11-0857 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: T,1-00000857
Property Address: 55935 PINEHUR'ST
APN: 775-241-065- - -
Application description: POOL - RESIDENTIAli ~�
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 23000
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT -
Owner:
LAUER DALE & PATRICIA
14103 205 TH AVE NE
WOODINVILLE, WA 98077
Contractor:
Applicant: Architect or Engineer: TESERRA
P.O.' BOX 1280
COACHEL'LA, CA 92236
(760)398-9222
Lica No.: 656128
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/09/11
i I A i
AUS+ `� 211 E �
� cr�v,a�F �.�.:a�.t►N r�.
LQPER1111T
LICENSED CONTRACTOR'S DECLARATION.'
- WORK ER'&COMPENSATION DECLARATION -.
I. hereby affirm under penalty of perjury at I am ensed'under' provisions of Chapter 9 (commencing with -
.Section 7000), f Division 3'of the Busin s and' ofessionals Code,.and my License is in,full:force and effect..
-
? I hereby affirm underhe
penalty, of perjury, one of tfollowing declarabons:' ,�
I have and"will maintain a'certificate of consent4o self -insure for workers' compensation, as provided
' License Class/ C8/1 2 ;, License No.: 656128 -
_
for.by Section 3700 of the Labor Code, for the performance of the work for -which this permit is
,27, :
ntractor:I
!l^tt�,, -.issued:
have,and will -maintain workers;; compensation insurance, as required by Section 3700 of.the Labor
.
.
Code, for the: performance ofthe,work for which this'permit isissued. `My workers compensation
-- OWNER :BUILDER DECLARATION- -
- insurance carrier and policy number are:
hereby affirm under penalty of perjury that I`am exempt from the Contractor's .Staie,License Lauri for the
Carrier. EVEREST. NATL IN Policy Number 7600006481111..
following reason (Sec. 7031.5, Bu siness,and�Rrofessions Code: 'Any city orcounty.thatrequires a permit,to
I certify that, in the"performance of the work for which this permit is issued;! shall'no t employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance„also requires,`the.applicant for.the
_
- person. in any manner so as to become subject to the workers' compensation laws;of California,
permit to file�a.signed statement that he or she is licensed pursuant to the'provisions of the.Contractor's State
an I agree that, if 1 sho becom 'subject to the workers' compensation.provisions of Section
' License Law (Chapter 9. (commencing with Secbon:7000) of Division 3 of the Business and Professions Code) or.
37 , of the Labor Code, shall comply with those provisions.
that he or she is exempt therefrom and•ithe basis for.the' alleged exemption. Any violation of Section 7031.5 by
- Q
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 0500).:
.Date: v e plicant:
'( _T I, as owner of theproperty, or my einployees,with wages,as their sole compensation, will'do.the work, and
the structure isnot intended or offered.for'sale (Sec. 7044, Business and Professions Code: The
WARNING, :FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS;UNLAWFUL, AND SHALL
' Contractors'•State License Law does not *apply to an owner of property who builds or improves thereon,
SUBJECT AN:EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or her through his or her own employees, pfovided that the
DOLLARS (s100,0001. IN ADDITION TO THE COST OF COMPENSATION,.DAMAGES ASP.ROVIDED FOR IN
:improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES..
one-year of completion,'the-owner-builder will have the burden of proving that lie or she did not build or
- - -
.-improve for the purpose:of sale.l. - -
APPLICANT ACKNOWLEDGEMENT
- (_) I, as"owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7644, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
conditions and d restrictions set forth on this' :application. .
property who builds or improves thereon, and,who contracts for the piojects`with a contractor(s) licensed
1. Each person upon whose behalf this application is made, each person:at.whose request and for
r pursuant to:the Contractors! State License Law-), -_
wh'ose.benefit work is performed under or pursuant to any permit issued'as a result of this application,
(_) I am exempt under Sec: . , B.&P.C. for this reason
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
-
performedunderor following issuance ofthis _permit.
