08-0419 (AR)'P.O. BOX 1504
'78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4ht 4 4Q"'
Application Number:
08-00000419
Property Address:
80444 -HERMITAGE
APN:
762-200-017- - -
Application description:
ADDITION - RESIDENT.IAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation: 4802
Applicant: 1/qvp Architect or Engineer..
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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.
License Classs::/�) B License No.: 684857
Date` (/7—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.).
(_ 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:
LQPERA11T
- ft:. 1I3I7.06&
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/24/08
Owner: G
POULTON
80-444 HERMITA qf��
LA QUINTA, CA 22 3 /'' R
ci `b'�41�
FN°F ot.._ l
Contractor: —1171-11,
EDWARDS CONSTRUCTION INC, B
51455 DESERT CLUB DRIVE
LA QUINTA, CA 92253
(760)777-8202
Lic. No.: 684857
-----------------------------------------------
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 GRANITE STATE Policy Number WC 555-61-55
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 subject to the workers' compensation provisions of Section
��f/(y�`l3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: / —/ _pplicant: '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA LL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSA
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.
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 cougty to enter upon the above-mentioned pro cion pur os
Date: �yignature (Applicant or Agent):
Application Number . . . . . 08-00000419
Permit
BUILDING PERMIT
Additional desc . .
Permit Fee . . . .
72.00
Plan Check
Fee
46.80
Issue Date . . . .
Valuation
. . . .
4802
Expiration Date . .
10/21/08
Qty Unit Charge
Per
Extension
BASE FEE
45.00
3.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
27.00
Permit
ELECT - ADD/ALT/REM
Additional desc .
Permit Fee
19.90
Plan Check
Fee
4.98
Issue Date
Valuation
0
Expiration Date
10/21/08
Qty Unit Charge
Per
Extension
BASE FEE
15.00
245.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
4.90
----------------------------------------------------------------------------
Special Notes and Comments
GARAGE EXTENTION 245
SQ. FT.
----------------------------------------------------------------------------
Other Fees . . . . .
. . . . ENERGY
REVIEW FEE
4.68
STRONG
MOTION (SMI)
- RES
.50
Fee summary Charged
---------------------------
Paid
----------
Credited
Due
Permit Fee Total
91.90
----------
.00
----------
.00
91.90
Plan Check Total
51.78
.00
.00
51.78
Other Fee .Total
5.18
.00
.00
5.18
Grand Total
148.86
.00
.00
148.86
LQPERMIT
B #
City of La Quinta
Building ez 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: gQ — � �
Owner's Name: fwtt .
A. P. Number: 2 -Zto — of %
Address: f3 e-) -444
Legal Description: O>F�o�s ZQ �Zi . `f R 2V1 �
Contractor: g
ity, ST, Zip:C gaC%.tK
Telephone: ? ::> �t
Address:
Project Description:
City, ST, Zip: L4&-
Telephone -7? 5 0.4oZ
State Lie. # :
City Lie. #:
Designer:
Address:
City, ST, Zip:&i.-K Cti ••
Telephone: �
�-C .60 'S
°d + �,� ,
q`, '_ {a��;
Construction Type: Occupancy:
State. Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: S .
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: ��
Estimated Value of Project: 2Si�
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitt �---,,,
Item
Amount
Structural Calcs.
Reviewed, read for corrections_
Plan Check Deposit
Truss Calcs.
Called Contact rson
,f,
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading, plan
2"" Review, ready focorrections/iss a
Electrical
Subcontactor List
Called Contact Person
3
Plumbing
Grant Deed.
Plans picked up
4123
S.M.I.
H.O.A. Approval
Plans resubmitted
23
Grading
IN HOUSE:-
''" Review, ready for correctios/issue
Z
Developer Impact Fee
Planning Approval
Called Contact Person
2
A.I.P.P.
Pub. Wks. Appr
Date of permit issue '
School Fees
Total Permit.Fees
R F Ci
.1�
CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET
PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT
Form updated & effective 11/17/2006
Green Sheet approvals are forwarded to the Building & Safety Department directly by Public Works.
Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department
until ALL requirements listed below are complete. Incomplete applications or applications which cannot
be processed will be returned to applicant.
