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12-1264 (PAT)P.O. BOX 1504 78-495 CALLE TAMPICO 4 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 12-00001264' Owner: Property Address: - 57355 INTERLACHEN MARRS, BARRY & KAREN APN: 762-180-006 - - 57-355 INTERLACHEN Application description: PATIO COVER - RESIDENTIAL LA QUINTA, CA 92253 Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 6000 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 12/21/12 Contractor: Applicant: Architect or Engineer: L M MASONRY OF�P pEP�' 74074 ASTER G�FNQ•NG� PALM DESERT, CA 92260 (760)413-4030 Lic. No.: 966567 ------------------------------------------------------------------------------------------------- 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 Professionals Code, and 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: C29 License No.: 966567 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is 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.). ( 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: �7C �er: CONSTRUC N LENDING AGENCY I hereby affirm under penalty of perjury that there .. 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: LQPERM IT 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 EXEMPT Policy Number EXEMPT I c=at, 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 ome subject to the workers' compensation provisions of Section 700 of th Labo ode, I fall forth/wtjth omply with those provisions. a0 te: f /CJ licant: - t_. WARNING: FAI UR�ECURE ORKERS' 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 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. 1 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 yate laws relating to b ' ing construction, and hereby authorize representatives of hihiii'cou ty t enter upon t above-mentioned pr . _ 'nspe 'on purpo as, Hate: �'f"Si ture (Applicant or Agent): Application Number . . . . . 12-00001264 Permit . . . ELEC-MISCELLANEOUS Additional desc . . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . . . 0 Expiration Date 6/15/13 Qty Unit Charge Per Extension BASE FEE 15.00 6.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 ---------------------------------------------------------------------------- 4.50 Permit . . . PATIO COVER PERMIT Additional desc . . Permit Fee . . . . 81.00 Plan Check Fee 52.65 Issue Date . . . . Valuation 6000 Expiration Date 6/15/13 Qty Unit Charge Per Extension BASE FEE 45.00 4.00 9.0000 THOU BLDG 2,001-25,000 36.00 ---------------------------------------------------------------------------- Special Notes and Comments 192 SF TRELLIS PATIO COVER WITH ELECTRICAL FOR TV NICHE PER ENGINEERED DESIGN. 2010 CODES. ARCHITECT CHARLES GARLAND 011991. FRANK ESQUIBEL ELECTRIC. ---------------------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 HOURLY PLAN CHECK 245.00 STRONG MOTION (SMI) - RES 60 Fee summary Charged Paid Credited. --------------------------------------------------------- Due Permit Fee Total 100.50 .00 .00 100.50 Plan Check Total' 57.53 .00 .00 57.53 Other Fee Total 246.60 .00 .00 246.60 Grand Total 404.63 .00 .00 404.63 " LQPERMIT Bin. # LAP City of La Quinta Building 8T Safety Division Permit # v[ P.O. Box 1504,78-495 Calle Tampico i ,1� [a.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: -7 )'1!) 6 K K S / r�355A g"CLA L "�l 9n% Owner sName:.QR'r.K_ k el i✓ A P. Number.Address: S 7 — S .�-r [..rrc S i✓ Legal Description: � ��U AT -t iia City, ST, Zip: .LW 690 1v✓TYZ) Contractor. (_ M M 14-5 (0 Telephone: Address: — `j f�jn Project Description: N-7'IO L G (fD t> City. ST, Zip:eALmo4sfK C4, IZZ�o i Telephone: `7fj Q q1 2 - e/O Chi • %i _ State Lie. # : — ' City Lie. #c 14 Arch., Engr., Designer. - Address: City., ST, Zip: Telephone: ,y .Y": mow' Construction Type: ,M )y p -,.TOccupancy: State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Conta Person: Ot K K Sq. Ft.: # Stories: #Units Telephone # of Contact Person: O Estimated Value of Project:ff n APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACK NG PERMIT FEES Plan Setsa Plan Check submitted ��G? Amount Structural Cafes a Reviewed, ready for corrections / S / Plan Check Deposit. . Truss Cafes. Called Contact Person/I y an Check Balance Title 24 Cala. Pians picked up % Construction " _— Flood plain plea_ _ _Plans"resubmitted.. — ---- G _ Grading plan 2'! Review, ready fo correction issue Electrical Subeontactor List Called Contact Person t7 Plumbing Grant Deed Plans picked up H.O.A. Approval Plans resubmitted I� Grading IN HOUSE:- '^' Review, ready for correctionsfissue Developer Impact Fee It Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr" Date of permit issue School Fees Total Permit Fees .