10-1155 (RER)r P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 10-0000_1155
Property Address' 48413 LEGACY DR
APN: 658-130-011-10 -31379 -
Application description: REMODEL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 3500
Applicant: A / Architect or Engineer:
--------------------------------------------------
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, an y License is in full force and effect.
Licpiae Class: B Li nse N .: 942804
—ZXZ
Date: it�Z (D/ ntractor.
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, 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. , BAP.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:
JACK GREENE
48-413 LEGACY
LA QUINTA, CA
DR
92
Contractor:
KOMPLETE INC
79409 PASEO DEL
LA QUINTA, CA 92
(760)625-6720
Lic. No.: 942804
VOICE (760) 777-7012
FAX (760) 777-70.11
INSPECTIONS (760) 777-7153
Date: 11/02/10
•---------------------------------------------—
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 GUARD INS Policy Number KOWC110176
_ 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 ject to th ,workers' compensation provisions of Section ,
3700 of the Labor Code, I sha ith cc ply with those provisions.
ate: 1 (�G to plicant:
WARNING: FA URE TO SECURE WORKE S' 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 End 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. I agree to comply with all
city and county ordinances and state laws relating to building constructs , and hereby uthorize representatives
of t ' county to enter upon the ove-mentioned property for inspe urposes.
Date: i —t Sig ure (Applicant or Agent):
Application Number . . . . . 10-00001155
Permit
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
25.00 Plan Check Fee
16.25
Issue Date . . . .
Valuation . . . .
928
Expiration Date
5/01/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
5.00 2.0000
----------------------------
HND BLDG 501-2,000
-------------=----------------------------------
10.00
Permit
ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . .
15.75 Plan Check Fee
3.94
Issue Date . . ..
Valuation
0.
Expiration Date
5/01/11
Qty Unit Charge
Per
Extension
BASE'FEE
15.00
1.00 .7500
----------------------------------------------------------------------------
PER ELEC DEVICE/FIXTURE 1ST 20
.75
Permit
PLUMBING
Additional desc .
Permit Fee . . . .
18.00 Plan Check Fee
4.50
Issue Date . . . .
Valuation
0
Expiration Date
5/01/11
Qty Unit Charge
Per
Extension
BASE FEE
1,5.00
1.00 3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3.00
----------------------------------------------------------------------------
Special Notes and Comments
EXPAND PATIO BY ADDING -58 L.F. 40"
PATIO WALL, CITY STANDARD, ADD 1
•ELECTRICAL OUTLET & 1
HOSE BIB. 2007
CODES.
----------------------------------------------------------------------------
Other Fees
BLDG STDS ADMIN (SB1473)
1.00
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
------------------------------
Due ,
---=-----------------------
Permit. Fee Total
58.75 .00 .00
58.75
Plan Check Total
24.69 .00; .00
24.69
-other Fee Total
1.50 .00 .00
1.50
Grand Total
84.94 .00 .00
84.94
LQPERMIT r {
Oct'16 10 10:14a Jack Greene 5050
36758869 - p.l
,LEGACY VILLAS'"
ARCHITECTURAL REVIEW APPLICATION
i
Unit:. 232
Unit Address: 4e-413 Legacy Dr Date: 10/15/10
Name: Jack Greene
Mailing Address: 3012 LAXEMEW Phone:
r.AKF. OSWF..O- OR 4705
To the Architectural Review Committee:
You are hereby advised that the following work is proposed and approval is requested. 1/11Ve
acknowledge that written approval from the Architectural Review Committee must be received
before any building or construction can commence. UWe also acknowledge that this approval
does not constitute municipat/county building department approval, and I/We agree to obtain
necessary munidpaUcounty building permit prior to commencement of any work. Failure to
obtain the foregoing will result in withdrawal of approval.
I/We acknomnrledge that approval by the ARC is not a guarantee of structural safety or engineering
soundness. IANe agree not to alter existing drainage patterns on the lot without express approval
of the ARC. WVe acknowledge that all approved changes in the original design will be at our
expense; that any damage to or relocation of existing sprinkler systems, underground utilities,
building, structure and exterior landscaping or other damage resulting from the construction
of these permitted improvements shall be at my/our expense; and the maintenance of the
permitted improvements shall be at our expense.
