11-1136 (PAT)P. -O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: '11-00001136
Property Address: L55161 SHOAL
CREEK
APN: 775-142-030-
- -
Application description: PATIO COVER
- RESIDENTIAL
Property Zoning: LOW-DENSITY-
RESIDENTIAL
Application valuation: • 3352
Applicant:
ci&,tit 4 4v Q"
Architect or Engineer:
A for
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
LICENSED CONTRACTOR'S DECLARATION
.I he 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 rofessionals Code, and my License is in full force and effect.
License Class: C51 C8 ense No.: 937811
Z<ate: � I ontractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury tha 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 I$500).:
(_ 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 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 the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.)..
Lender's Name:.
Lender's Address: -
LQPERMIT
Owner:
JOHN DYKSTRA
55161 SHOAL CREEK
LA QUINTA, CA 92253
Contractor:
VALLEY PATIOS
37897 CHESTERFIELD
BERMUDA DUNES, CA
(760)534-4634
LiC. No:: 937811
VOICE (760) 777-7012
FAX (760) 777-7011 .
INSPECTIONS (760) 777-7153 '
Date: 10/17/11
92203
WORKER'S COMPENSATION DECLARATION
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 SOUTHERN INS CO Policy Number WSIO047500-01
_ 1 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 be oma subjec to the workers' compensation provisions of Section .
3700 of the Labor Code, I all forthv; comply with those provisions.
i
Date: n pplicant;
WARNING: F URE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL,.AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA 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 restrictioris 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 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
offtthis colun to enter upon the above-mentioned property for i pectin urposes.
Date: 6U nature (Applicant or Agent):
Application Number . . . . . 11-00001136
Permit . . PATIO COVER PERMIT
Additional desc _
Permit Fee 63.00 Plan Check Fee
40.95
Issue Date Valuation . . . .
3352
Expiration Date 4/14/12
Qty Unit Charge Per
Extension
BASE FEE
45.00
.2.00 9.0000 THOU BLDG 2,001-25,000
18.00
----------------------------------- -----------------------------------------
Special Notes and Comments
252 S.F. DURALULM ALUMINUM PATIO COVER .
AT REAR OF RESIDENCE. 2010 CODES.
---------------------------------------------------------------
Other Fees BLDG STDS ADMIN (SB1473)
-
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
Due
Permit Fee. Total 63.00 .00 .00
63.00
Plan Check Total 40.95 00 .00
40.95
Other Fee Total 1.50 .00 .00'
1.50
Grand Total 105.45 .00 .00
105.45
LQPERMIT _ -
Bin.#
Cj/ �f Lel Quinta .
BuMpg 8t Safety DitrIsion
Box 1504,78-495 Calle Tampico
14-Quanta, CA 92253 -:(760) 777-7012
Building Permit Appikation and Tracking Sheet
Perinit #P.O.
w
Project Address: sE-`('/ Seo l
Owner's Name:. yfr /i'( J O014
A. P. Number.
Address:
Legal Description:
Contactor. kjrzw I' l S l,e r
City, ST, Zip: (�
Telephone: ' s
Address: 7 8 -6'-P e- J-'4
Project Description:
City, ST, Zip:
/�
Telephone:
State Lie. #: City Lia M.
n
Q.✓ 0. V' �a � GG...siro�..
Arch., Engr., Designer
q.
Address:
City., ST, Zip:
Telephone: Construction TYpe:. Occupany:
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Sq. FL: s #Stories: # Unity:
Telephone # of Contact Person: �� 0). Estimated Value.of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
'Reed ..
TRACENG PERMTFFEES
Pian Sets
Plan Cheek submitted item Amount
Structural Calls
Reviewed, ready for corrections Plan Check Deposit. .
Truss Cake.
CaUed Contact Person Pian Check Balance
Mile 24 Calcs.
Pians picked up Construction
Flood plain plan
Plans resubmitted.. Mechanical
Grading plan
2'' Review, ready for correctionstbaue Electrical
Subeontactor List
Called Contact Person Plumbfag
Grant Deed
Plans picked up S.MJL
H.O.A. Approval
Pians resubmitted Grading
IN HOUSE:-
3" Review; ready for cormcdonvIssue Developer Impact Fee
Planning Approval
Called Contact Person A-I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
PGA- WEST-
RESIDENTIAL
ESTRESIDENTIAL ASSOCIATION, INC.