Date: -Z) -Og Developer:
Tract No.: L$ HS Tract Name:
Address(s): 90 ' `/ 4 V )4EIa ,,
CON97-i(,✓c771'� ;�N C-
/eST Lot No.(s): Poltr 1
k CA 9 22.5- 3
The following are the requirements for Public Works Clearance to authorize issuance of a building permit
from the Building & Safety Department:
❖ CUSTOM HOMES: PROVIDE ITEMS #2, #3, #4 AND #5 BELOW
TRACT HOMES: PROVIDE ITEMS #1, #2, #3, #4 (AS APPLICABLE) AND #6 BELOW
COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1, #2', #3 AND #5 BELOW `�ECIVED
❖ WALLS: PROVIDE ITEMS #7 BELOW MAR 2 5 2008
SIGNS: PROVIDE ITEMS #8 BELOW
Development Services
1. Attach .Pad Elevation Certificates in compliance with the approved design elevation for building
Pad (maximum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current
(within 6 months of current date). If a precise grading plan creates the pad for approval, please
withhold green sheet submittal until a Pad Elevation Certificate can be provided.
Attach geotechnical certification of grading plan compliance.
V 3. Attach recorded final map showing proposed building locations .are legal lots.
1/Attach a completed < 1 acre per lot or infill project Fugitive Dust Control project information form,
PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference
nu er or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot)
are submitted separately with grading plans & are subject to additional requirements.
5. Attach an approved. precise grading plan for the building location(s). AO flood zone developments
will require an approved flood plain development plan.
6. Attach an approved rough grading plan for the building location(s).
7. Attach wall plan & related approved grading plan.
8. Attach sign layout/plan & related precise grading/landscape plan.
11 2) P M J- t�y 0 t r CA P- f 6�.A&44f O•v /-
1 have reviewed and confirmed the requirements listed above as presented and find the improvements tc
be sufficiently complete for construction of the pTopo5o buildings/structures/walls/signs on the subject
lot(s). Pursuant o my i th a pr ma a released for building permit issuance.
Recommended by: Dated:
Public Works Distribution: (Green Sheet to Building & Safety counter
I_) Green Sheet to Community Development
Declined for approval for reason(s) as follow(s), please correct and resubmit:
City of La Quinta - PM '10 Project Information (<1 acre per Lot or Infill Proiect) Page 1 of 3
Form updated & effective 8/25/2005
Project Information
Project Phase
Project Contractor:
Project Phase
(Check One):
❑ Construction
Demolition IN
310 e
Project Name:
Qo U I- TO /J 6 -LF OW2 / egdd't
Project Tract
Number:
-24' I
Lot Number(s):
n
1 "o ra ; o
Antic' ated Start Date:
Y 8
Project Street
Address:
(rO Y7 y� �Vy•�i9Gjt
Anticipated
Completion:
Total acres in active
construction 1 <i acre
per Lot):
03 A Cat
Project Contact
Information
Please Note: Dust control is required 24 hours a day, 7 days a week,
regardless of construction status. Person listed below is responsible
for dust. control during business and non- business hours.
Name:
Aa LL
Title:
P1 of Pte.T
Company, Name:
30 17c�Ar2 l i✓S T, div
Mailing Address:
$/- yir
City:
L, 6Z L, 7—.4 CA 9 22 1'3
State:
Zip Code:
Primary Telephone
Number:
,� Z p Z
6
Fax:
24 Hour
Access/Emergencyu�-
Phone:
Cell Phone:
Q
PM 10 Certificate
Number:
Expanded PM10 plans for commercial and residential developments > 1 acre are required by
the City of La Quinta.
�]
V
r�
PM' 10 (< 1 acre per Lot or Infill Project) Fugitive Dust Control Plan Page 2 of 3
Plan updated & effective 8/25/2005
This plan shall take into account applicable SCAOMD Rule 403 regulations. Training may be obtained by
contacting SCAQMD (Sharon Zamora - Phone: (909) 396-2183). This plan shall consist of'the following
action items:
❖ WATERING: Continuous watering is required to prevent dust and must occur a minimum of 4
times daily. Water shall be applied to dry soils to stop:
• Visible dust emissions over 20% opacity
• Visible dust emissions that travel over 100 feet.
