09-0936 (AR)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 09=00000936—
Property Address: 55455 LAUREL VALLEY
APN: 775-181-090- - -
Application description: ADDITION - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 50000
T4 t! t'4 4v Q"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
GRAEME & ANN YOUNG
55455 LAUREL VALLEY
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/09/09
Contractor: 'Yn
Applicant: Architect or Engineer: J L P CONSTRUCTION, INC V"� tJ G
PO BOX 581151
N PALM SPRINGS, CA 92258 C�!Y
^ / (760)251-6944 �Q�n
NI /" Lic. No.: 939821 4N�F QG
. ljFpT rq
--------------------------.--------------------------------------------------------
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.
Lic Class: B LicenseNo.: 939821
r Date: �`"�D_a ontractor: _ —
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 ISec. 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, 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 sate. 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. , 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 ISec. 3097, Civ. C.).
Lender's Name: �t
Lender's Address: 1�
r
LQPERM IT
P/v
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 XEMPT Policy Number EXEMPT
ix-I certify that, in the performance of the work for which this permitis 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 1 should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall f comply with those provisions.
bate: �/_" _' plicant: ?
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 J$1 00,000). 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 above information is correct. 1 agree to comply with all
city and county ordinances and tate laws relating to building construc 'eT, and hereby authorize representatives
of this county to enter upon a above-mentioned property for inspec on pur uses.
t_
Date: /��_ /C - Zl ' nature (Applicant or Agent -
f
Application Number. . . . . . 09-00000936
------ Structure Information 134 SF ADDITION
-----
Construction Type . .
. . . TYPE V, UNPROTECTED
Occupancy Type . .
. ... DWELLG/LODGING/CONG <=10
Other struct info . .
. . . CODE EDITION 2007
# BEDROOMS
.00 '
FLOOD ZONE NO
1ST FLOOR SQUARE FOOTAGE
13.4.00
-------------------------------------------------------------
2ND FLOOR SQUARE FOOTAGE
---------------
.00
Permit . . . BUILDING PERMIT
Additional desc 134
SF ADDITION
Permit Fee . . . .
414.50 Plan.Check Fee..
269.43
Issue Date . . . .
Valuation . . . .
50000
Expiration Date
5/08/10
Qty Unit Charge
Per
Extension
BASE FEE
252.00
•• 25.00 6.5000
----------------------------------------------------------------------------
THOU BLDG 25,001-50,000
162.50
Permit . . . ELECT - ADD/ALT/REM
Additional desc .
Permit Fee . . . .
19.69 Plan Check Fee
4.92
Issue Date . . . .
Valuation . . . .
0
Expiration Date
5/08/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
134.00 .0350
----------------------------------------------------------------------------
ELEC NEW RES - 1 OR 2 FAMILY
4.69
Permit . . . MECHANICAL
Additional desc .
Permit Fee . . . .
24.00 Plan Check Fee
6.00
Issue Date . . . .
Valuation . . . .
0
Expiration Date
5/08/10
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 9.0000
EA MECH APPL REP/ALT/ADD
9.00
-------------=--------------------------------------------------------------
Special Notes and Comments
134 SF RES. OFFICE ADDITION TO EXISTING
RESIDENCE. TYPE V -B CONSTR. R-3
OCCUPANCY. 2007 CODES.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
2.00
LQPERMIT
a
-
Application Number
. . .
09-00000936
-----------------------------=-------------------
Other Fees . . .
. . . . .
