11-0973 (SOTB)P.O. BOX 1504
.78-495 CALLE TAMPICO •
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 11-00000973
Property Address: 52382 SHINING STAR LN
•APN: 767-200-999-47 --312022-
Application description: STRUCTURES OTHER THAN BUILDINGS
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 2155.
Applicant: Architect or Engineer:
Lr4
334
--------------------------------------------------
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 and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
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).:
(_) 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, 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 I am exempt under Sec. , B.&P.0,,f9r this reason
Date: q P)A I N _Owner:
V 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:
LQPERA1IT
Owner: '_
BRADFOREt) & LISA
52-382 SHINING
LA QUINTA, CA 9
(760)702-3443
Contractor:
Owner
VOICE (760) 777-7012
'60) 777-7011
'60) 777-7153
9/28/11
r
------ - -----------
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 issu&d. My workers' compensation
insurance carrier and policy number are:
Carrier - - - - - - - - - - - - - - - - - - - - - -- Policy Number
I 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 be ome subject to the workers' compensation laws of California,
and agree that, if I should becom subject to the workers' compensation provisions of Section
3700 of the LatLRK I sh II f �rthwitp comply with those provisions.
OlDat &_12/pplicant:
WARNING: FAILURE TO SECURE KERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CR Al PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$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 workis 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 abovein crmation is -correct. I agree to comply with all
city and ounty ordinances and state laws relating to building yeIctioyndhereby authorize representatives
of this c unty enter upon the above-mentione y fortionposes.
bate: ignature (Applicant or Agentl:
Application Number 11-00000973
Permit BUILDING PERMIT
Additional desc _.
Permit Fee 54.00- Plan Check Fee
35.10
Issue Date Valuation . . .
. 2155
Expiration Date 3/26/12
Qty Unit.Charge Per r
Extension
BASE FEE
45.00 .
1.00 9.0000 THOU_•BLDG,2,001-25,000
9.00
----------------------------------------------------------------------------
Special Notes and Comments .
14.4 FT DIA. X 12 FT MAX. PALM FROND
THATCHED ROOF PALAPA WITH ENGINEERED
FOUNDATION. 2010 CODES.
Other Fees_ . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
ENERGY REVIEW FEE
3.51.
STRONG MOTION (SMI)- RES
:50.
Fee summary Charged Paid Credited
Due
Permit Fee Total 54.00 .00 .00
54.00
Plan Check Total• 35.10 .00 .00
35.10
Other Fee Total 5.01 00 .00
5.01
Grand Total 94.11 .00 .00
94.11 ,
LQPERAIIT
Bin #
Permit #^ �y,
Project Address:
City of La •Quinta
Building 9 Safety Division '
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Owner's Name:
A. P. Number:
�.. a-�'
Address:
Legal Description:
City, ST, Zip`_
Contractor:
Address:
Telephone:
Project Description:
City, ST, Zip:
Telephone:'
<H
t ' r.•>.,a
State Lic. # :
City Lie. #:
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone:
State Lic. #:
Name of Contact Person:F,�16
•`
Construction Typc Occupancy:
mrw:x Protect type (ci le e): New Add 'n Alter Repair Demo
11� 5t*Sq. Ft.: /&Z, # Stories: #Units:
Telephone # of Contact Person: '- Estimated Value of Project: ( %�
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd Rec'd TPACKIIVG PERMIT FEES
Plan Sets
b
Plan Check submitted -1 Q. Item Amount
Structural Cala.
Reviewed, ready for corrections Plaa Check Deposit
Truss Cala.
Called Contact Person Plan Check Balance
Title 24 Cala.
Plans picked •p Coustraction
Flood plsin plan
Plans resubmitted Mechanical
Grading plan
2" Review, ready for correcti a Electrical
Subcontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S.M.I.
