12359 (AR)44
P.O. BOX 1504
Building 80-547 Pebble Beach 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Mr. a Mrs. Wine
_. BUILDING: TYPE CONST.
Address Same
City Zip Tel.
La Quinta, CA 92253 771-2102
Contractor
Ludington/Link General Contractor
Address
45-550 Ocotillo A
City Zip Tela
State Lic. City
& Classif. B 5571331 Lic. # 2274
Arch., Engr.,
Designer
Address Tel.
City (Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I amilicensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of tf�dBusiness and Professions Code, and my license is in full force and
effect
SIGNATURE ✓ �, DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031 . 5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure,, prior to Its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3'.of the Business and Professions Code, or thathe 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the -city Certified copy is hereby furnished.
(CERTIFICATE F EXEMPTION FROM
WORKEJ;§', - M�ENSATION INSURANCE
�
(This section need not be completed if th4er„_,, is for one hundred dollars ($100) valuation
or less.) `"
I certify that in the performance of thg 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..,-" � r
Date ' r / f cdwner � ,
0/�olAVI�OTICE TO APPLICANT: If, after making IhiS�Certificate o/ Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
A.P. Number
Legal Description_
Project Description
No. 12359
OCC. GRP. _____
Enclose atrium
Sq.No.
SizeF. sQ
No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
$9,255.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
76.05
Const.
117.00
Mech.
21.00
Electrical
20.25
Plumbing
S.M.I.
.70
Grading
Driveway Eno.
Infrastructure
TOTAL
z35. 00 V
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line `
Rear Setback from Rear Prop. Line
Side St r,.eeYSetback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date �k \Per; it %
Validated by: �\'
Validation: \
OCT a�V
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEr.S
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
+ ^
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SD. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SD. FT.
=$
LUMBER GR.
FINAL INSP.
URINAL
SQ. FT.
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
CERT. OCC.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE' PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING t
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
" "ARCHITECT'URAL/,LAND,SCAPE`VARIANCE APPLICATION
PGA WEST.R'ESIDENT`IAL ASSO:C^IATTON INC.
PLease.,compl'ete an" d'.._nc.lude `this request`;•form.,_ along with four (4)
sets of .yo`ur p"roposed.'home improvement".,:plans: to:
PGA WEST RESIDENTIAL, ASSOCIATION, I_YC.
P,..,O : Box''.10.60
La Qu nta,,''CA 92253
or.:'• 5,5-;:940 PGX' Bo i'1"evard
`La'- Qui:ta,. Chi' 9,2253
.Attn: P';gperty 'Manager
NAIME C7 E./Z R.'t 4-i�l 4" 'IAV 1 'Kl ,. :i DATE C'
ADDRESS:G>
The -161 Lowing aperopriateinformati.on should accompany your
completed` appl•caton:
1. Four (4) sets ,or complete. plans•` to: include:
.a. Ir-hprovements an /d .,
b. Pot°. pl'an ; ..
`c.l,a �.dimens-ions proposed
d. Rel'ation'ship to;: neighboring 'units
e. Materal�•and''color scheme
f P-lann.ed 'modifications of all ait- ernal. systems *(land-
scape,,: sp:r;ink.lers,r gas lines, a°lect`rc:al,, etc.)
2. Agreement • and, Covemant'~-Ruaniag wit i ,the-. Land completed
and not i `.' Two ( 2 ). o`rigin'al w
3. Condi-ti ons.: of Appi;oval. and -.Discl•aimer° form (signed)
4•'. Facing; and•�`Adjacer 11
''Neighbor form r(if app l,i:cable)
5. Construction ' Regul ations form (;sig'aea)
ELECTRICTILproved. A
[ .. ]. P_ [. °] Disapproved
Signature` _ *Date
LANDSCAPE [ ] . App.roved [..] Di s -approved
Sig•nat.u'r� "• Date
Y: .
ARCi?IT zL 0 I pproved .E'E [ Aa Disapproved
n r W2 T�g
Signatus Date'
ARCH/Rev.- 5/93., -1-
i •`.. 4
Y
CONDITTONS OR.,APPRROVAL AND,.DI`SCLAfMER
1. Unless sp.ecifi.calIy.agre'ed otheriSesin Writing by the Board
Direct`ors, ap.�rovak''of the submitted plans is expressly
candi ti oned'.,uponp the owner agreeing to assume the:. cost for
any,.addtional maintenance di:r:ectl:y° or ridire.ctl caused by
the proposed modifi ciaL_`on(s) aadi'tio'n('s) , or improvement(s) .
2. Dur.ing there approval proc'es's , the Associ;ati a"n may require that
its arczitec l.ar_dscape. consultant;: attorney; contractor,
etc, reviews th'e. Drobosed.-,plans. SUCH',REVIEWS) ARE VERY'
LIMITED. IN SCOFF"AN'D M.a`_'. NOT ---BE -RELIED' UPON' BY:. THE OWNER TO
ENSURE ,CORR.ECTNESS OF :PLAN'S .FROM.',EITHER A LEGAL,
ARCH I T,ECTURAL ,. STRUCTURNL ,. ENG I NEER I -NG , LANDSCAPING, ETC.