=--------------------------
ENERGY REVIEW
FEE
26.94
STRONG MOTION
(SMI) - RES
5.00
Fee.summary
-----------------
Charged
----------
Paid Credited
---------- ------- - -- ----------
Due
Permit Fee Total
458.19
.00•
.00
458.19
Plan Check Total
280.35
.00
.00
280.35'
Other Fee Total
33.94
.00
00
33.94
Grand Total
772.48
.00
00
9
772.48
LQPERMIT
Bin #aP
Qty of La Quetta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
O `
Project Address: 15S-4W LAV gSi,
Owner's Name: MJ 6
A. P. Number: -77'j • ISI - D1 p
I W
Address: 51154 95
City, ST, Zip: QU 1 22,53
Telephone: FINE F
Legal Description:
Contractor:
Address:
Project Description: AW 0 C �•�b
City, ST, Zip:
Tele hone:
, tip;::•<.•:>:..::}•.}:.}::;.: ;;:<..•:_:
ACJ i 5 I !J (p !J
•
State Lie. # : City Lie. #; - b3 - 6,34
Arch., Engr., Designer:
Address: �� N•[�l'� aN ��J-�••�
City., ST, Zip:
Telephone: (p
State Lie. #:
:..�;j}::s,<}�>�<:k:�:•.<::<:<;z••
Construction Type: Occupancy:
Project type (circle one): NewAdd' Alter Repair Demo
Sq. Ft.: 1 # Stories: # Units:
Name of Contact Person: 5U<0 LOCKye
Telephone # of Contact Person: ?Ip b 322''i3?j�
Estimated Value of Project: tj p
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'.d
r, CIi IGS n nn 2 n
PERMIT FEES
Plan Sets
3
Plan Check submi 4 ed/ l�� + ~ `� ��
Item
Amount
Structural Calcs.
[[�� rr pp
Reviewed, ready f rrecatec[s 2 20
Plan Check Deposit
Truss Calcs.
Called Contact Pe ton. S
Plan Check Balance,
Tide 24 Calcs.
a
Plans picked up y
Construction
Flood plain plan
Plans resubmitted /e/
Mechanical
Grading plan
2°" Review, ready for correction ssue , dV140
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 correctionstissue
Developer Impact Fee
Planning Approval
Called Contact P
A.I.P.P.
Pub. Wks. Appr
Date of p741t issue O
School Fees
Total Permit Fees
�'' � OIC.. ►...��_ r_ 1�( /LGJ rVq..7 Gi
9 �' 2 StYs • P(�s I�c1cSFi�
bac I ella Valley Unified School District
83-733 Avenue 55, Thermal, CA 92274
(760) 398-5909 — Fax (760) 398-1224
This Box For District Use Only
DEVELOPER FEES PAID
AREA:
AMOUNT
LEVELONEAMOUNT:
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMMAND. AMOUNT:
DATE:
RECEIPT:
CHECK #:
IMTIAIS:
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
1
Project Name: PGA West -Nicholas Course Date: November 5, 2009
Owner's Name: Graeme & Ann Young Phone No.
Project Address: 55-455 Laurel Valley
Project Description: Addition to Existing SFD
APN: 775-181-090
Tract #:
Lot #'s:
Type of Development: Residential XX1 Commercial Industrial
Total Square Feet of Building Area: 134
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under
penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer.
Dated: November 5, 2009 Signature:
***********************************************************************
SCHOOL DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code Gov. Code Project Agreement Existing Not Subject to Fee
17620 65995 Approval Prior to 1/1/87 Requirement
Note: Pursuant to AB -181, any room additions of 500 square
Number of Sq.Ft. 134 sq. ft. feet or less on existing dwelling units are exempt from
Amount per Sq.Ft. $ 0.00 developer fees. Pursuant to AB -181, any mobile home being
Amount Collected $ 0.00 relocated or replaced within our school district is exempt'
from developer fees.
Building Permit Application Completed: Yes/No
By: Jamie T. Brown, Asst. Supt., Business Services
Certificate issued by: Laurie Howard, Secretary III Signature:
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the
project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90 -day period to protest the imposition of these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90 -day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other
requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of
Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up
to three (3) such extensions may be granted.
MV:c/mydocs'devfecs/cellificate ofco npIi<ulce loan tablvsSTO USE.doc 1/16/03 T
OCT/09/2009/F.RI 01:39 PM Monarch Accounting FAX No.760 776 5112 P.001
wt,rj .x
PGA WEST II RESIDENTIAL ASSOCIATION, INC.
