12-0361 (PLBG). P; O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number. - 12°000003'61
Property Address: 551_T1 PINEHURST
APN: 775-241-057- -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2000
Applicant:
Tit!t 4.4 Qle"_
Architect or Engineer:
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
SCOTT URIE
55611 PINEHURST
LA QUINTA, CA 922
Contractor:
BUBBLE SPRINGS
VOICE.(760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
APR G 3 2n�2
Date: 4/04/12
_
P.O. BOX 1046
RANCHO MIRAGE, (2 9227.O�+Y(� via J
\�
. fit` y
�
(760) 341-2336 ��—"
LiC. No.: 128796 --�-• _
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'• ; ' LICENSED CONTRACTOR'S DECLARATION -
--
WORKER'S COMPENSATION DECLARATION" _
hereby affirm under lierialty of perjury that:I am licensed under p visions of Chapter 9:(commencing -with
I hereby affirm under penalty of perjury one of the following declarations:
Section 7000) of Division 3.of the Business an rofession ,.and my License is in full force and effect.
_. I have and will maintain a certificate of consent to self -insure for workers compensation, as provided
license Class: 17531035 . ce e;No .;728796
for 6y Section 3700 of the Labor: Code, for the performance of the�work for, which this: permit is
t
issued.
�I-haveand as required,by Section3700 of the Labor
..:Date.... _ontractor. -
will _maintain workers'.compensetion,insurance,
Code, far_the performance of thework for which this permit is,issued �My workers' compensation
-
OWN - ILDER DECLARATION ;:
insurance carrieEand policy num6erare: -
I hereby affirm under penalty -of perjury thaTtam'ex pt from�the Contractor's State License1aw for the
Carrier EVEREST'.NATL -_ Policy Number 76 0 0 016 3 5111•
following reason (Sec. 7031.5, Business`andProfessions Code. Any city orcounty that requires a permit to
_ I certify thatlin the performance of the ;work .for which -this permit is issued, I shall not employ any
sous become compensation -laws of California,
construct, alter, improve, demolish, or repair;any.structure, prior to its.issuanceralso requires,the applicant for the
,' personin any manner to subjec the workers'
•
permit to file a signed statement that he o'r'she is'licensed pursuant to the -provisions of,the Contractor's State
and agree that, if I should b subject h workers' compensation provisions of Section
License Law (Chapter 9-icommencing with Section�70001 of.Division 3 of the Business and Professions Code) or
3700 of thE,Labor Code sha .fpyt(�wit y rth thos.e'provisions. '.
.,� h. ..!
that he or she is exempt therefrom and tha 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 isnotintended or.offeredfor 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 contractor(s) licensed
pursuant to the Contractors' State License Law.).
(_ ) I am exempt under Sec. , BAP.C. for this reason,
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 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
WARNING: FAI URE TO SECUR RKERS' COMP,E ��TIONCOVERAGE IS -UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES D CIVIL FINES UP -TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN:ADDITION TO.THE CO OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, ..
':APPLICANTACKNOWLEDGEMENT
IMPORTANT Application'is hereby. made to,ttfe 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 underor 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 ofsuchpermit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the above informaI is correct. I agr t mPly with all
city and county ordinances and state laws relating to building constru�n�and,bereby a re resentatives
of this Aunty to enter upon the above-mentioned property for ins to u es
te�. ,! i
/ � Si atura (Applicant or Agent):
Application Number . . . 12-00000361
Permit . .
. PLUMBING
Additional desc .
Permit Fee . . .
. 18.00
Plan Check Fee
4.50
Issue Date . . .
.
Valuation . . .
. 0
Expiration Date
10/01/12
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
RUN 200 L.F. 1" GAS LINE FROM METER
TO
FIRE PIT LOCATION.
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
PGA WEST
RESIDENTIAL ASSOCIATION, INC.
Page I of 2
March 28, 2012
Mr. & Mrs. Scott Urie
16505 9th Pl. NW
Shoreline, WA 981'77
RE: 55-611 Pinehurst - Lake Side — Alumawood Cover Remove and Replace Existing
Patio, Misting System, Fire Pit and New Gas Line
Dear Mr. & Mrs. Urie,
The Architectural Committee- has received and reviewed your Architectural Variance
Application submittal dated March 19, 2012. The proposed. modifications and/or additions
include: 1) Removal of existing concrete hardscape (800 sq.ft.). 2) Construct new colored, salt
finish concrete hardscape (.1157 sq.ft.). 3) Install, fire pit with a new gas service line. 4)
Construct a 15'-0"x18'-0" Alumawood.shade structure with stucco wood framed support column
enclosures. 5) Tnstall a misting system with -equipment and services.