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
Review, ready for correctionslissue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fee
Total Permit Fees
a7- j .. l:�.�-R-- Q�l6 4 ls3� 9pp•
� G� 1'w,)S � ��i PC,�
Rancho Santana Homeowners Association
�C/o Desert Management
t P.O. Box 799
r } Rancho Mirage; CA 92270
760-862-1202 Fax 760-862-1210
September 28, 2011 "` �
Bradford & Lisa M scho
52-310 Shining Star tn. t
La Quints, Ca. 92253 `,
Re: _Architectural -k& Landscape Variance Request — Approved
52-382 'Shining Star Lane
Dear Mr. &;Mrs. Mascho: r ..
Your, 'request for Pool, Palapa, back . yard landscaping & outside painting has been
reviewed by the Archtectural,Committee, Landscape Committee and -Board of Directors
and your request has been approved(please see attached approval form)..•
If you have any questions or require additional ` information, please call Desert
Management at 760--862-1202. • , . a
Sincerely,
Board of Directors • :p'
Bonnie Hagerman, 4
Sr Association Manager
Rancho Santana HOA ,i!, + 4
i' ARCHITECTURAL COMMITTEE CERTIFICATE v
(Exhibit "A" to the Architectural
Improvement Application and Agreement) ,
The Architectural Improvement A plication and Agreement wasreviewed by the
Architectural Committee on / ' and has been: `
.Approved, ` Conditionally Approved Rejected
' Subject to the 'following
Conditions set forth below
Returned for Further Information
Required Modifications
Comments
.4
Yes NO r
Recording to be sent by owner to County Recorder's office for roof and/or,,
exterior wall modifications. '
Deposit Required 4 posit Am equ' $
Date Architecturaftofnmittee
` F
Architectural Committee Architectural Committee
Architectural Committee Architectural Committee
NOTE: THIS APPROVAi. IS VALID FOR 90 DAYS FROM APPROVAL DATE
i t
t _ y
RANCHO SANTANA HOMEOWNER ASSOCIATION
C/O DESERT MANAGEMENT
P.O. Box 799, Rancho Mirage, CA 92270 -
` Phone 760-862-1202 Fax 760-862-1210
Landscape bequest
Please print clearly '
Name Date"
Address
Contact Information
Phone �(� ���� _��yJ� Email .
Fax
REQUEST
o Add ❑ Remove . ❑ Trim ❑ Tree(s) ❑ Bush(s)
o Other (specify) Y
Location of request Reason for request a
. M
Owner Signature
For Office/Committee Use Only
r
Date received o Assoc' ' expense
Date reviewed r- Owner expense 4
Approved
❑ D s Cost authorized by owner $
Notes
GREEN FORMS SHOULD BE SUBMITTED TO DESERT MANAGEMENT.
PLEASE DO NOT CALL THE LANDSCAPE COM UTTEE MEMBERS AT HOME.
To:
71--780 San Jacinto Dr Ste: E2; Rancho Mirage,. ..- 92270 oh, (760) 834.-8860: fax (760) 834-8661
Letter of Transmittal
City of La Quinta Today's Date: 9-15-11
78-495 Calle Tampico City Due Date: 9-16-11
La Quinta, CA 92253 Project Address: 52-382 Shining Star
Attn: Kay Plan Check #:
We are forwarding:
Includes: # Of
Copies:
El
®El
11
El
11
171
El
1
11-973 (foundation)
Submittal: ® 15t , ❑ 4th
❑ 2nd ❑ 5th
❑ 3`d ❑ Other:
® By Messenger ❑ By Mail (Fed Ex or UPS) ❑ Your Pickup
Descriptions: Includes: # Of Descriptions:
Copies:
Structural Plans
❑
Structural Calculations
❑
and Details
Truss Calculations
❑
Soils Report
❑
Structural Comment List
❑
Redlined Structural Plans
❑
Redlined Structural Calcs
❑
Redlined Truss Calcs
❑
❑ Redlined Soils Reports ❑
Comments: Structural content for the foundation of the palapa is approvable.
