---
_ 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 thew ers' compensation provisions of Section -
37700 of the Labor Code, I sf` II rthwith co p with those provisions.
We: // / %/ /lican
WARNING: FAILURE TO SECURE WORZS' PEN Ti COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL - S 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 c struction, and hereby authorize representatives
of this county to upon the above-mentioned propert r ns action pur sas.
Date `V `v nature (Applicant or Agent):
Application Number . . . . . 05-00004544
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
45.00
Plan Check
Fee
29.25
Issue Date
Valuation
.. . .
. 2000
Expiration Date
4/08/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
15.00 2.0000
----------------------------------------------------------------------------
HIND BLDG 501-2,000
30.00
Permit . . .
PLUMBING
Additional desc .
Permit Fee . . . .
18.00
Plan Check
Fee
4.50
Issue Date . . . .
Valuation
. . .
. 0
Expiration Date
4/08/06
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
FIREPLACE ONLY.
------------------ ---------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY
REVIEW FEE
2.93
Fee summary Charged
Paid Credited
Due
--=------------------------
Permit Fee Total
-=--------
63.00
-----=----
.00
-----;----
.00
63.00
Plan Check Total
33.75
00
.00
33.75
Other Fee Total
2.93
.00
.00
2.93
Grand Total
99.68
.00
.00
99.68
LQPERMIT
Bin #:r.
- City of +La =Quinta
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Building & Safety -Division •. �`
P : Box 1504,"7.8495 Calle Tampico
Permit
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� 1a Quinta, CA. 92253 - (760) 777-7012
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Building PermitYApplication and Tracking Sheet
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Project Address:
Owner's Name: S O� 1
A. P. Number: /
Address:. 1
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• Legal Description:
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City, ST; Zip: L.
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Contractor:
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Telephone:
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Address::
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Project Description:
City, ST, Zip:
Tele hone: '
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State Lie. # :
City Lie. #:' : 03 SS
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Arch., Engr., Designer:
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Address:
City, ST, Zip:
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Telephone:
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'Construction Type: .Occupancy: • • ,
State Lie. #:
Project type (circle,one): New Add'n Alter Repair Demo
Name of Coritact Person:
Sq. Ft.:
# Stories:
# Units:
,Telephone # of Contact Person:
Estimated Value of Project: on
APPLICANT: DO NOT WRITE BELOWTHIS LINE
#
Submittal
Req'd
Rec'd
TRACKING .
PERMIT FEES
Plan Sets
Plan Check submitted
Z r
Item.
mount_
Structural Cales.
Reviewed; ready for corrections
a
Plan Check Deposit
f
='
Truss Calcs.
Called Contact Person
ql+
1
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
y ��
Flood plain plan
Plansresubmitted��
3
Mechanical
Grading.plan
2"" Review; ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
O Z Lz
Grant Deed •
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
7rd Review, ready for corrections/issue
Developer Impact ee
Planning,Approval
1
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
'
f
Total Permit Fees
OCT -11-2005 13:37 FROM:STOWE INS. 7603426803 TO:760 777 7105
CERTHOLDER COPY
STATE -P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
COMPENSATION
INSURANCE
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE.DATE: 10-10-2005 GROUP:
POLICY NUMBER: 1744804-2005
CERTIFICATE ID. 3
CERTIFICATE EXPIRES: 10-01-2008
10-01-2006/10-01-2006
CITY OF LA QUINTA SK
78-495 CALLE TAMPICO
LA QUINTA CA 92263
This is to certify that we have issued a valid Workers' •Compensation Insurance policy in, a form approved by the
California Insurance Commissioner to the employer named below. for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice t0 the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend; extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of Insurance may be issued or to which it may pertain; the insurance
afforded by the policy described herein Is subject to all the terms, exclusions, and conditions, of such policy.
AUTHORIZED REPRESENTATIVE PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #1700 - ARMANDO OROS - EXCLUDED.
ENDORSEMENT #1700 - ARNULFO OROS - EXCLUDED,
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-10-2005 IS
ATTACHED TO AND.FORMS A PART OF THIS POLICY.
j
EMPLOYER
OROS, ARMANDO (PARTNER) AND OROS, ARULFO
( PARTNER )
82108 SUNDOWN CT
INDIO CA 92201.
SK
[B10 -SKI
PRINTED : 10-10-2005
P. 2/2
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TRILOGYA.TLA QUINTA
AMINTENANCE ASSOCIATION.
May 27, 2005
Sonia Dreyer,,
60202 Sweetshade Lane
La Quinta, CA 92253
Property Address: 81196 Red Rock Road
Dear Ms. Dreyer:
We are pleased to inform you that your application for installation of rear yard, front courtyard, fireplace a d seat
wall, received on May 16, 2005, has been conditionally approved by the Design Review Committee per -the attached
Conditions of Approval form. However, the date palm cannot be planted, as it is not on the approved plant list.
This approval does not constitute consent by the Association for the applicant to encroach; trespass, or build on
any property other than that of the applicant. This approval is related solely to the items reserved for approval by
the CC&R's in accordance with the Architectural Guidelines. The approval does not extend to the quality of work
done by your architect, or contractor, or to any structural engineering, soils engineering, or site grading and drainage
design. You are urged to obtain the services of a state licensed professional for consultation as needed.
Please be advised that this approval does not relieve you from obtaining any necessary building permits from the
governmental agencies involved. It is strongly recommended that you hold your final payment to any contractor
doing work on the exterior of your home until such time that- a Design Review Committee member has inspected
your property and your deposit has been refunded to you. If any damage has been caused by your contractor to
common area property, the Association will have the necessary repairs made and deduct the cost from your deposit.
Therefore, it is important for you to wait for the deposit refund before you pay your contractor in full.
Sincerely,
For the Design Review Committee
Melinda Gutierrez, CCAM
Association Business Manager
Enclosures
cc: Board of Directors
Design Review Committee
y Professionally Managed By Action Property Management, Inc.
-way, La Ouinta, CA 92253
60-750 Trilogy Park
(760) 777-6059 (760) 777-6097 fax
mgutierrez@actionlife.com
www. actionl ife. coni