13-0017 (SOTB)4 P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
f� Date: 1/04/13
Application Number: 13-00000017 Owner:
Property Address: -79020 CARMEL CIR TOM ANDERSON
APN: 646-400-013- - - 79020 CARMEL CIRCLE
Application description: STRUCTURES OTHER THAN BUILDINGS LA QUINTA, CA 92253 /1
Property Zoning: LOW DENSITY RESIDENTIAL P
L/r��\1
Application valuation: 3000
F
Contractor: JAN � 4 2013 10
Applicant: Architect or Engineer: PAYNE, RICHARD ALLEN
52565 AVENIDA BERMUDAS
CITY OF LA QUINTA
LA QUINTA, CA 9.2253 FINANCEDr:PT.
(760) 578-6149
Lic. No.: 947805
-------------------------------------------------------------------------------------------------
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 nd Professionals Code, and my License is in full force and effect.
License Class: B No.: 947805
rector:
- 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).:
1 _ 1 1, 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 _ 1 I am exempt under Sec. , BAP.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 ISec. 3097, Civ. C.).
Lender's Name: wN
Lender's Address: •
LQPERMIT
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 9,TATE FUND Policy Number 9016599-12
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 shou become fiubj et'[Cth orkers' compensation provisions of Section
3700 off the La r de, shall fo thwi comply ith those provisions.
Date: /Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMP NSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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 abov i formation i cor t. I agree to comply with all
city and county ordinances and state laws relating to g co s uction, a e eby a prize representatives
of
is
co y to er pon the above-mentioned p perry or in p coon purp s S.
DDaate: Signature (Applicant or Agent):
Application Number . . . . . 13-00000017
Permit . . . ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . . 15.75 Plan Check Fee
3.94
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 7/03/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20
----------------------------7-----------------------------------------------
.75
Permit . . . PLUMBING
Additional desc . .
Permit Fee . . . . 18.00 Plan Check Fee
4.50
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . ° 7/03/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS
3.00
------------------------------------------------------------7---------------
Special Notes and Comments
BBQ TO INCLUDE 27 L.F. 1/2" GAS LINE AND
ELECTRICAL STUB OUT FOR FUTURE USE. 2010
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 33.75 .00 .00
33.75
Plan Check Total 8.44 .00 .00
8.44
Other Fee Total 1.50 .00 .00
1.50
Grand Total 43.69 .00 .00
43.69
LQPERMIT
vered Overhang Off of Home
4ARDSCAPE
HERE
7 Ft.
' ... -.- . -1 - Property line
And Block Wall...
/ Gas
Stub
1
1 � Gas line
1
I
f 27 Ft.
!
i
t
1 The Wall Is 5' 10" On
1 this side...
BBQ .. i
And 4' Tall On This
HERE Side...
30"/ 12 Feet
CITY OF LA QUINTA
Pool BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATEJ, By
Application For Gas
To BBQ, 10.22.12
Anderson
79020 Carmel Circle
LQ CA 92253
612-910-1927
deephaventom@gmail
RANCHO LA QUINTA
MASTER ASSOCIATION
Architectural Control Committee.
November 6, 2012
Mr. Tom L. Anderson
79-020 Carmel Circle
La Quinta, CA 92253
Re: 79-020 Carmel Circle
Approval of Submission
The Architectural Committee reviewed your submission for the installation of a new
Bar B Q. The submissions as presented are approved upon condition of. -
The Committee requires the following:
• All work is to be done in accordance with all applicable requirements of
governmental entities, including the City of La Quinta and in accordance with
all Homeowners Association architectural guidelines and ,governing
documents.
• No access from the Golf Course may be used.
• Please provide a copy of the Work Permit from the City of La Quinta prior to
starting the project.
When the work has been finished, please return the `Notice of Completion" to the
Association Office. The Association's architectural consultant will perform a final
inspection after receipt of such notice; when verification of the approved plan
modifications have been concluded, your Security Deposit will be processed for
refund.
Thanking you in advance and if any questions please do not hesitate to call me at the
on-site ffice 777.8807.
in rely,
Mary E. Wer, CCAM
Association General Manager .
760.777.8807 fax 760.777.8961
Email : mwalker0drminternet.com
www.rlqma.com
cc: Architectural Comm.
P.O. BOX 6419 • LA QUINTA, CA 92248-6419 • 760-777-8807 • FAX 760-777-8961
lin.#
City. of La Quinta
BulkUng 8c Safety Division
P.O. Box 1504,78-49S Calle Tamplco
Ia.Quinta, CA 92253 • (760) 777-7012
Building Permit Applicatlon and Tracking Sheet
Perintt #^
\�
Project Address:
Owner's Name:.441
A. P. Number.
Address: . O ,Legal
Description:
City, ST, Zip:/` C?i.7i5Contractor..
�1C4#&3&b 1
Telephone: Address:J
��"►YI U%
Project Description:
//'
City, ST, Zip:61V ( / , "y I � (i L
► 1 ! G L� Air
Telephone ' 6
1
�, N '- ��i V
State Lia # : -7 Q City Lia #;
Ard , Eagr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #: _
........ ......:. ,
Construction Type,. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: # Stories: # Unit;:
Name of Contact Person:
Telephone # of Contact Person: Estimated. Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
k
Submittal
Ptah Sets
Req'd
Recd
TRACMNG PERMIT FEES
Pian Cheek submitted item Amount
Structural Cala.
Reviewed, ready for corrections Plan Check Deposit.
IPass Glu.
Called Contact Pcrsou Plan Check Balance
Title 21 Cates
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2'! Review, ready for correctioWiissue Mectsieal
Sulreontaetor List
Called Contact Person Plumbing
Grant Deed
Plans picked up ML
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
s'+ Review; ready for correctionsAssue Devdoper Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit Issue
School Fees
Total Permit Fees
..:k