Upon completion of the improvement, 1/we agree to immediately notify the ARC and authorize
them to enter onto the property to inspect the improvement. Failure to notify the ARC of
completion or refusal to allow inspection shall result in withdrawal of the ARC approval. Any time
during the process Uwe agree to comply with any request to enter onto the property or for
additional information for purposes of determining if the improvement is being constructed in
acoordance with the approval plan and in compliance with the covenants and guidelines. Refusal
by me/us shall result in withdrawal of approval.
Failure to start or complete the improvement within the time specified on the application shall
result in withdrawal of approval unless an extension is requested and approved in writing.
Applidint (Please Pratt Your Name) (Signature)
ftlft2nt (Please Prart Your Name) J(signawm)
l
Si '4 1
Oc.. 16 10 10:14a Jack Greene 5036758869 p.2
Architectural Review Application
Page Two
p
Unit: 232
Proposed Start Date: Estimated time for completion:_ November 15, 2010
Description of Project (attach another sheet if necessary)
Patin h—d"ion nl ac se— -=P of mark provided by Komnlete Znc
w
Upon the sale of your unit, disclosure of these modifications must be made to the Buyer.
----------------------------------------------------------7--------------
The above requested mod' tions have been reviewed by the Architectural Review Committee
and have been:
_ Approved Reiected Held oendina further infnrmnffnn
f
ember
Date: lllo9la3I
I
ARC Member
I
I
I
t
I
t
TEAf1111
KOis PLEaTE
Job Description.
i
TO:. FROM:
Mr. Greene KOMPLETE INC.
48413 Legacy Dr. Lic.#942804
La .Quinta, CA 92203 79409 Paseo Del Rey
! La Quinta, CA 92253
emil:
Job description: PATIO EXPANSION. Up to 400 sq.f
Demo all patio walls, Save plants.
Take wall and debris to dumpster.
Relocate sprinklers, wires etc.
Dig for footings and slab. Haul extra dirt away.
Install rebar, set forms.
Pour concrete slab, 274 sq.f. Sand finish. And footings. (city standard)
Blockwall, 60 lin.f.long and 40"high. With rebar in -it. Filled with concrete.
Stucco, paint. Finish wall has to match existing.
Add few weep holes for water to run away.
Add electrical outlets. '
Contractor will provide all City licensing & permits to the HOA
manager before commencement of work.
Contractor will also provide Certificate of insurance to
the HOA naming HOA as additionally insured before commencement of work.
10/15/2010
�DI Elmo Kassin O�
Komplete Inc. �O�D
Owner/CEO
�
�
Phone: 760
V .625.6720 O
Fax: 760.645.6225
t
,
1
C'�-O raA-kj Fat,�U .
25'-8'
17'-2"8'-6„
o NEW PATIO WALL (-0,0-oL-
EXISTING PILASTER co - coo
TO REMAIN
r`
EXISTING PATIO WALL `
TO BE DEMOLISHEDBO
I c
IIco
EXISTING PILASTER
TO REMAIN
Existing open patio to remain 123 SQ.FT.
Proposed open patio to enlarge 273 SQ.FT.
CITY OF LA QUINTA
BUILDING & SAFETY DEPT. TOTAL open patio 396 SQ.FT,
APPROVED
FOR CONSTRUCTION
DAT 13 OkAl
TEAM PmjeCt: Legacy dr. 48-413
KOMPL IE Wrk no. 0910 Drawn by. Madis KaruFW
Date: 10/14/2010 Client: Mr. Greene O
KOMPLETE INC. La Quinta, 92253 CA Drawing name: Drawingscale:
teamkomplete@gmail.com Phone: (760) 625 6720
www.teamkomplete.com Fax: (760) 645 6225 Partial floor plan Page: NK
Bin #
10
Project Address:
A. P. Numbs
City of ju QU0inta
Building 8r Safety Dlvft
P.O. Box 1504, 78-495 Caffe Tampko
U QuInta, CA 92253 - (760) 777-7012
Building Permit APPlication and Tracking Sheet
®
i--, Owner's Name.C1 re e• o, e—
Address:
CRY. ST,
Plan Sets
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School Fees
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Item Amount
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