"Date: Owner:
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 '
- CONSTRUCTION LENDING AGENCY
permit to cancellation. '
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that I have read this application and state that the above information is correct. I agree to comply with all
. work for which this permit is issued (Sec. 3097, Civ. C.). -
city and county ordinances and state laws relating to buildindconsyuction, and hereby authorize representatives
above-mentioned property f r in action purposes.
_
Lender's Name:
�;fa:hiscouW.enthe
Q e: Vre (Applicant or Agentl:-
Lender's Address:
'
LQPER1111T
LQPERMIT
Application Number . . . 11-00000857
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit' -Fee . . . . 234.00 Plan Check Fee
152.10
Issue Date . . . . Valuation . . . .
23000
Expiration Date 2/05/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
21.00 .9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
189:'00
Permit . . . MECH POOL
Additional desc .
:Peetmit.:..Fee ., 26-0.0 Plan. Check, 'Fee
6.50
Issue, Date Valuation
0.
Expiration: 'Date,'. 2/05/12
:Qty Unit Charge Per
Extension
BASE,.FEE
15 A 0
1 . 00 - 11. 0000 EA MECH FURNACE, >10.0IC
11.0`0--
s• -
Permit ELEC POOL PERMIT'RES"
Additional desc .
P.eririit Fee' ' , . 45`. 0'0 Plari ,Check " Fee , .
11.25
Issue -Date . . . . Valuation
0
Ekp rati;on.Date 2/05/12.
'Qty.;—Unit Charge Per .-
Extension
BASE• .FEE; ' :.
15.00
1 ;00 30.•0000 .EA ELEC•-„PRIVATE ”:SWIMMINGPOOL
30.-00
Permit . . . PLUMBING
Additional desc .
Permit Fee 33.00 P1-an'Check Fee
8."25
Issue, Date Valuation
0"
Expiration Date 2/05/12
Qty Unit Charge Per
Extension
BASE' FEE
1.5 -10
2:00 6.0000 EA PLB FIXTURE*--
12.0.0
1.00 3:0000 EA PLB WATER:,INSWALT/REP
3.:00
1.00 3.0.000 EA PLB.GAS PIPE -1-4 OUTLETS
3.00
Special Notes and Comments
-
POOL/SPA, INCLUDES 41 L.F. 1 1/2" GAS
LQPERMIT
Application Number . . . 11-00000857.
----------------------------------------------------------------------------
Special.Notes and Comments
LINE. ALARMS/BARRIERS SHALL BE IN PLACE
AT PRE-PLASTER INSPECTION..EQUIPMENT
ENCLOSURE NOT INCLUDED. 2010 CODES.
-----------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN.(SB1473)
1.00
Fee summary Charged Paid
Credited.
Due
Permit Fee Total 338.00 .00
.00
338.00
Plan Check Total 178.10 .00,
.0.0
178.10
Other. Fee Total 1.00 00
00
1.00
Grand Total 517.10 .00
.00
517.10
LQPERMIT
I
o
PGA WEST.
RESIDENTIAL ASSOCIATION, INC.
August 10, 2011
Mr. & Mrs. Dale Lauer
14103 205th Avenue NE
Woodinville, WA 98077
Re: Architectural Variance Submittal - 55-935 Pinehurst - Pool & Spa
Dear Mr. & Mrs. Lauer,
Page 1 of 2
The Architectural Committee is in receipt of a grading plan, date stamped July 25, 2011, submitted by Teserra.
The plan, with proposed drainage and concrete elevations, was requested as a part of the submittal process to
have the contractor address the design and implementation of a proper drainage and concrete installation
according to the building code, industry standards and the unique condition of each site. The Committee and
HOA do not check and/or participate in the review or approval process of the design and installation.
The homeowner and contractor shall provide an installation that meets all code and building standards as they
apply to this project. Also, the homeowner is responsible for this addition and/or modification of the property
as required by the Indemnity Agreement. (See Item 19)
The Committee accepts the project architecturally m accordance with the Architectural Guidelines,
Association's CC&R's, and Maintenance and Indemnity Agreement.
The following conditions and/or requirements are pertinent to the acceptance.
1. Prior to the start of any work, provide a signed set of plans, stamped by the City of La Quinta, and the
city issued permit.