STANDPOINT, ~
3. Theapplicant FURTHER -AGREES. A.VD REPRESENTS that., as a
condition o°f `submi:taL • they _have independently reviewed
and confirmed t1hit' the .proposed' .p.lans -are correct`: from a
legal,-, strut'tural ,:, a•rch te'ctural , en"g;'meer ng, and/or
landsca- "n5'�standpoz nt' and"wil 1i'not in any ywa.y., other
than t,ha` which-, :has been., a :scI os ed- in . the' application,
negatively impAc,t ,the;Associ,at`ion o ",,.cause damage„ or
additional maintenance: -.to Association --;owned and/or'
maintained- property.
4. The ,appy i cant FURTHER AGREES AND REPRESENTS ghat. the applicant
has compl_ea w_t a1.1: applicab14 M adexal , ` Sate, County and
City laws °and -ordinances and has'`obt'ained all. necessary
permits i connection with the:proposed plans.. Applicant
-further agrees to send c.o•pies of �`al l -permits to the
Association .pri.or. .o-- the adtkial i.mpl-ementation! of. the
proposed plans.
PLEASE MOTE THAT APPR'OVAL OF THE PROPOSED /PLANS BY THE
ASSOCIA'T'ION. DOES N,C:T CHANGE ;°.OR• ABROGATE THE APPLICANT'S
OBLIGATION -TO OBTAIN ALL--NECES;SARY 'PE'R�'�I='S AVD/OR .COMPLY
WITH ALL AP-LICnBLEr"GOVERNMEN-TA'L REGULATION'S.
Dated %Accepted by:
Appli--c-ar_t's. signature
(-`-I� L a C i) tii
Prim ed applicant's name
ARCH/Regi 5/93 -a-
CONS-TRU,CT,ION . REGULATIONS
1. Any damage .done to common, -area facili;t,i'es as ,.a .result of this.
cons t'ructi"on: mustbe repaired. prior to the, completion of
project: Return` of dep:o ;it -.:check wig'_ be heId.:,up until work is
sitisfac-orily ccmpletzd.
2. No dirt' --deb:ris or other related ;co,n. ruction maaerial is to be
dumped ^o.n• the PGA 'West `site.. A1.1 `exces'-s'materdals are to be
dumped of -sit"e.
3... No material is to."be...delivened and: placed in street. It will
be requi.r:ed to. pl:ace ; al 1 . pal I ets ; c:ement. and: other materials in
homeowner's!, dri ve'way, .ya-rd: or -garage.
4. Any mat-er..i,al.,stockt)i"led is the, driveway.,..-is"`t:o be left in such
a 'manner- that . i .t wi"l l not be, an annoyance - orjY 3 `Visual
distractib n':'to_ osurround ng.,homeow•ners: Do not block mailbox
access`. - or -the` postal• service will, not deliver.
5.. Do ,not" stockpile material;. on ,.adj:ac`ent lots.
6. All trash -:and debris,,&r'e to` --be picked up daily and the street
cleaned,as needed .
7. When your comp any,. has cr:eated..a safety .haz,a=d, such as, an open
trench, hole, 6:xpased wises;,` et:c. , it, must. be. barricaded` -in.
such a manner -necessary. to prevent injuries ;and accidents.
8. Each unit's. irrigation.: and el.e'ctr-ical-,facilities are .connected
with. adjoining p.r.onerti'es : When mgdificati ons are improper to
such systems, neighboring landscap,'inq'may :be destroy -ed. Please
contact the -Property ,:Management office •when mgdifying
irrigation.or electrical ys"hems in any way;.at (619) 771-123x.
All landscape and e:lectricar l.. -mo di;f i c"anions must be included 'In
the. plans and are 'sub J"ect. td",approval .
9. _ When entry onto golf,, course- property . is necessary in any way,
contact. Go Course�.Operati�oii"s. through Management at the
Homeowner'`s Associ at_onoffice at, -.`(.619.-)'. 771-1234.
10. Do not remove PGA West construction° .bar-riers� without
permission. ':
11. If..escrow is not-. closed,. no. work .shal'I:.commence..
12. Park a1:1 vehicles am the same s: de; -of the road so as not to
cause traffic con5e"sftion.
ARC./Rev 5/93 -6-
13 Property lines must b:e verified by Homeowner/contractor before
starting any work.
14. ALL 'DAMAGES or_'NON=COMPLIANCE.WITH THE SE` CONSTRUCTION
REGU-LAT I;ON S WHETHER "DUR I�NG OR UPON' COMPLET I;QN - - OF- PROJECT, IF
NOT REPAIRED" WLTHIN . (5) DAYS `WILL.; BE' REPAIRED OR CORRECTED BY
THE ASSOCIATION SAND. BILLED TO' THE `-''H'OMEOWNERs"i.
i5. Whenv appl'.yi4ng surface matt+er'al to pa.tio.s, walkways', etc. , the
homeowner. 'assumes, . risks for damages wh-.ich..m4y be caused by
mow;ers.; edgers=.;.or other':'gar. derUng'�`.equipmeni .
16. Drainage;. systems 'for new con s•truction.:: wil l' 'be designed,oh an
ind3.vidual.:bas's . Owner/contract•gr to.ework ;With Architectural
Committee aad.Landscape-`.Manager for approved°.system.
1'.