VA& 39755 BERKEY DRIVE STE A
PALM DESERT, CA 92211
P� PHONE (760) 776-5100 • FAX (760) 776-5111
May 18, 2008
Graeme & Ann Young
10809 Saskatchewan Drive Tower 1
Edmonton, Alberta
Canada T6E 455
Reference: 55-455 Laurel Valley, La Quinta, CA
Architectural Change Request for Room Addition
Dear Graeme & Ann Young:
The Architectural Committee of PGA WEST II Residential Association met on May 14, 2009 and,
among other items, reviewed your Architectural Applications for a room addition at your home at
55-455 Laurel Valley, La Quinta at PGA West U.
Your Application for Architectural Change has been approved by the Architectural Committee and
they require the following.
A Maintenance Agreement will be required, one will be sent to you for proper
execution as soon as it is prepared. The Owner must accept full responsibility for the
construction, landscape plan and future maintenance of the room addition including.
roof.
A Notice of Completion Form must be submitted when the work is completed.
Please note to the Contractor and all employees that parking is only allowed on ONE
side of the Street on Laurel Valley during the course of the work. Violations will be
cited with fines levied after a hearing.
Review by the Committee is oniv for general conformance with the Architectural
Rules. It is the responsibility of the owner to fully understand and conform to the
Architectural Rules criteria whether or not all deficiencies are noted during the
review. It is also the owner's full responsibility to field verify all existing conditions:
The Committee's decision with regard to project design will be final. Please refer to
the Architectural Rules for all required submittals.
Approvals given by the'Architectural Committee are good for only six months from the date
on the approval letter. After that time a new application must be submitted.
Ux/-T-
OCT/09/2009/FRI 01;39 PM Monarch Accounting FAX No.760 776 5112 P.002
Page 11 5/18/09
Architectural Committee
55-455 Laurel Valley, Room Addition
Absolutely no changes to the plans are allowed without the written approval of the Association.
If you have any additional questions or concerns, please do not hesitate to contact Joanne Rose,
Association Manager, at 760/776-5100, Ext. 20.
Sincerely,
PGA WEST H RESIDENTIAL ASSOCIATION
Architectural mmittee
oanne Rose, C
Association Manager
cc: ARC
Unit File
1127- -1011.
FRAMING:(C-5)
-
-CITY: OF LA QUINTA: SUB -CONTRACTOR LIST
JOB ADDRESS
PERMIT NUMBER
OWNER ,Y0UW(s BUILDER - T_ L-
This form shall be
posted on the job with the Building Inspection
Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to worl
on this job.. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidanc(
of building permit.
For each applicable trade, all information
requested below must be completed by applicant. `On File' is not an acceptable response.
Trade / Classification
Contractor .. ::: ::.:::.::.:.>
:;:<::;>; ;:::::::>:::<::::> .. :. .:.-:.:.::>:
.:.... Stat�:.Contractot's License...
:::.;; : nsw
1Norkers.Co ertsat%n 1 .. ani:° :::..:::::;:;:.::'::.:.
. Git .. Busi{ie5s
MASONRY IC•29)
Company Name
License Number
Exp. Date
Carrier Name
Policy Number
Exp. Date
License Number
Exp, Date
z /
C_ 3 (�
LCla�scation
B, C-8)
(xxxxxx)
(xx/xx/xx)
(e.g. State Fund, CalComp)
(Format Varies)
(xx/xx/xx)
(xxxx)
(xx/xx/xx)
EARTHWORK (C-12)
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3> la
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DRYWALL (C-9) ..<./3a
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CONCRETE (C-8)
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PLUMBING (C-36)
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DRYWALL (C-9) ..<./3a
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MVAC. (e-20)
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ELECTRICAL. (C -10f—
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RQOFING'3
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SHEET.METAL (C-431
---
FLOORING
GLAZING (C-17).:
INSULATION (C -21-/O
S� .�
aZ3 =6�d
2/i D
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SEWAGE DISP:-(C-42)
PAINTING (C=33)
_.—. .
CERAMIC T105(C-54)
--
CABINETS (C-6)
�-
FENCING (C-13)
----
LANDSCAPING IC=27) - ::
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POOL (C-53)
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