2. The homeowner and the contractor to schedule a meeting with the Landscape/Irrigation Manager, Bill
Bobbitt, and the Maintenance Manager, William Aceves, prior to the start of any work. The purpose is
to confirm the condition pre -construction, establishing the responsibility for existing HOA property.
3. The contractor is to verify and locate any easements and underground utilities. Any damage or
disruption is to be repaired immediately.
4. The contractor is responsible for all protection, rerouting and modifications of existing utility services.
5. The HOA is not responsible for verifying property lines, easements, existing utility services, irrigation
and drainage lines.
6. The HOA does not provide permission to access the rear property from the lake area or adjacent
neighbor rear yards.
7. Any electrical wiring exposed during construction must be reported to the Association.
8. The contractor to repair and/or replace any damaged irrigation, landscape, hardscape, lights, drainage
devices or street surface to the satisfaction of the HOA.
9. All modifications to the existing sprinkler systems are to be made by the contractor to the satisfaction of
the HOA.
54-320 Southern Hills, La Quinta, California 92253-5665, Telephone 760-771-1234 FAX 760-771-5125
Page 2 of 2
10. The HOA is not responsible for demolition or removal of existing hardscape, landscape, sprinklers and
lighting.
11. All landscaping repairs and new landscaping are to be approved by the landscape manager and must be
based on a landscape plan.
12. The homeowner and contractor are advised to comply with the contractor's working guidelines and
vehicle rules.
13. The contractor is not allowed to stockpile any material, equipment or construction debris in the street.
All debris must be cleaned up daily.
14. The street gutters cannot be used for concrete wash out and the contractor is responsible for keeping the
gutter clear and free of debris. Streets are to be cleaned daily.
15. Upon completion, the homeowner is required to provide a signed copy of the city inspection card and
the Contractor Certification letter (enclosed).
16. The homeowner and the contractor to schedule a meeting with the landscape/irrigation manager and the
maintenance manager prior to submitting a Notice of Completion form
17. The project should be completed within 60 days of starting.
18. The Committee's review is only for the architectural implications of the project. Compliance with all
codes and engineering for the project are the responsibility of the homeowner and contractor.
19. A Maintenance and Indemnity Agreement shall be -signed prior to the start of work and at the completion
of the project. Same shall delineate all applicable work,, 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 original request.
An approval is based only on the aesthetics of your .proposed plan and 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 at the HOA office, (760) 771-1234, Extension 15.
Cordially,
Kelly c alliard
Operations Manager
For the Architectural Committee
KM/bvf
Enc. 1
CC: Architectural Committee
Bin #
CI�y. -O� �.-QU�n�d•
;Building.&- Safety Division
P.O Box.1504 78 495 Calle Tampico
La Qliinta; CA, 92.253 . (766) 77777012
Building'P..ermit Application and Tracking Sheet
Permit #
Project Address: 55 -9 3 S vyL T
Owner's Name:
A. P. Number:
Address: S S 3 5 ,` -,+,; T
Legal Description:
Contractor: -s lZ
City, ST, Zip: a Q0147q CA 9225
•:fy,}{:ii?iMi�X? iiY'f,>,J::'::�i'r'�}?ii}:��y S;.
-Telephone:
Address:
Project Description: _ S L
City, ST, Zip• 6E A 2 •
2., nA S C rnl.E
Telephone: p
< 'S>`,33€: z': <: •`•gs
State Lic. # : S �.2 g City Lic..#.:
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lic.#:
;>'. is s',:tiw°" : :c:'': <:::<«:>:><,:A •>s;:
y�:,,.:„<.:;;.>:;;;;r:<.:4::<:z}:
.. r.....i::.:::;: ;
`Constiuetion Type: tj Evj Occupancy:
Project.type.(circleone): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft;:
# Stories:
#Units:
Telephone # of Contact Person: 0 2—So Z 3
Estimated Value of Project: Z_71190 0
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACIQNG
PERMIT FEES
Plan Sets
Plan Check submitted
Al
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading'plan
.21' Review, ready for correcfionsRssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans'picked up
S.M.I.
H.O-A. Approval
Plans -resubmitted
Grading
IN HOUSE:-
7nd Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total'Permit Fees