12-1307 (SOTB)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
12-00001307
55539_ -FIRESTONE
775-151-003- - -
STRUCTURES OTHER THAN BUILDINGS
LOW DENSITY RESIDENTIAL
7261
Architect or Engineer:
13 P
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
--------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7 001 f Division 3 of the ess d Profess'onals Code, and my License is in full force and effect.
License CI s: B C27 1 License N 684857
/ate: I �1—actor: –
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of pdrjury 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).:
1 _ 1 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 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:
LQPERAI IT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/03/12
Owner:
GORDICA BILL M & ��
55539MFIRESTONE MID &A � FD
LA QUINTA, CA 92253 1
( 1u I CL -Ci 04 2012
Contractor: I CITY OF LA.QUINTA
EDWARDS CONSTRUCTION INC, PtMICE DEPT.
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 WC1914223
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner/sl as o becom subject'to the workers' compensation laws of California,
and agree that, if 1 sho d ome ct t the workers' com ensation provisions of Section
3700 of the Labor C e, I all f rt ith c mply with thoseovisions.
Zeta (V 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 ($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 t e abovhfin"ranon correct. I agree to comply with all
city and co nt ordinances and state laws relating to ilding on, n hereby auyze representatives
of/th%'�rcou tCy{ Venter the above-mentioned pr a inp r %oses.
Date: ELL lure (Applicant or Agent). . `' �'
Application Number . . . . . 12-00001307
Permit . . . BUILDING PERMIT
Additional desc .
Permit Fee . . . . 99.00 Plan Check Fee
64..35
Issue Date Valuation
7261
Expiration Date 6/01/13
Qty Unit Charge Per
Extension
BASE FEE
45.00
6.00 9.0000 THOU BLDG 2,001-25,000
------------------------------------------------- ---------------------------
54.00
Permit . . . ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee 15.75 Plan Check Fee
3.94
Issue Date . . . . Valuation . .
0
Expiration Date 6/01/13
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 .1500 PER. ELEC DEVICE/FIXTURE 1ST 20
.75
------------- --------------------------------------------------------
Special Notes and Comments
170 SF FREE-STANDING TRELLIS W/ OUTDOOR
FIREPLACE PER ENGINEERED DESIGN.
ELECTRICAL INCLUDED. 2010 CODES.
ENGINEER: DENISE POELTLER C33446.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
HOURLY PLAN CHECK
145.00
STRONG MOTION (SMI) - RES
.73
Fee summary Charged Paid Credited
------------------------------------------------------
Due
Permit Fee Fee Total 114.75 .00 .00
114.75
Plan Check Total 68.29 .00 .00
68.29
Other Fee Total 146.73 .00 .00
146.73
Grand Total 329.77 .00. .00
329.77
LQPERM1T
i O(ING ENGINEERING SERVICES www.valuengr.com
71-780 San Jacinto Dr. Ste. E2, Rancho Mirage, Ca. 92270 ph. (760) 834-8860 fax (760) 834-8861
Letter of Transmittal
To: City of La Quinta Today's Date: 11-15-12
78-495 Calle Tampico City Due Date: 11-16-12
La Quinta, CA 92253 Project Address: 55-539 Firestone
Attn: Kay Plan Check #: 12-1307
Submittal: ® 1St ❑ 4th
By: John W. Thompson
Rancho Mirage Office: ® (760) 834-8860
Other: ❑
❑
2nd ❑
5th
❑
3`d ❑
Other:
We are forwarding: lRJ By Messenger
❑ By Mail (Fed Ex or UPS) ❑ Your Pickup
Includes:
Descriptions:
Includes:
# Of Descriptions:
Copies:
®
1 Structural Plans
❑
Revised Struct. Plans
®
1 Structural Calculations
❑
Addendum Struct. Calcs
❑
Truss Calcs
❑
Revised Truss
❑
Soils Report Update
❑
Revised Soils Report
®
1 Structural P/C Comments
❑
Approved Structural Plans
❑
Redlined Structural Plans
❑
Approved Structural Calcs
❑
Redlined Structural Calcs
❑
Approved Truss Calcs
❑
Redlined Truss Calcs
❑
Approved Soils Report
❑
Redlined Soils Reports
O
Other:
Comments:
Structural content is approvable; Engineer of Record to Sign and Stamp the structural plans.
