11-0812 (GRES)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
4.*4'AWW9WPA
11-00000812
._Z&SAQ-CITRUS
772-101-OOG-
GARAGE - RESIDENTIAL
LOW DENSITY RESIDENTIAL
14000
VOICE (760) 777-7012 ilo
T4hf 4 =1L
FAX (760) 777 -7011 -
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
Architect or Engineer:
BUILDING PERMIT
Owner:
WILLIAM FOWLER
79800 CITRUS
LA QUINTA, CA 92253
Contractor:
GALLAUDET CONSTRUCT
52202 ROSEWOOD LANE
LA QUINTA, CA 92253
(760)516-9000
Lic. No.: 91SI430
Date: 10/05/11
bm U
I - IL
OCT 10 2011
CITY OF LA QUINTA
FWANCE-DEPT �- ___
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions 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 and P f ional 3nd 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: B N 919430
0.
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
ZC.ntract��
issued.
1.1�oate:
I h ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
_T_T_ \J_
Code, for the performance of the.work for which this permit is issued. My workers' compensation
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am.exempt from the Contractor's State License Law for the
Carrier EXEMPT Policy Number EXEMPT
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
I certify that, in the performance of the work for which this permit is issued, I shall not 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 s . ect to the 5a50rs' 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
and agree that, if I should become s t to ompensatl on provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
A700 of the Labor Code, ith I ose provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section'7031.5 by
2
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
�/.te: pplicant:
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
WARNING: FAILURE TO SECU I COMIUSATION 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 herself through his or her own employees, provided that the
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED 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.
Date:
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, 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. , B.&P.C. for this reason
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:
LQPERINIIT
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.
I . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit woik 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 1 80_4&1!57,iII subject
permit to cancellation.
I certify that I have read this application and state that the above informati corre a 0 ly with all
city and county ordinances and state laws relating to building co ti , nd her U 0' re esentatives
9f this ount t t r pon the above-mentioned proper r " ec " n r ose
Date: 16 -7 0112ignature (Applicant or Agent):
Application Number . . . . . 11-00000812
Structure Information
Construction Type . . . . . TYPE V, UNPROTECTED
Occupancy Type . . . . . . DWELLG/LODGING/CONG <=10
Other struct info . . . . . CODE EDITION 2010
FLOOD ZONE NO
GARAGE SQ FTG 49.00
---------------------------------------------------------------------------
Permit . . . 1. . . ELECTRICAL-CARPORT/GARAGE
Additional desc
Permit Fee . . . . 15.98 Plan Check Fee 4.00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/02/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
49.00 .0200 ELEC GARAGE
----------------------------------------------------------------------------
OR NON-RESIDENTIAL
.98
Permit . . . . . . CARPORT/GARAGE
Additional desc . .
Permit Fee . . . . 153.00
Plan Check Fee
99.45
Issue Date
Valuation . . . .
14000
Expiration Date 4/02/12
Qty Unit Charge Per
Extension
BASE FEE
4S.00
12.00 9.0000 THOU BLDG.2,001-2S,000
108.00
------------------- ---------------------------------------
Special Notes and Comments
----------------
49 SF ADDITION TO EXISTING GARAGE -(TO.
CREATE GOLF CART AREA)per STRUCTURAL
PLANS.ANTHONY P. LITECKY C71171. 2010
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SBi473)
1.00
HOURLY
PLAN CHECK
70.00
STRONG
MOTION (SMI) - RES
1.40
Fee summary Charged Paid
----------------- ---------- ----------
Credited
---------- ----------
Due
Permit Fee Total 168.98
.00 .00
168.98
Plan Check Total 103.45
.00 .00
103.45
Other Fee Total 72.40
.00 �.00
72.40
Grand Total 344.83
.00 .00
344.83
LQPEnl]T
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Bin
Qty of La Quinta
Building &T Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: 7f MO
Owner'sName:
A. P. Number: 2�� / 17&4
Address: --7q 900 &'�fi'IZ�
Legal Description: th� 13 Z M
City, ST, Zip
Contractor:Ga#a—ad&M
p
Telephone:
Address:
Project Description: A I
City, ST, Zip:
611 17�
Telephone:
State Lic. # :qI143(�) �7/0wt;L C.
Arch., Engr., Designer:
Address: '011
t,4 -
City, ST. Zip: lldkL -�a�
0
-7& 0
Telephone:
.. ................
Construction Type: Occupancy:
Project type (circle one): New (:A��n�Alter Repair Demo
StateLic.#:
Name of Contact Person: la '4
I L-/ / r/f
Sq. Ft.-.'
# Stories:
I #Units:
Telephone # of Contact Person: ,
Estimated Value of Project: I L4 Plob.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Reqld
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted -,,,Z--.
Item
Amount'
Structural Calcs.
Reviewed ready c rections
Plan Check Deposit
Truss C21cs.
Jn.
Called Contact PAn
Plan Check Balance
Title 24 Calcs.
Plans picked u p
Construction
Flood plain plan
Plans resubmitt�d
Mechanical
Grading plan
2" Review, ready for corrections/issue
Electr�cal
Subcontactor List
Called Contact Person
Plumbing AA
I\ Aj
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for correctionfue
Developer Impact Fee
1
Planning Approval
Called Contact Person
A.I.P.P
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
1344 01;,
/0
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CITRUS
COURSE HOMEOWNERS ASSOCIATION
NOTICE OF APPROVAL
William Fowler
17143 13th Ave NW
Shoreline WA 98177
RE: 79800 Citrus
Dear Williarh Fowler:
March 31, 2011
Your Request for an architectural change has been approved.- Specifically, you have approval to proceed with the
following:
Install third car garage to their existing garage structure. Stipulations: requirement that the roofline is to be no
lower than the existing garage roofline. Furthermore if the City requires architectural drawings of the addition
these drawing are to be submitted to the Committee for their review too. A permit from the City is to be
submitted to the management company prior to the start of construction.To make the addition a sizeable palm
needsto be removed. The Committee suggests the Palm be moved to the outside wall left of the front entrance.
We reserve the right to make a final inspection of the change to make sure it matches the Request you submitted for
Approval. Please follow the plan you submitted or submit an additional Request form if you cannot follow the original
plan.
Your approval is conditional with the 9tipulation of the following: Stipulations noted above.
You must follow all local building codes and setback requirements when making this change. A Building Permit may be
needed. This can be applied for at the City offices. I
Our approval here is only based on the aesthetics of your proposed change. This approval should not be taken as any
certification as to the construction worthiness or structural integrity of the change you propose. If applicable, please be
-aware that you are responsible for contacting the appropriate utility companies before digging.
Thank you for submitting your application and we look forward to receiving your notice of completion upon
commencement of completed work. For your convenience a "notice of completion" document has been attached.
We appreciate your cooperation in submitting this Request for Approval. An attractive Community helps all of us get the
full value from our homes when we decide to sell.
Sincerely,
Citrus Course HOA
Encl. I