• Water source % hch water meter at front (south) side of pad.
❖ EDUCATION: Responsible Dust Control Individual and key personnel shall attend SCAQMD PM10
class and obtain .PM10 certificate number prior to construction activity.
❖ WEATHER MONITORING: Wind predictions shall be monitored.
❖ SIGNAGE: Use Coachella Valley Fugitive Dust Control Plan Handbook Construction Site Signage
Guidelines.
•:• TRAFFIC: Construction traffic shall not be allowed on the pad, unless absolutely necessary. If
vehicles operate on pad, pad shall be kept firm and moist through hose watering or sprinklers.
Fugitive Dust. shall be prevented by fencing off site to prevent unauthorized traffic on pad. (15
mph maximum traffic speed).
❖ PARKING: Parking is not allowed on the pad. All vehicles must park on street (at designated
'areas only).
❖ TRACK OUT: Provide 24 hour street cleaning and -track out system as approved by City Public
Works Inspector. (No dirt on public or private roads). Track out shall be cleaned up within one
hour of incident.
❖ DIRT PILES: Dirt piles shall be limited to 50 cubic yards and built per California Building Code
grading requirements. Piles shall be kept moist or covered with tarp material. Larger dirt piles will
require stockpile or grading permit.
FENCING: Provide PM10 fencing at perimeter of public roads and where applicable. Wood slat
fencing can be installed at rear of property and return 20 feet on either side if HOA restrictions
apply. Block walls can replace PM10 fencing during the construction phase.
•:• EQUIPMENT: Extra hoses and sprinklers shall be maintained on site.
•:• EXCAVATION MEASURES: All areas to be excavated or graded shall be pre -watered. Water shall
be applied during excavation or grading operations also.
❖ DUMP TRUCKS: Opentop dump trucks to be wet down, moist and tarped prior to leaving site.
INACTIVE SITE: Within 10 days of ceasing of activities, re -vegetate or permanently stabilize as
required. ,
City of La Quinta - Site Specific Construction Phase PM 10 Agreement Page 3 of 3
Agreement updated & effective 8/25/2005
The signature of the property owner (or authorized representative:
Shall act as his/her acknowledgement of dust control requirements and their enforceability,
pursuant to AQMD Rules 403 and 403.1;
❖ Shall constitute and agreement to comply with all project conditions as identified -in the approved
dust control plan;
The Property owner (or authorized representative):
❖ Acknowledges that dust control is required 24 hours a day, 7 days a week, throughout the period
of project performance, regardless of project size or status;
❖ Shall ensure that each and every contractor/subcontractor and all other persons associated with
the project shall be in continuous compliance with all requirements of the approved. dust control
plan;
•:• Shall take all necessary precautions to minimize dust, even if additional measures beyond those
listed in the dust control plan are necessary;
Shall authorize representative of the City/County to enter upon the above mentioned property for
inspection and/or abatement purposes; and
❖ Shall hold harmless the City/County and its representatives from liability for any actions related to
this dust control plan or any City/County initiated abatement activities.
Signature of Property Queer or Authorized Representative
Printed Name
Title Date
� o _,.A 61vf7-- -�
pang
L- r% vi wvnr.
24.5 SQ. FT. ADDITION
TO GARAGE
SITE PLAN
80�444
HERMITAGE.
L=A
CAL�IFORNIA
APN 762-200-017
PORTION OF LOTS 20 & 21
TRACT 28118
1 REMOVE ALL LANDSCAP
& HARD5CAPE - REROU'
IRRIGATION LINES @
LOCATION OF ADDITI01
REMOVE LATH & PLASTE
ADJOINING WALL W/ NE
EXPANSION
EXI5TING TREE
TO REMAIN
\-------------------------
\ " ..........
\x/
1 / \
/ - Z�RE�M�OVE ALL LANDSCAP
RDSCAPE - REROU'
IRRIGATION LINES @
LOCATION OF NEW DRI'
�.-- .®..oma..®..�...��..