The work is to be done as shown on the 8 %2"xl1",site plan sketch dated March 19, 2012, and
related details and , product catalogues. The proposed modifications are acceptable for this
location in accordance with the Architectural Guidelines, Homeowner','s Association CC&R's
and Maintenance and Indemnity Agreement
The following conditions and/or requirements are applicable:
1. The `HOA MUST be m receipt `of contractors' current' insurance certificates PRIOR to
starting any work. As of today, the HOA has not received proof of insurance for Custom
Mist,. Inc., the misting system installers.
2. Contact Bill - -Bobbitt, the Landscape and Irrigation, Manager, and William Aceves, the
Maintenance Manager, to have a preconstruction meeting, '(760) 771-1234, extensions 23
and 24,. respectively.
1. The homeowner is` res ponsible for all removal`of existing shrubbery, irrigation and yard
lighting. Any modifications ' to .the irrigation ,and yard lighting to be approved by the
landscape and maintenance managers.
2. All damage done .to existing HOA property during the construction and installation of
utility services. is to be repaired by the contractor and done to the satisfaction of the HOA.
3. The contractor to .repair and/or replace any damaged irrigation,landscape, hardscape,
lights or street surface to the satisfaction of the HOA..
4. The owner to provide additional details on raised fire pit and finish.
5. The color of the new flatwork to be `Dune' by Davis Colors.
54-320 Southern Hills,"La.Quinta, California 92253-5665, Telephone 760-771-1234 FAX 760-771-5125
Page 2 of 2
6. All demolition and construction debris to be removed daily and no stockpiling in the
street.
7. The street gutters are not to be used for concrete and construction material clean up. The
street is to be broom -washed, as needed each day during -construction. Neither debris
nor dirt is t& be washed- down the gutter.
8. The street and, work area are to be kept clean and safe daily.
9. The contractor. is to observe all Association rules and regulations. Contractor vehicles to
be parked on one side of the street.
10. The Alumawood -structure must meet .the commercial grade design, specifications for all
materials; arid`structure'de'sign. The.'cor tractor to,provide'aletter`of corifi riiation prior to .
ordering materials and starting project.
11. All Alumawood.attachments ,to: the exterior stucco wall to be sealed for water intrusion.
12. A building permit"�is required for the shade structure and. a signed inspection card to be
presented at the completion of the project.
13. The electric fan to be permitted by the City of La Quinta:
14. The gas service to be permitted by.the-City.of La:Quinta..
15. The location of the misting system pump equipment is .to be placed 'in a location not
visible from the lake common area" and..not be a'rioise issue.
16. The homeowner is required to purchasetwo signs from the Association to be installed on
the top of the structure. The verbiage ori each sign issues ,a warning -regarding walking on
the overhang. The signs are available from the Associatioin for a fee lof $25:00 each.
17. Upon completion, the homeowner is required' to provide. the Contractor Certification
letter (enclosed).
18. A Maintenance and Indemnit4greement shall be signed' to the start of work and at
the completion of the project. Same shall delineate all applicablelwork, which current
and future owners shall be compelled to solely :maintain and/or replace as needed and the
document shall be recorded with the County:.of Riverside "and* runs with the land.
We reserve the right to make a final inspection of this change to make sure that.it matches the
origuial request. Ari approval is based only -on -the aesthetics ofAyour proposed plainand should
not be taken as any certification as to the construction worthiness or structural integrity of the
proposed. change.
We appreciate your cooperation in .submitting, this request for approval. If I may be of further
assistance, please contact me atthe HOA office, (760) 771-1234, Extension 15.
Cordiall ,
G
Kell altar
Operations Manager
For the Architectural Committee
KM/bvf
Cc: Architectural Committee
/D,-;e,14ZIA
ol
Bin #
C, of Lauinta .
60410g q SafetyDivision . .
P.O. BOY 1504, •78-495 Calle Tampico
1A.Qd1nta, CA 92253 -:(70) 777-7012
Building Permit Application and Tracking Sheet
Permit #
ProJeoA Address: .�.. ..
ner s Name:.
A. P. N.un bbcr
Address:
Legal Description:
City, ST, Zip:
Contractor:
Telephone: z>..>� : „.. :• ~.
Address: 7-' - ,���, ' 0
Project Description:.
City, $T, Zip jC 6.1v
/
Tele hone �Gp— S DC7
r :'�
City Lie.
7
O �.o..- � 6 q7�6
State Lic. 4:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lie. #: f ,;� 1
Construction type:. Occupancy:
. project type (eirale one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Unita:
Name of Contact Person:
Telephone # of Contact Person: Estimated Value of Project:70
APPLICANT: DO.NOT WRITE BELOW -THIS UNE
#
Submittal
Req'd
Recd
TRACMG
PERMIT FEES
Ptah Sets
Plan Check submitted
Item Amount
Structural Calm
Reviewed, ready for corrections
Plan Check Deposit. .
Truss Calcs.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted'.
Mechanical
Grading plan
2sd Review, ready for correctionsfissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IM HOUSE:-
'"' Review, ready for correctionsirmue
Developer Impact Fee
Planning Approval _
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
17
Total Permit Fees '776.60