11-0470 (RER)J
P.O{1. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000470
Property Address: 54187 SHOAL CREEK
APN: 775-041-010- - -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application Valuation: : 10 000 0
Applicant: Architect or Engineer:
41
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
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: 748605 License No.: B
Y
Date: 711,11(l 'lliGContractor: !-'LGL.L.e.L J, rnLtmA
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 1$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.).
(_) 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.).
( ) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for theperformanceof the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERAIIT
Owner:
DULICK JAMES
54187 SHOAL CREEK
LA QUINTA, CA 92253
.(925)300-5762
Contractor:
LANG CONSTRUCTION
80590 CAMINO SAN
BERMUDA DUNES, CA
(760)702-7744
Lic. No.: B
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/15/11
------------------
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 STATE FUND Policy Number 1889409-2010
_ 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 become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forthwith
comply.with those provisioris.
Date: ]/Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 be 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 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
of this county to enter upon the above-mentioned propertt�yyo faorr� inspection purposes.
Date: %� �� ignature (Applicant or Agent): O[A-L '�/ .
Application Number . . . . 11-00000470
Structure Information
Construction Type . .
. . . .TYPE V, UNPROTECTED .
Occupancy Type . . .
. . . DWELLG/LODGING/CONG <=10
Other struct info . .
. . . CODE EDITION
2010
-----------------------------------------------------------------------------
# BEDROOMS
00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
639.50 Plan Check Fee
415.68
Issue Date . . . .
Valuation•
100000
Expiration Date ..
1/11/12
Qty 'Unit Charge
Per
Extension
BASE FEE
414.50
50.00 4.5000
----------------------------------------------------------------------------
THOU BLDG 50,001-100,000
225.00
Permit
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
35.85 Plan Check Fee
8.96
Issue Date . . .
Valuation . .
. . 0
Expiration Date
1/11/12
Qty Unit Charge,
Per
Extension
BASE FEE
15.00
20.0'0 .7500
PER ELEC DEVICE/FIXTURE IST 20
15.00
13.00 .4500
---------------------------------------------------------------------------'-
EA ELEC DEVICE/FIXTURE >20
5.85
Permit
MECHANICAL
Additional desc .
Permit Fee
24.00 Plan Check Fee
6.00
Issue Date
Valuation
0
Expiration Date
1/11/12
Qty Unit Charge
Per
Extension
_
BASE FEE
15.00
2.00 4.5000
--------------------------
EA MECH VENT INST/ DUCT ALT
----------------------------------
9.00
----------------
Permit . . .
PLUMBING
Additional desc .
Permit Fee
24.00 Plan Check Fee
6.00
Issue Date
Valuation
0.
Expiration Date
1/11/12
Qty Unit Charge
Per
Extension
LQPERNIIT
Application Number ..
. . . . 11-00000470
Permit . . . . . .
PLUMBING
Qty" Unit Charge
Per
Extension
BASE FEE
15.00
1.00 6.0000
EA-. PLB FIXTURE
6.00
1."00 3.0000
EA PLB GAS PIPE 1-4
OUTLETS
3.00
--------------------------------------------- -----------------------------
Special-Notes and Comments
REMODEL TO KITCHEN /
DINING & LIVING
AREA OF EXISTING SFD
PER ENGINEERED
PLANS. 2010 CODES.
Other Fees . . . . .
. . . . BLDG STDS ADMIN
(SB1473)
4.'00
ENERGY REVIEW
FEE
41.57
STRONG MOTION
(SMI) - RES
10.00
Fee summary Charged
----------
Paid
--------------------
Credited.
----------
Due
-----------------
Permit Fee Total
723.35 .00
.00
723.35
Plan Check Total
436.64 .00.
.00
436.64
Other Fee Total
"55:57 .00
.00
55.57
Grand Total
1215.56 .00
.00
1215.56
LQPEMN11T
Bin #
J
Oty of La Quinta
Building 8I Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
l �1
Project Address: 54187 Shoal Creek - PGA West
Owner's Name: James D. Dulick
A. P. Number: 7.75-041-010
Address: 54187 Shoal Creek - PGA West
Legal Description: Lot A411, Tract 24317, Residence 1
City, ST, Zip: La Quinta, CA 92253
Contractor: Lang Construction
Address: 80590 Camino San Gregorio
Telephone: (925) 300-5762 �>r's'��<•':<:>`:.?::::zz::>�?>%:;<r
Project Description: Remodel a Single Story Single
City,ST,Zip: Indio, CA 92203
Family Residence Kitchen.
Telephone: (760) 934-9020
: ^ :: •:••••:••.•:::::•:::::::.::.::.
i::`:s'; <;s:#:::>::>si>::; ::::>:<:«:i«
Removal of load bearing walls and replace with
StateLic. # : $-748605
City Lie. #: 0104571
clear span. beams. to open the living area:
Arch., Engr., Designer: Larry W. Lang, P.E.
Address: 80590 Camino San Gregorio
City., ST, Zip: Indio, CA 92203
Telephone: 7 7 - 7 74
P ( 60) 02 4 z '€:'•#?s':>::: :.;? ::::::: :: ##::;::
>>
State Lic. #: 35749 >:>. <:<a:>:s>:>.«
'':? <'• ??%<:<<:? <::;r::::;;:>:.;:;;
Name of Contact Person: Larry W. Lang
Construction Type: V -B Occupancy: Single Family
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.: 560 # Stories: One #Units: N/A
Telephone # of Contact Person: (7 6 0) 702-7744
Estimated Value of Project: $100,000.
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
s
Item
Amount
Structural Calcs.
2
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Persont'
�i
Plan Check Balance.
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
//__
w�b
Mechanical K
C
Grading plan
2°" Review, ready fo correction ssue
. (
Electrical J
Subcontactor List
Called Contact Person
'2
Plumbing
Grant Deed
Plans picked up 1, .
S.M.I.
H.O.A. Approval
(V//0
Plans resubmitted
Grading
IN HOUSE:-
3 d Review, ready for correction ssue
T 4s
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
�Z..1/:Z.1!5;. lr�p
,a,, , -.2e/
I
06/03/2011 11:54 M 760 771 5125 PGA WEST RES ONE Q002
PGA WESY.
RESIDENTIAL ASSOCIATION, INC.
June 2, 2011
Mr. James Dulick
54-187 Shoal Creek
La Quinta, CA 92253
RE: 54-187 Shoal Creek - Architectural Variance Reauestl=igr Renonfions
Dear Mr. Dulick,
In review of your plans prepared by Larry Lang, P.E., sheets Al, A2, S1 & S2 dated May 6,
2011; the proposed interior renovations are acceptable. This letter is for your use in completing
the plan check with the City of La Quinta Building and Safety.
The Architectural Committee and Homeowner's Association will complete our review and
processing of your request when the application is complete and the staanped plans are available.
If I may be of further assistance, please contact me at the HOA office, (760) 771-1234,
Extension 15.
Cordially,
C
Ke , cGalliard
Operations Manager
For the Architectural Committee
KM/bvf
Ce: Architectural Committee
54-320 Southern Hills, La. Quinta, California 92253-5665, Telephone 760-771-1234 FAX 760-771-5125