BRES2017-013178-495 CALLE TAMPICO D �i4�ll�Cl/
LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BRES2017-0131
Property Address: 56054 BALTUSROL
APN: . 775360014
Application bescription: LUPINACCI / 172SQFT ADDITION
Property Zoning:
Application Valuation: $10,000.00
Applicant:
PEREZ, JUAN
PO BOX 1868
.LA QUINTA, CA 92253
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 Professions Code,
and my License is in full force and effect.
License Class: B License No.: 900828
Deter Contract
OWNER -BUILDER DE RATION
I hereby affirm under penalty of perjury that I a 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.).
(_) 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.).
(_) 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
Lender's Ad
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/1/2017
Owner:
VINCENT LUPINACCI
56054 BALTUSROL
LA QUINTA, CA 92253
Contractor:
LEGACY CONSTRUCTORS INC
78365 HWY _.11 #396
LA QUINTA, CA 92253
(760)880-3445
Llc. No.: 900E28
WORKER'S COMPEMSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certi-icate of consent to self -insure for workers'
coml tion, as provided for by Section 3700 of the Labor Code, for the performance
of th rk for which this permit is issued)
have and will maintain workers' compensation insurance, as required by
Se in 3700 of the Labor Code, for the performance of the work for which this permit
is iss d. My workers' compensation inswance carrier and policy number are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy Number: 9213354
_ I certify that in the performanc-e 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 SectOn 3700 of the Labor Code, I shall forthwith
comply with those provisions.
la2�
Date: Applicant?"r
WARNING: FAILURE TO SECURE WORKERS' COMP NSATION 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 ACKAOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 :he City of La Quinta, its officers, agents, and
employees for any act or omission related b 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 caro ellation.
I certify that I have read this application anc state that the above information is correct.
I agree to comply with all city and county o-dinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the
above-mentioned property for inspection purposes.
Dat L ` L Signature (Applicant or Agent :
4
Date: 8/1/2017
Application Number:
BRES2017.0131
Owner:
Property Address:
56054 BALTUSROL
VINCENT LUP' NACCI
APN:
775360014
56054 BALTU5ROL
Application Description:
LUPINACCI / 172SQFT ADDITION
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$10,000.00
Applicant:
Contractor:
PEREZ, JUAN
LEGACY CONSTRUCTORS INC
PO BOX 1868
78365 HWY 111 #1396
LA QUINTA, CA 92253
LA QUINTA, CA 92253
(760)880-3435
--------------------------------------------------------------------------------'-------------
Llc. No.: 900B28
Detail: AD151TION 172SF AND RENOVATION AT MASTER BEDROOM AND SITTING
ROOM. 2016 CALIFORNIA BUILDIKPG CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400
0
$65.36
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$18.24
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, FIRST 100 SF
101-0000-42400
0
$127.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
ADDITION, FIRST 100 SF PC
101-0000-42600
0
$179.36
Total Paid for ADDITION: $390.64
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473'FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,000SF
101-0000-42403
0
$152.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
RESIDENTIAL, FIRST 1,'000SF, PC
101-0000-42600
0
$50.16
Total Paid for ELECTRICAL - NEW CONISTRUCTION: $202.16
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT
101-0000-42402
0
$38.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
OTHER MECHANICAL EQUIPMENT PC
101-0000-42600
0
$38.00
Total Paid for MECHANICAL: $76.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$1.30
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.30
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00.
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
1 Bin #
City of La Quin to
Building K Safety Division
Permit -78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address: S 7/�"�(%j ��� Owncr's Name: V ��� 1 C,,
A. P. Number: -7S—, s60, aL
Address:
Legal Description:
City, ST, Zip: &LA -4T/0 CA— - l 5S
Contractor: r
Tele hone:
:<_'`_>
Address: �r�g- w
#3�
Project Description:
City, ST, Zip:
Telephone: .r
P
::::;,:,.-_- :• :.:-: :y`:
YN
State Lic.
City Lie. W.-
Arch., Engr csign
Address: r0.
City, ST, Zip: LiQ Q[
r"3
Telephone: {Q[C� ,. ��]� � ',� ;��-�>•� �=A�,,t
State Lic. #: Q.