Structural Plan Review Time =1.5 HR
NOV
15 2012
This
Material Sent for:
❑ Your File�Y.
Z
Per Your Request
❑ Your Review®
Approval
❑ Checking
❑
At the request of:
Other: ❑
By: John W. Thompson
Rancho Mirage Office: ® (760) 834-8860
Other: ❑
�9� 19L
PGA WEST..
RESIDENTIAL ASSOCIATION, INC.
Page 1 of 2
December 4, 2012
Mr. & Mrs. William Gordica
135 Eagle Ridge Drive SW
Calgary Alberta
Canada, T2V - 2V6
RE:. 55-539 Firestone — Patio Cover and Fireplace with Pizza Oven
Dear Mr. &-Mrs. Gordica,
The Architectural Committee has received and reviewed your Architectural Variance
Application submittal for a proposed patio cover/trellis and fireplace plan prepared by Robert A.
Pitchford -Design and Drafting dated October 25, 2012. The proposed modifications are
acceptable in accordance with the Architectural Guidelines. Homeowner's Association CC&R's
and Maintenance and Indemnity Agreement
The following conditions and/or requirements are applicable:
1. Contact Bill Bobbitt, the Landscape and Irrigation Manager, and William Aceves, the
Maintenance Manager, to have a preconstruction meeting, (760) 771-1234, extensions
23 and 24, respectively.
2. All damage done to existing HOA property during the construction and installation of
utility services is to be repaired by the contractor and done to the satisfaction of the
HOA.
3. The contractor to repair and/or replace any damaged irrigation, landscape, hardscape,
lights or street surface to the satisfaction of the HOA.
4. All demolition and construction debris to be removed daily and no stockpiling in the
street.
5. The street gutters are not to be used for concrete and construction material clean up.
The street is to be broom -washed, as needed each day during construction. Neither
debris nor dirt is to be washed down the gutter.
6. The street and work area are to be kept clean and safe daily.
7. The contractor is to observe all Association rules and regulations. Contractor
vehicles to be parked on one side of the street.
8. A building permit is required for the shade structure and a signed inspection card to
be presented at the completion of the project.
9. The shade structure to have select grade lumber.
10. The structure to. have sufficient blocking to prevent twisting and curling beams and
lattice material
11. A paint or color sample is to be provided for review.
54-320 Southern Hills, La Quinta, California 92253-5665, Telephone 760-771-1234 FAX 760-771-5125
Page 2 of 2
12. If lighting is to be included, it must be low wattage and not intrusive to the neighbor's
view.
13. The structure height, at the eave, is to be as discussed with Bob Edwards.
14. The gas service is to have a City of La Quinta permit.
15. Upon completion, the homeowner is required to provide the Contractor Certification
letter (enclosed).
16: A Maintenance and Indemnity AgZ:eement shall be signed prior to the start of work
and at the completion of the project. Same shall delineate all applicable work, which
current and future owners shall be compelled to solely maintain and/or replace as
needed and the document shall be recorded with the County of Riverside and runs
with the land.
We reserve the right to make a final inspection of this change to make sure that it matches the
original request. An approval is based only on the aesthetics of your proposed plan and should
not be taken as -any certification as to the construction worthiness or structural integrity of the
proposed change.
We appreciate your cooperation in submitting this request for approval. If I may be of further
assistance, please contact me at the HOA office, (760) 771-1234, Extension 15.
Cordially,
C
Ke cGalliard
Operations Manager
For the Architectural Committee
KM/bvf
Cc: Architectural Committee
Branch :OCC,User :3600 Comment: Station Id :XX52
By NO COR FILED
VAd COMPANY A
,Ja. -f i1C i I
rmh No. 1G-27Ia0 +g 9 1 ,
..tlan No. I
!wI•` w IG 4
u:N Rl:rc)Rut:u MAILTO: •�e � a4
BERTH LTD a1
<=J t
35 HAOLH RIDGE DRIVE 9W �
ALOARYa ALBERTA TZV2V6
SPACT AHUY )R 1,!5k
II. IAXtiIAII:MI:Nfti IY): DOCUh1VN1ANYTRANSFFR1Aaf 496.10 lI
x Computed on the wnudcmune w •tdua of property ean-yed, OR
name an Ahnvr Computed on the amudermron or salve less hcnsor eneurtdttmtces� I
rertwntng u ume of sate s �
t
+ .^ -71,q_4C1 �� j.n sgpwurc of lkctoranl w AS—derammm6 fac- FumNme L ;
3 GRANT DEED j
t FOR A VALt1Alil.l: C ONSII)IiRA,rioN. receipt of'which is hereby acknowledged.
