14-0097 (PLBG)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 14-00000097
Property Address: 81325 GOLF VIEW DR
APN: 762-410-032- -
Application description: PLUMBING
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 800
Applicant:
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BUILDING & SAFETY DEPARTMENT
Architect or Engineer:
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BUILDING PERMIT
Owner:
BERGERON RESIDENCE
81325 GOLF VIEW
LA QUINTA, CA 92253
(
Contractor:
PRECISION PATIOS
67210 KANN ROAD
DESERT HOT SPRINGS,
(760)413-2007
Lic. No.: 539152
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/30/14
D;0 2014
CJ
JAN 3
CITY OF E A i.�UINZ i
e1r.—....- -
--------------------------------------------------------------------------------------------------
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
1 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: C47 D03 License No.: 539152
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
-
���
issued.
Date: � Contractor: /� �
—_ 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
OWNER -BUILDER DECLARATION
insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
Carrier EXEMPT Policy Number EXEMPT
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
person in any manner so as to become subject to the workers' compensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
and agree that, if I should become subject to the workers' compensation provisions of Section
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3700 of the Labor Code, I shall forthwith comply with those provisions.
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
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any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500).:
Dater 11,E 1( gpplicant:Q( n
n (n n
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(_) 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
. and who does the work himself or herself through his or her own employees, provided that the
DOLLARS ($100,0010). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 _ 1 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.).
(_ I 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
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. 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 property for inspection purposes.
batt:_1 LVSignature (Applicant or Agent): �_kf��i�� ,�
i��
Application Number . . . . . 14-00000097
Permit PLUMBING 2013
Additional desc . .
Permit Fee . . . . 11.92 Plan Check Fee .
Issue Date . . . . Valuation . . .
Expiration Date . . 7/29/14
.00
0
Qty Unit Charge Per Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS 11.92
------------------------------------------------------------------------
----
Special Notes and Comments
GAS LINE 80 LN FT'X 1 1/2 ' APPROVED PER
AJ 2010 CODES
-
---=-------------------------------------------------------'----------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
PERMIT ISSUANCE M/P/E 90.39
PLAN CHECK, PLUMBING 23.83
Fee summary Charged
Permit Fee Total 11.92
Plan Check Total .00
Other Fee Total 115.40
Grand Total 127.32
LQPERMIT
Paid Credited Due
.00 .00 11.92
.00 .00 .00
.00 .00 115.40
.00 .00 127.32
1
Bin#
City 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 #
Project Address:
Owner's Name:
A. P. Number:
Address:
Legal Description:
Contractor: /, TVTelephone:
�C �,f '� V
City, ST, Zip:
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Address: 6-7-z, -D .Kl V �Ro
Project Description:
City, ST, Zip: �A
Telephone: 6
::..:.:;, :..;,.;,.:::;. :;:.:; :•:
State Lic. # :
City Lie. #
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #!:
,.
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project. eo u
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.1.
.H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for correctionsrassue
Developer Impact Fee
Planning Approval
Called Contact Person •
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
Golf View Drive
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81325 Golf View Drive
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Lot 32 Tract 28,838-3, La Quinta, Riverside County
as
PGA WEST
FAIRWAYS ASSOCIATION
January 7, 2014
Shirley Bergeron
1907 7`' Street SW
Calgary, AB, Canada T2T 2W9
Re: Architectural Application.— 81325 Golf View
Dear Homeowner:
The Architectural Committee has reviewed ,your request for the installation of an outdoor fire pit in the
rear yard of your residence. I am pleased to inform you that the Architectural Committee has approved
the application as submitted.
Enclosed is Exhibit C — the Compliance Review Request form. Please complete this form after the work
is completed and return it by mail or fax to the address below so the completed project can be inspected.
If you have any questions, please contact Cassie Gertz at 760-776-5100 Ext. 345 or email
Cassie.Gertz(a�.Nlanagementtrust.com.
Sincerely,
For the Architectural Committee
PSA WEST Fairways Association
let McDfnald, CCAM, PCAM
,As ciao Manager
C — Compliance Review Request
cc: Lot File
Architectural Committee
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Post Office Box 1690 • La Quinta, California 92247 • Phone (760) 776 -5100,' -;Fax (760) 776-5111 • www.pgawestfairways: com