Name of Contact Person: C' 7 ��y��
Construction Type: Occupancy:
Project type circle one New dd'n Alter Repair Demo
Sq. Ft.: (70' # Stories: # Units:
Telephone it of Contact Person: �7• & m
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Place Clieck Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction '
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2-d Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Gran( Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'rd Revicw, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
1
Total Permit Fees
JUN 19 2017-
A
CITY Or- LA QUI.NTA
COMMUNITY DEVELOPMENT
Coachella Valley Unified School District
83-733 Avenue 55, Thermal, CA 92274
(760) 398-5909 — Fax (760) 398-1224
Project Name: PGA West
Owner's Name: Vincent Lupinacci
Project Address: 56-054 Baltusrol,
This Box For District Use Only
DEVELOPER FEES PAID
AREA:
AMOUNT
LEVEL ONE AMOUNT-
LEVEL TWO AMOUNT:
MITIGATION AMOUNT:
COMM/MD AMOUNT:
DATE:
RECEIPT:
CHECK #:
INITIALS
CERTIFICATE OF COMPLIANCE
(California Education Code 17620)
Project Description: Addition to existing single family
APN: 775-360-014
Tract #:
Type of Development: Residential xx
Commercial
Total Square Feet of Building Area: 191 sq. ft.
Date: August 1, 2017
Phone No.
Lot #Is:
Industrial
Certification of Applicant/Owners: The person signing certifies that the above information is correct and makes this statement under
penalty of perjury and further represents that he/she is authorized to sign on behalf of the owner/developer.
Dated: August 1 2017 Signature: " /
***********************************************************************
SCHOOL DISTRICT'S REQUIREMENTS FOR THE OVE PROJECT HAVE BEEN OR WILL BE SATISFIED IN
ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE ONE)
Education Code Gov. Code Project Agreement Existing Not Subject to Fee
17620 65995 Approval Prior to 1/1/87 Requirement
Note:
Number of Sq.Ft. 191 Pursuant to AB 181 any room additions or enclosures of 500
sq. ft. or less are exempt from developer fees. Any mobile
Amount per Sq.Ft. $0.00 homes being relocated within the same school district's
Amount Collected $0.00 jurisdiction are exempt from developer fees.
Building Permit Application Completed: Yes/No
By: Elsa F. Esqueda, Director of Facilities and Maintenance
Certificate issued by: Laurie Howard, Secretary Signature:
6LXJ-
NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES
Section 66020 of the Government Code asserted by Assembly Bill 3081, effective January 1, 1997, requires that this District provide (1) a written notice to the
project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fees"), of the 90-day period to protest the imposition of these
Fees and (2) the amount of the fees. Therefore, in accordance with section 66020 of the Government code and other applicable law, this Notice shall serve to
advise you that the 90-day protest period in regard to such Fees or the validity thereof, commences with the payment of the fees or performance of any other
requirements as described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this
time or in whole or in part prior to issuance of a Certificate of Occupancy. As in the latter, the 90 days starts on the date hereof. This Certificate of
Compliance is valid for thirty (30) days from the date of issuance. Extension will be granted only for good cause, as determined by the School District, and up
to three (3) such extensions may be granted.
V`,'Iccrccrtiilc_Itc of cf n, I imit u;-Ihoxl (107 11/2010
PGA WESToo
FAIRWAYS ASSOCIATION
Notice of Architectural Review
June 6, 2017
Vincent & Norwood Lupinacci
56054 Baltusrol
La Quinta, CA 92253
Re: Architectural Application — 56054 Baltusrol (Eagle Bend SBA)
Dear Mr. & Mrs. Lupinacci:
The Architectural Review Committee has reviewed your application to enclose a portion of the rear
covered patio at your residence. I am pleased to inform you that the Committee has approved your
application as submitted with the condition that you submit final stamped plans prior to commencing
improvements. If any changes are made by the City you will need to submit a summary of changes to the
Architectural Review Committee prior to cominencement.