' MARY "LOUISE DOTYe who Acquired title as Mary Lou Paul, a widow
hereby (jRAN'1'(S) to
/5YQfb9yW11AWWffjdfAW. BRUTUS HOLDINGS CORPORATION
the real property in the City of Le Quints
n County of Riverside Stutc ofCalifornia. described as
P
AS PP.R LEGAL DESCRTPTT01. ATTACHED HRRP.TO AND MADE A PART HER P,
f
H
THIS WXI MBNT IS BRING RE-RECORDED TO CHANGE THE VESTING*•
f�ly�rs �
Dated Juno 3, 1993 1!6!.%"/ r L!/�✓ ��,el
STATh OF CALIFORNIA jos Marr Louisa Doty
COUNTY OF )
Ou I before me.
parvnally appeared
Personally knnwn m me for paned w mean the Aria oramsracmry
evidence) to be the pa onisl uhn.e r amtls) ra•Ne subsenbed to the suthtn
mstrumnit and acknouledgtd m me that he-At,ihey eseeuted the vane
m hrs•henthm nulluoucd colt.d. e+l. and that by bts her dmr us n•
lure(V ten the Imtrmnenl the pavmfs) or the enut) upon hehalfofsshteh
the Pemmol acted, -reined the m.eumanl
wl') NF -St; my hand and oM-1 seal
SI)pmture IThn uea for ollletm nutuml tem
3IAIL't'A\ VrATF W.14Tti AS DIRECTED ABOVE Iaal tlNlt
RIVERSIDE,CA Page.2 of 4 Printed on 12/3/2012 4:52:27 PM
Document: DD 1993.369176
Branch :OCC,User :3600 Comment: Station Id :XX52
State of '- u r r I yr n c,L4.— 241641
County of . -Q �
Unj/�lAA 1j7_l p9 lbelore me•_&l+ !_� 1�- t • �%0 /�
il� uq tIt110r M1v1. 1!•�.\I ItIV Nplallr glpl K•
personally appeared 1 i)�I J I•_•l(_I — -- - -- ^
IWs.\.utm n•s•
0 personally known to me - OR - proved to me on trio basis of satisfactory evidence
to be the person(s) whose name(s) is/are
subscribed to the within Instrument and ac-
knowledged to me thalholshe.Ahoy executed
the same in his/her/their authorized
I capacity(les)• and that by his/her/their
signature(s) on the Instrument the person(s).
........................ or the entity upOnbehallol whIchtheperson(s)
r OFFICIL SEAL acted, executed the Instrument.
MELINDA L. WILSON
• i Wdn039 my herltl and otllCial seal.
NOTARY PUSUCCALIFDRNu r
FrxlNpaVOElanf4esrtary = r
! .'•MYC1mmisalmB110"Jvfy!!l,teas
L. .................`....1 '�345f�
crs , a rrlrw.
I
CAPft,
01INDioip),�
0 CORPOAATe v
OFFICERIS) —_
E) PARTNERIS) my
(3 ATTORNEV•IN•FACT
Q TRUSTEEIS)
Q SUeSCRISWO WITNESS
C3 OUARDIAN'CONSERVATOR
O OTHER
SIGNER IS REPRESENTING:
rl•Y/da(A:ronLr f)tIrlllrrint-� •• -
ATTENTION NOTARY: A111.i01..rtu—It•0n r00uv.m10011. n OPTIONAL a cwV po.aru a oni etW<yrom or m• ccrolcete ro wwulnon.cO Cxumom
THIS CERTIFICATE Tide or Type of Document
MUST BE ATTACHED Number al Pages , [ •—
OE THE DOCUMENT �- _ 9 _pate of Document .7G,r..1 •3 /� )3 __—
OESCRIBFO AT RIGHT: Stgner(s) Other Than Named ADOve�--
RIVERSIDE,CA
Document: DD 1993.369176 ,
.ran wuv.e rasa. oqC
First American Title Insurance Company
A .utnrAOrT N Tx. sw A•Ir.Han Frn0rrr0/ f-erp0nuen
C••mr
Page 3 of 4
Printed on 12/3/2012 4:52:27 PM
• Branch :OCC,User :3600
Comment: Station Id AX52
EXHIBIT A 241LG41
�DCHINIUM COMDAZS1N01 .