' Page 1 of 2'"
October 3, 2011 y
Mr. & Mrs. John Dykstra
55-161 Shoal Creek '
La Quinta, CA 92253
RE: 55-161 Shoal Creek - New Duralum Aluminum Patio Cover & Patio Extension
Dear Mr. & Mrs. Dykstra,
The Architectural Committee has reviewed your request to install a Duralum aluminum patio
cover and extend the golf course side patio at your 55-161 Shoal Creek residence. The proposed
modifications are acceptable in accordance with the Architectural Guidelines, Homeowner's
Association CC&R's and Maintenance and Indemnity Agreement. -
The following comments and. requirements are applicable:
1. Contact Bill Bobbitt, the Landscape and Irrigation Manager, and William Aceves, the.
Maintenance Manager, to ' have a preconstruction ' meeting, (760) 771-1234, extensions r
23 and 24, `respectively.
2. The materials and installation details are to comply with the 'Commercial' specifications
'for the wind and live load requirements.
3. The contractor cannot use the street for stockpiling construction material or debris.
r F 4. The street gutters are not -to be used for concrete and construction material clean up.
Neither debris nor dirt is to be washed down th&gutter: i
5. The contractor to repair and/or replace any damaged' irrigation, landscape, hardscape,`
lights or street surface to the satisfaction of the HOA.
6. Contractor.to observe all parking and driving regulations.
7.. The installation to have a City of La Quints building permit and the -signed inspection
card provided to the Association upon completion.
8. The homeowner is required to purchase two signs from the Association to be installed
on the top of the structure. The verbiage on each sign issues a warning regarding
walking on the patio cover. The. signs are available from the Association for a,fee of
$25.00 each.
54-320 Southem.Hills, La Quinta, California 92253-5665, Telephone 760-771-1234 FAX 760-771-5125
4
Page 2 of 2
9. , The contractor to use sealant in holes for attachment through stucco into support. "
10. Any damage to stucco. or roofing to be repaired by the contractor. Walking on the roof +
tiles may cause damage to the underlayment.
r'
11. The HOA is- not ,responsible for. any damage to the Duralum aluminum patio cover
during the painting of, the unit and they are not liable for any injury or damages due to .
the patio cover. ,
12. Contractor to provide a signed, copy of the - `Contractor's Notice of Completion
Certification Letter' (enclosed) with the `Notice of Completion' form.
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An approval is based only on the aesthetics of your proposed plan and should
not be taken as, any certification as to the construction worthiness or- structural integrity of the
proposed change.
We appreciate your cooperation in submitting this,request for approval. If I may be 'of further
assistance, please contact me at the HOA office, (760) 771-1234, Extension 15.
Sincerely, ,
Kell alliar,
0:)1sManager ,
,
For the Architectural Committee '
{
K1M/bvf
.Enc. 1"
Cc: Architectural Committee ;
t
+ IL _ t.
To: PGA West 'Residential Association, Inc. Architectural Committee
c/o PGA West Residential Association, Inc.
RE: Notice'of Completion Certification Letter for:
i 1
Homeowner Name. &Address ., k
Homeowner:Signatuce 4 Date
Project Name
Dear Members of the Committee.
This letter acknowledges our compliance with the plans and specifications submitted and
approved for the architectural variance at this address.
i r
We also certify that all the work performed is according to .the building code and approved .by
the Focal building department. Any changes to the original plan and architectural request have
been resubmitted and approved.
This information is'submitted in conjunction with the owner's 'Notice of Completion' document. `
Contractor Signature i - Date
• . ` . , t
Contractor Company '
I
10'-312
L
I
•
T -3Z•
Dykstra Residence
55-161 Shoal Creek Rd
La Quinta, CA 92253
Proposed Concrete Extension
TY OF LA QUINTILDING
& SAFETY DEPT.
F
APPROVE®
FOR CONSTRUCTION
DATE /O' / 7- 11 BY Al
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Driveway
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