This Material Sent for:
❑ Your Files
❑ Your Review
❑ Checking
Revised Structural Plans
Revised Struct. Calcs
Revised Truss
Revised Soils Report
Approved Structural Plans
Approved Structural Calcs
Approved Truss Calcs
Approved Soils Report
Other:
® Per Your Request
❑ Approval
❑ At the request of:
Other: ❑
By: John W. Thompson
Rancho Mirage Office: ® (760) 834-8860 REC UV ,E D
Other: ❑
SEP 15 2011
BY.-
�
4VA
a
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING &.SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760) 777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
W-ORTANTt NOTICE TO PROPERTY OWNER
Dear Property Owner.
An. application for a building permit has been submitted in .your name listing yourself as the builder of the property
imprGvements.specified at
We are .providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this, permit issued in your name as the
Owner. -Builder. We will not issue a building permit until you -have read, initialed your. understanding of each provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting 'authority.
Y. Dead and initial each statement below to signify you understand or verify this information.
AC_1. I understand a frequent practice of unlicensed persons is to, have the property owner obtain an "Owner -Builder"
wilding permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers'
on my,property.
understand building permits are not required to be signed by property owners unless they are responsible for the
ion and are not hiring a licensed Contractor to assume this responsibility..
I understand asan "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on -
and contracts.
U�' I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
my construction is at -least five hundred dollars ($500), including labor.and materials, I may be considered an "employee'
Jer state and federal law.
6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
overnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for. each "employee." I -also understand my failure to abide by these laws may subject me to serious financial
I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
u -es cannot .legally build them with the .intent to offer them for sale, unless all work is performed by licensed
rtractors and :the number of structures does not exceed four within .any calendar year, or all of the work is performed
contract with a1icensed general building'Contractor.
understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
or,personal. injuries sustained. by any subsequent owner(s) that result from any latent construction defects in the
ship or materials.
W�4. I understand I may obtain more information regarding my obligations as an "employer" from the Intemal Revenue
Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CS -LB) at 1-
F00-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors.
0. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
legally and financially responsible for proposed construction activity at the following address:
I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
le laws and requirements that govern Owner -Builders as well as employers.
12. 1 agree to notify the issuer of this form immediately of any additions; deletions, or changes to any of the'infotmation 1
av provided on this form Licensed contractors are regulated by laws designed to protect the public. if you contract with
someone who does not have a license,. the Contractors' State License Board may be unable to assist you with any financial loss
You may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also
important for you to: understand that if an unlicensed Contractor or employee of that individual or fum is injured while working
on your property; you may be held, liable for damages. If you obtain a permit asOwner-Builder and wish to lire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing: dw. • Note: A copy of the property owner's driver's license, farm notanzatiom, or
other verification acceptable to the agenrequired to be presented when the permit istul
to verify the property
owner's signature. �� ntyl /
Signature of property owner Date:
Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OVtWNEWS BEHALF
Excluding the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize
the following person(s) to act as. my agents) to apply for, sign, and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required to bepresented when the permit is issued to verify the property owner's signature..
Property Owner's Signature: Date:
4
'P'RDJECT
ADDRESS:
Brad and Lisa. Mascho
(760) 835-3456
PALAPA FOOTING
51-382 Shins ine
QUINT
La c�.0 i nta BUILDIN� & s q
• APp�J3�V DEP7;
FOR C NSTRUCE®
JOB: =R 11-153 DA N
DATE: o8 September 20 1
•
dwlf�l" lymWreow
"t• STRUCTURAL AND CIVIL ENGINEERING
DENISE R. POELTLER, INC.
77725 ENFIELD LANE, #130
PALM DESERT, CA 92211
a
{
TEL._ (760) 772-4411 FAX (760) 772-4409
drpfly@aol.com
tr SEP 0 2011 S
13X'.. A