(A) AN UNDIVIDED 1/19TH ZHURBST IN AND TO LOTS 3 AND 4 OF ?RACY 110. 21361-3,
10 THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE, STATE OF CALIFORNIA, A8 PER HAP
FACOROED IN BOOM 161, PAGES 20 THROUGH 26 INCLUSIVE, IN THE OFFICE OF THE
MUMTY RECORDER OF SAID COUNTY. -
EXCEPT UNITS 8-172 THROUGH B-190 INCLUSIVE AS SHOMN ON THE CONDOMINIUM PLM)
RECORDED AUGUST 19, 1986 AS INSTRUMENT NO. 198980 OD OFFICIAL RECORDS.
ALSO EXCEPT ALL OIL AND OAS, HYDROCARBON AND OTHER MINBRAL RIGHTS BELOW 900.00
FEET BENEATH THE SURFACE OF SAID LAND, WITHOUT THE RIGHT OF SURFACE ENTRY AS .
REBBRVED BY SUNRISE DESERT PARTNER$. A CALIFORNIA LIMITED PARTNERSHIP IH THE
OEBD RECORDED JUNE 30, 1987 AS INSTRUMENT MO. 186097, OFFICIAL RECORDS.
(D) UNIT B-187 A8 SHOWN ON THE CONDOMINIUM ALAN RECORDED AUGUST 19. 1986 AS
INSTRUMENT NO. 198980 Op OFFICIAL RECORDS.
T=PA=AaceaTuFRo9 EA0a TEgpA=M
=RYl1iI01
t ...ua Ulltm ftwWq&q EEI
' her revue.
x—ally Apps ed
partonatly krwwn w tae (or prmad to ma on the basis of sattsfactoq
ovtdenc0 w be Ute penorgs) •chola nawe(s) olom subsenhed to the wtlhtn
wthtanent and acknoWedged to me that hasheahey n C Wed tha .nnx
in hmhetthen aethan,ad eapactp(tes). and that by hiwbar•thett cop -m.
eutcls)an the wetwnrcnt dte paraon(s) w the roup upon Ixhalf of Witch
the rm-dsl actet -wed the wstrumrnl
W1TNFSS m) hand mW oMwal sed
Srgtatura _ t this W. ror ufk,d e.W tel „dt
A1A1L TA\ STA rY.NEN-r8 A% DIRECTED ABOVE tatip,�p
RIVERSIDE,CA Page 4 of 4 Printed on 12/3/2012 4:52:27 PM
Document: DD 1993.369176
Bin #
City of La Quints
Building at Safety Division
P.O. Box 1504, 78-495 Calle Tampico
Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
` 1 3La
Project Address:5-5 5 3 9 F-( P-�57Tc�64E
Owner's Name: M (•;( L., C�OeCJY cA-
A. P. Number: 775 -- I S- / — co 3
Address:
7
Legal Description: UKJ (T / 8 % 2I 3�� — >
Contractor: �C>5 �'sD t 'L57
City, ST, Zip: L-t&, !; (14TZ C41
Telephone: `
Address: t)
Project Description:
City, ST, Zip: L.4� 64C7(
Telephone: t7 777 v�2P-City
.�-4"M: ,
State Lic. #: o +657
ie. #•
Designer-.
Address: —7%--6 'LZ
City, ST, Zip:
Telephone: '7654.6 Z8 56F.
Stale Lie. #:
Name of Contact Person: 12ZPr, F
Construction Type: Occupancy:
Project type (circle 6ne • New Add'n Alter Repair Demo
Sq. Ft.: 70 .# Stories: # Units:
�"
Telephone # of Contact Person:
00
Estimated Value of Project. S0
APPLICANT: DO NOT WRITE BELOW THIS LINE
Req'd
Rev'd
TRACKING
PERi11Tl' FEES
FUSubmittUall
Plan Cheek submitted
li
item
Amount
l Coles.
Reviewed, ready for corrections
Plan tk Deposit
Truss Cores.
Called Contact Person
Plan Check Balance
Energy. Coles.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
24 Review, ready for correctionsfissne
Electrical
Subeontactor 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 correctionsAssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub, Wks. Appr
Date of permit issue
School Fees
E
i I
Total Permit Fees