Please note that the Architectural Guidelines state the following: Section 7.7, (a) Stockpiling of
Materials. Materials delivered to or generated by work on a particular Lot should be neatly stockpiled on
such Lot and shall be incorporated into the work of Improvements or discarded/removed within a
reasonable time. Where possible, such materials shall be screened from view of the public and
neighboring properties. Section 7.8, Disposal of Debris. Any debris generated from a job site must be
removed from the site. No material may be placed in or near the street, Common Area, neighboring Lots
or any other portion of the property covered by the Declaration and Supplemental Declarations.
If a portable restroom is needed, notify the Association as the location for the restroom will need to be
determined by the Manager. Portable restrooms must be tan in color.
Golf Course Property Access -- Approval of architectural change plans by the Architectural Committee
does not include any right of access by Owner's contractor or subcontractor through golf course property.
To request permission to access Owner's Lot through golf course property the Owner must contact golf
course management at PGA WEST at 760-895-8064 regarding a temporary access license. Access
without written permission could be deemed criminal trespass.
Enclosed is an 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.
RECEIVED
J U N 19 2 01? The Management Trust — Desert Division
39755 Berkey Drive, Suite A. Palm Desert, CA 92211
C TY OF LA Ql1INTA Phone: (760) 776-5100 Fax: (760) 776-5111
COM1MUNI T Y DEVELOPMENT %1N �••.c�ciwestiair%vatis.c m
r,
If you have any questions, please contact Kari Martin at 760-895-6345 or by email at
Kari.Nlartiit rt Nlana eitienttrust.com.
Sincerely,
For the Architectural Committee
PGA WEST Fai ways Association
Cassie Gertz, AIVI, CA I General Manager
The Management Tru — DesertDivision
cc: Lot File
Architectural Committee
Building Permit Number:
Project Description: Patio Enclosure remodel
Exempt: I]
(Materials may contain hazardous wastes and
are not subject to recyciing provisions)
Construction Debris Management Plan
Plan SubmEttal Date 1 7/13/2017
Job site
Owner's N
Number, Street, or PO
city, state, Postal C
Owner's Phone Nun
Owner's E-Mall Add
Project Manager's
Project Manager's Phone N
Project -Managers E-mailA
56054 Baltusrol
Vince Lupinaccl
56054. Baltusrol
is Quints, CA. 92253
c/o
N/A .
Randy Bills
760-880-3445
rcblggacy0Yshoa.com
BuiWerl Contractorl Legacy Construction Inc.
Num1w,8bsetorPOBoxJ 44697 Warner Tr
CRY, Stabs, Postal Code I Indian Wells, CA. 92210
Project squareFactagal Approx.190 square feet
City Approval By Ranado Gouldlock-DECIBuntec Waste .
Date of City Approval �*� �.[-r1
To Be Discarded:
Product
Trash
Asphalt
BrIckiBlock
Cardboard
Commingled
Concrete
Drywall
Donated / Rettse*
*Descrlbe Items
Torts
0.90 Not recyciable
0.11
0.00
Totals: Recycle Trash
1.71 0.9
Product
Masonry (broken)
Plaster
Soap Metal
Tile (floor)
Tile (roof)
Wood
Landscape Debris
Tons
0.00 Recyclable
0.22 Recyclable
0.00 Recyclable
0.02 Recyclable
0.03 Recyclable
0.30 Recyclable
0.00 Recyclable
Projected Diversion:
65.12°l0
1 understand It Is the property owner's responsibility to submit copies of weight tickets or receipts to the District
Environmental Coordinator as these hauls occur. I herby certify that completion, implementation and adherence of the
Debris Management Plan (DMP) for the above named project shall guarantee that at least 65% of the Jobsite waste Is
diverted from Iandfllling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining
materials generated from the first day of the project through the completion of the project In accordance with this plan. This
DMP is issued in the name of the property owners) and shall remain their property throughout the construction and/or
demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still
issued in the name of the property owner(s) and the owner retains legal tesponslbiUty for ensuring that the provisions of the
DMP are adhered to. The property, owner(s) and general contractor shall be kept informed of the diversion progress through
"anthly reports. If self -hauling, all refuse material from this project site must be taken to an approved recycler or transfer
Owner / Developer / Project Manager / Superintendent
Date