�p 3 CITY, OF LA QUINTA'SUB-CONTRACTOR LIST JOB ADDRESS PERMIT NUMBER OWNER BUILDER. This form shall be posted on the job with the Building Inspection Cardat all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Anyy-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 voidance 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 ContractorStaW:;Contractovs License ,W kComnsa Company Name Classification License Number Exp. Date Carrier Name Policy Number Exp. Date License Number Exp.. Date (e.g. A, B, C-8) (xxxxxx) (xx/xx/xx) (e.g. State Fund, CalComp) (Format Varies) lxx/xx/xx) (xxxx) (xx/xx/xx) EARTHWORK (C-12) CONCRETE (C-8)'::. FRAMING :(C-5) STRUCT'.":STE'EL-t1b'T61) MASONRY SONRY C-29) L 0 PLUMBING, (C-36) LATH, PLASTER (Pr35) DRYWALL (C-9)..:: .HVAC. (C-20) ELECTRICAL, (C 6) ROOFING' .:SHEET -METAL (C-43)-%*.':' .00PING GLAZING (C-17): INSULATION:.: (C72)..: SEWAGE DISP--- (C -42) - PAINTING (C-'33) CERAMIC TILE (C-54) CABINETS (0-6) FENCING (C713) LANDSCAPING (CG27) POOL (C-53) r P.O. BOX 1504 LA QU(NTA; CALIFORNIA 92247-1504 BUILDING do SAFETY DEPARTMENT 78-495 CALLE TAMPIco (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 IROPF,R'v (11%qR' S PACKAGE Disclosures & Forms for Owner-Ba#lders AppiyIng for Constmetion Permits. !W Pnpefty owner: Ail- wo .cation for •'& burg MmR. ionhas been mba"d .in Your nww . youmdf as the baikim . of the V oWq q h Q and it %nnatien vert cafim Fong m m ke ym awma of your Os�(iae lutlder.Pose" `Oiy iixw by Wide]We emit :sa d: roar lunar a: tie w9lnet � a .1 ttt 7'� live rt.ad, ymir eisdsrctatrelitrg of rad► pr lizw , MICU and returned Mbnorm b a: at otu oMcW address laftated. An agent of the owaer camwt exacute this not= YOU, the property owns. obtain the prior approval of the permitting authority_ . wuwu VCWW'M sfV* You Wi6mtoed or *Y* dtis kformadw 1pUrwdetstand a frequent practice of unlicensed persons is to have the Property owner obtain an. " Owner -Bonder" ' that erroneously implies that the property owner is providing his m her own tabor and materia! per- I, as an Uwncr-But7der, maybe held liable and and Eris or her employm while mea to splens fmaacial risk for any itijuties sustained by an traliceasod person irgtutes.'I am willfull on my pt'e4�y- �My homcownet s inwtraaee may not provide coverage for ose th y actiar as anOwner-Builder sad am aware. of the limits of my insurance coverage for injuries to wu*M - - cin � property. 1 under building permits are not required to be -on and art cot hiring. a �Qe by property owners unless they are responsible for the Contractor to assume this.r ty: I understand as aa."Owner_Builder" I am the &It party of n000:d on the pymit t understand that 1 may protect m �� potential 611uucial risk by hiring a licensed own. and having the permit filed in his er her tame instad of my I understand Contractors are required by law to be licensed and bonded in and contracts. California'and to lisCtheir license numbers of is I understand if I employ or otherwise engage any persons, other than California licensed Contractors, acid the total vah o y COUtate and is l feast five hundred .dollars (5500), including labor and materials. In ay be considered an "employe under state and federal law- .. .... ..... ....... _. _ ...................... WtdeTs4and . if I am considered as " ...:. .. . ................ ..... . t, withhold �lO�" �imder state sad ibdend law, -I must register with the state and fele payroll tars, provide woitm- cOmPtusauft disabWW insurance, and contributrr to unt r ptoyaa compensation for tis(c. these each "employee_^ I also understand my faiium to abide by ese laws may subject me to setions fn. �. understand under California Contractors, S structures cannot 1 tate I:recenSe Law. an Uwner-Builder who builds single-family resides egally build them with the invent -to offer them for sale, unless all work is performed by licer subcontractors and the number of structurzs does not exceed four within any calendar year, or all of the work is perfou under contract with a licensed general building Contractor. r [ understand as an Owner- um" if I sell the property for which this permit is issued, I may be bdd liable for any or Pertiousl summed by any sabsotiaaent ownw(s) that result from any latent mottuetion defects. in the . worlamu>mip or materials. AI understand I may obtain more information regarding my obligations as an ``employa'�. fivaa RaWeaae Service, the United States Small Business Administration, the Calfornia Department of Benefit Paymeaita, said tht California Division of Industrial Aocidems. I also understand I tray contact the California Contraabors' State Licensee Board. (CS .M at i- NO-32I-CSLB (2752) or www-csib.ca.gov for amore information about livensed contractors. 0. [ am aware of and oonsent to an Owner -Builder building permit applied for in my name, and understand that I am the Petty k&dly—jad �L mT�O �ropoyed , . cons>zuctioo a�tiv^ty at the following address: agree that, as the party legally and ftnacia lly mipoasable for prepowd coaastuction activity. I will abide by all app ' k. d►we and nxphrutem thatgovem QTMW trildeca as well -as; employers.