F-1
APE RT
NORTDEMOS I T 10 PLAN
H
SCALE: 1/4" = 1'-0"
ADDED PORTION
Of DRIVEWAY
TO MATCH
EXISTING
7'-0"
RELOCATED CART
GARAGE DOOR
• E
a
CV
\
r,
ZO
-0
WALLS TO BE -----.-•
REMOVED SHOWN DOTTED
NEW WORKBENCH
16'-11 1/2"
RELOCATED
GATE
LOCATION,
PROPOSED
CU
12'-0 1/2"
20'-0 1/2" fiPPROX.ORTH.
0
R T
I A
E
z
I T
E
a
~
o
Of
U')
SCALE:
1/4" =
<C
0
X
I
Q
W W
........-
LLJ...
Q=
0
a
0a
W O
Z 1-
a
CV
\
r,
ZO
-0
WALLS TO BE -----.-•
REMOVED SHOWN DOTTED
NEW WORKBENCH
16'-11 1/2"
RELOCATED
GATE
LOCATION,
PROPOSED
CU
12'-0 1/2"
20'-0 1/2" fiPPROX.ORTH.
p A
R T
I A
E
S
I T
E
SCALE:
1/4" =
1'-0"
Y �
TANDY'S INSPECTION SERVICES, INC.
PO BOX 13766 - PALM DESERT, CA 92255-3766
OFFICE / FAX - 951.769.9717
PAGER 760.776.3339
SPECIAL INSPECTION DAILY I WEEKLY REPORT
TYPE OF INSPECTION PERFORMED
PERMIT NUMBER
' 0) 4_�9. (In l r JJ I ki lc:;'rAI l I e)
TYPE OF+STRUCTURE
DATE `
RESIDENTIAL F COMMERCIAL
PHYSICAL ADDRESS n C 6DE STREET E G.T»� �7
U 4 >tG�"
�1'/}rl.t.►:"✓.'.il fi1� '..,..'(.• .�-;
JOBWAME (INCLUDE�+ E OF COUNTRY CLUB / BUSINESS PARK I CORPORATE CENTER I LOT NUMBER.. ECT.)
v1.4r7 A/ S
4L-7' ,r - /� r �, I h b9
� Gd_ ,) G A-
ARCyHIITECCTQ� n.-
ENGINEER
GENERAL CONTRACTOR
SUB CONTRACTOR ;
DESCRIPTION OF WORK INSPECTED
CORRECTIONS AND/OR NOTES
WFI nlNr INFnRMATIC)N
WELDERS NAME CERTIFYING AGENCY'S NAME AND ID NUMBER PROCESS AND ELECTRODE
4
TIME
1 HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK,
UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS WORK
TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS & APPLICABLE BUILDING LAWS.
AIR TEMP. I SAMPLE TEMPI SLUMP I ADDED WATER I TIME IN MIXER
/it //,r",c, u,)
'— INSPECTORS SIGNATURE
S+? U 417 W6 — lk
INSPECTORS CERTIFICATION AGENCY AND NUMBER
' 0) 4_�9. (In l r JJ I ki lc:;'rAI l I e)
V,- 1) n V I F I_) y /in I, r/
.� r r. r :'� .r.. , ' Jr ^ !� 71 --r- st j L
'=t .•r . t 'cz /-1==T— Y n I
�1'/}rl.t.►:"✓.'.il fi1� '..,..'(.• .�-;
i.--�1�-rniL•-�" l�e.r.� 7. ;�',._ �[
11!""i
1. Ff'I,`17m 4j,
- LI or
CORRECTIONS AND/OR NOTES
WFI nlNr INFnRMATIC)N
WELDERS NAME CERTIFYING AGENCY'S NAME AND ID NUMBER PROCESS AND ELECTRODE
4
TIME
1 HEREBY CERTIFY THAT I HAVE INSPECTED ALL OF THE ABOVE REPORTED WORK,
UNLESS OTHERWISE NOTED, AND TO THE BEST OF MY ABILITY I HAVE FOUND THIS WORK
TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS & APPLICABLE BUILDING LAWS.
AIR TEMP. I SAMPLE TEMPI SLUMP I ADDED WATER I TIME IN MIXER
/it //,r",c, u,)
'— INSPECTORS SIGNATURE
S+? U 417 W6 — lk
INSPECTORS CERTIFICATION AGENCY AND NUMBER