14-0048 (RER)P.O. BOX 1504 t .
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number`.
Property Address:
APN:
Application description
Property Zoning:
Application valuation:
Applicant:
Of
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760).777-7153
14-00000048 Owner:
81256 VICTORIA LN MANDEL JUDITH E
764-270-999-136--3002.34-' 81256 VICTORIA
REMODEL -.RESIDENTIAL LA QUINTA, CA 92253
MEDIUM HIGH DENSITY RES (619)517-7778
1500
Contractor:
Architect or Engineer: KELLNER, JEFFREY F.
P.O. BOX 6289
BIG BEAR LAKE, CA
(760)774-5333
Lic` No.: 834358
FEB 10 2014
315 CITY QF QUINTA
-Date: 2/06/14
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 Pr fessionals C e, 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; B Lic se o.: 834358
_
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
gate:
" issued.
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 per' y t¢ I am exempt from the Contractor's State License Law for the
Carrier E MPT Policy Number EXEMPT
following reason (Sec. 7031 .5, sine s 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
e subject tot workers' compensation provisions of Section
and agree4C,
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
3 00 of tforthwi co y with those visions.that
_
he or she is exempt therefrom and thebasis 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 (5500).:
DatEJ+ App
1, 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 OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
SUBJECT AN EMPLOYERKLTIES 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 ($100,000). IN ADDITION TO THE COSTOF 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.).
- •• - APPLICANT ACKNOWLEDGEMENT
(_ 1 I, as owner of the property, am exclusively contracting with Iicensed.contractors to construct the project (Sec.
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the -
" 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of,
conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
1 . Each person upon whose behalf this application is made, each person at whose request and for -
• pursuant to the Contractors' State License Law.).
-. whose benefit work is performed under or pursuant to any permit issued as a result of this application,'
(_ ) I am exempt under Sec. , BAP.C. for this reason
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.
Date: Owner:
- 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
CONSTRUCTION LENDING AGENCY
permit to cancellation. ' , -
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
I certify that 1 have read this application and state that the above information.is correct. I agree to comply with all .
work for which this permit is issued (Sec. 3097, Civ. C.). -
city and county ordinances and state laws relating to buildi - onstruction, and hereby authorize representatives ,
- -
of this cou ty enter upon the above-mentioned prope f/i pectin purposes W
Lender's Name:
'
_
OaSignature (Applicant or Agent): _
Lender's Address:
_
LQPERMIT
Application Number . . . 14-00000048.
------ Structure Information ADD WINDOW AT GARAGE - .ORGINAL
PLAN OPT -----
Other struct info . ... . . CODE EDITION
2013
Permit REMODEL 2013
Additional desc .
Permit Fee . . . . 60.06 Plan Check Fee
- .00
Issue Date . . . . Valuation
0
Expiration Date 8/05/14
Qty Unit Charge Per
Extension
1.00 600600 LS MISC DR/WIN; NEW, FIRST
60.06
-- -------- ----- ------ --------------------
Special Notes and Comments
ADD WINDOW AT CART GARAGE - ORIGINAL
PLAN OPTION [CONVENTIONAL] THIS PERMIT
DOES NOT INCLUDE.ALTERATION.TO LATERAL
RESISTING SYSTEMS OR MEP INSTALLATIONS.
2013 CALIFORNIA•BUILDING CODES.
February 6, 2014 4:32:02 PM AORTEGA
-------------------------------------------------------- ----------------
Other Fees . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, REMODEL
58.63
STRONG MOTION (SMI) - RES
.50
Fee summary Charged Paid Credited
Due
Permit Fee Total 60.06 .00 .00
60.06
Plan Check Total .00 .00 .00
.00
Other Fee Total 60.13 .00 _00
60.13
Grand Total 120.19 00 .00
120.19
LQPERMIT _ ..
j,4t, '-� . 1''.1,1�47
Bin. #
City*Of La Quionta
Bullding 8L Safety Division
P.O. Box 1504,78-495 Calle Tampico
4.Quinta, CA 92253' - (760) 777-7012
Building Permit Application' and Tracking Sheet
pP g
P749.
/
Project Address Z Z7')lOwner's
A. P. Number. � :f/�� _ O
Name:. . i U n
Address•Q' /
O/o 2J
J
Legal Description: (
'Qt,
Contractor: ,y�:`
City, ST, Z44-,'./�S C�
— , 5• ' .'.
Telephone — %� �% >cx� fax,
Project Description: J Q�
AddresQ
City, $T, C
CJ v
Telephone�a �'f
State Lic. # : City Lic. #: 4S
Arch., Engr., Designer
Address:
City., ST, Zip:
Telephone: Y
State Lic. #1.9— >,s' _
.<.. , ;xu' `
Name of Contact Person
Construction Type: ¢� l Occupancy:
Project type (circle one): r<Egb Add'n ter Repair Demo
Sq. Ft.:
tories:
# Units:
Telephone # of Contact Person: -' Y 3 3
Estimated Value of Project: Q
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Reed
TRACK NG PERMIT FEES
Plan Sets
Plan Cheek submitted Item
Amount
Structural Ca1cs.
Reviewed, ready for corrections Plan Check Deposit. .
Truss C210.Called
Contact Person Plan Check Balance
Tide 24 Calci.
Plans picked up Construction
Flood plain plan
Pians resubmitted.'. Mecharilcal
Grading plan
2id Review, ready for corrections/issue Electrical
Subeontactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up S M I
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE--
'n° Review; ready for correction Sae Developer Impact Fee
Planning Approval
Called Contact Person A.%P.P.
Pub. Wks. Aper
Date of permit issue
School Fees
Total Permit Fees
•
Trilogy
January 9, 2014 .
Judith Mandel
Irwin Mandel
81256 Victoria Ln
La Quinta, CA 92253
Property: 81256 Victoria Ln
Account: 015000067211
CONDITIONAL APPROVAL
Dear -Judith Mandel:...,
We are pleased to inform you that your plans for installation of a window in the rear side of the golf cart
garage, received on 01/07/2014, have been approved by the Design Review Committee with the following
conditions: 7, 8, 19 and 23. This work requires city permit. Install Design Review feature above
window to be consistent with the existing windows (see attached copy).
Please note: Any damages caused by contractor due to construction must be repaired.
This approval does not constitute consent by the Association for the applicant to encroach, trespass, or
build on any property other.than that of the applicant. This approval is related solely to the items reserved
for approval by the.CC&R's in accordance with the Design Review Guidelines. The approval does not
extend to the quality of work done by your architect, or contractor, or to any structural engineering, soils
engineering, or site grading and drainage design. You are urged to obtain the services of a state licensed
professional for consultation as needed.
The Design Review Committee is composed of volunteers. As such, it does not review applications to
ensure compliance with building codes, or other local or state laws. Please be advised that this approval
does notrelieve you from obtaining any necessary building permits from the governmental agencies
involved to ensure compliance with these codes. Any violations of these . ordinances will be your
responsibility to correct. Thank 'you for your patience in this � matter and for complying with the
Association's policies and standards.
S c rely,
F r he si Review Committee
Barry Ste ett, CCAM, CMCA, AMS
General anagen
Enclosures
cc: Board of Directors
Design Review Committee
Trilogy at La Quinta Maintenance Assoc.
Professionally Managed by Action Property Management, Inc.
60-750 Trilogy Parkway, LaQuinta, CA 92253-7717
Phone: 760-777-6059 Fax: (760) 777-1620
www.actionlife.com
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