- agree to notify the issuer of this foam immediately of any a mimpn: daktioos, or diven to atny of the iraforaatatiem I have provided on this foam. Lioensod contractors are regulated by laws designed to protect the public. If you contract with someone who done,user have a l unw, rho Coattraai m' Stats: Lkeaae Board "y be t A4c m nekt you with my #%Mno d loss you' may sustain as a rcaalt of -a Complaint your only remedy against tmlicamed Contracwrs may. bo in," vWUL It is also LT you ter nadoratand that if eaaployee:of drat btdividttal or ft is ldpod vMk woemg on YOU Property: lrou may be kdd H" for dunsies. If youobtainoa pooh- as Owner-Bw�der and m* to,� Camenots, ym will be rtxpots" for vft tym iel or bot t one Coors peepeely Hoemed WO tl�e.dMa ter wows' insuraaroa;oovecage. .. Bdvre a building pmalt ear be issued, this form must be completed and awned by tht property OwItt r aced rnttarned to the agea q responsible for h5lift ttraa.peradt. NoW A esp) of tft#tA" q = q ei w's R ir. &WO84 fam neftWeagesh or Odw VariJioadotc ars ehe argeaaq is. to 1e prtsemed siren 4W pa;narit k iatsire� so. Verify &C pr1paq owner's skwataare.. She of proptxty Date: Note: The 0flowing Authorization Form isi+egtdred to be completed by tine property owner only wlten.dmgnatmg an agent of the property owner to apply fora conrtru on petnrit for the Owner - Builder -Excludin g the Nntioe to Property Owrrar, the atec�on of which I undeestaad is my personal vtWonsuW�ity; t herby authoriLt Bet fonowiog person(=) to act as my ageog;) to apply for, sign, and file the documents mmesary to obtain an Owner -Builder Permit for my project Scope of CousUuctiota Project (or Description of Work): AebOCA t, ;y %V CtAr mtar Project Location or Address: 7,5 :.1eV L/4 Ae2v LA �fllAJll4t a 3 513 , SIO Name of authorized Agent: 4AUY /,%RADS Tel No . Address of Authorized Agent: 4A! �1te moi/ MR 'I declares under peatatty of perjury that I am the property owner for the address listed above and I personally filled out the a infarmation and exrtify its accuracy,. Note. A dopy ofthe mmer's driver's tkmw, form notarization.or outer verification aaarptabti to the agency is irred' be pmairrrted *hen the permit is iniied to verify the property owner's siEnapare. Property Owner's Signa Date: 0 . September 27, 2012 Barry & Karen Marrs 57-355 Interlachen La.Quinta, CA 92253 PGA WEST II RESIDENTIAL ASSOCIATION, INC. 39755 BERKEY DRIVE STE A PALM DESERT, CA 92211 PHONE (760) 776-5100 • FAX (760) 776-5111 Reference: 57-355 Interlachen, La Quinta, CA Architectural Change Request —Free Standing Pergola and Misting System Dear Barry & Karen Marrs: The Architectural Committee for PGA WEST II Residential Association met on September 25, 2012 and reviewed and approved your architectural plans and approved with the following conditions being met. • All other Architectural Rules & Regulations of PGA WEST II Residential Association dated Revised 8/1/07 pertain. • A Maintenance Agreement will be required, one will be sent to you for proper execution as soon as it is prepared by counsel. • Your contractor must meet with Bob Pantanella, Director of Community Services prior to commencing any work so they are aware of access, parking and other regulations of the Association, Mr. Pantanella's phone numbers is 760-564-1032. • The Behr stain color will a Caste Gray on the wood. Review by the Committee is on/y for genera/ conformance with the Architectural Ru/es It is the resoonsibi/ity of the owner to fu//v understand and conform to the Architectural Ru/es criteria whether or not a// deficiencies are noted during review. It is also the owner's fu// responsibility to field verify a// existing conditions The Committee's decision with regard to orolect design will be final Please refer to the Architectural Ru/es for al/ required submittals. Please contact Luis Umana, Sunshine Landscape at 760/346-3999 and Joanne Rose, the Association'Manager, prior to any irrigation modifications associated with this change. Damage to landscaping, i.e. shrubs, trees, flowers and turf is the responsibility of the contractor. The original landscaping must be brought back to its original condition when the project is completed Approvals given by the Architectural Committee are good for only six months from the date on the approval letter. If construction has not commenced within six months after the project approval date, a new application must be submitted. -7;7j�, f i fi EQ Nwv Car, LYwv iacb Vkd�IYb i 1?, ua9 to orb c Sh n s Pal P6a8 ren9N5 RF � � INFO OCT 232012 BY:�- FM EIR � C— 0— ft* WVd- F* k 1p'.4 Drag to orbit SMR =Pay ncasremenm OCT 2 3 2012 ME vTIVED OCT 23 2012 BY: Re EB New C— Aew Tab Wemw Ibb k1 'hd ,Y ®O ©I O Drag m «eR ShM c Pan I hH�vemmb �— ME vTIVED OCT 23 2012 BY: