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BPOL2017-0066LICENSED 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: C53 License No.: 665655 Dater /Contractor OWNER- LDER 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).: (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.). (_► 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 Name: Lender's Address: 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' compensati , as provided for by Section 3700 of the Labor Code, for the performance of the w for which this permit is issued. C— 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: REPUBLIC UNDERWRITERS INSURANCE COMPANY Policy Number: RU W 1005040 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 3700 of the Labor Code, I shall forthwith comply with those provisions. r t Applican 4 r/ 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 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 asa 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 elating to building construction, and hereby authorize representatives of this city to ter upon the ab mentioned property for inspection purposes. Date: _!�5 r— iSignature (Applicant or Agent) a (*fu VOICE (760) 777-7125 78-495 CALLE TAMPICO D. LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 5/16/2017 " Application Number: BPOL2017-0066 Owner: Property Address: 48420 BIG HORN DR GEORGE LA BORDE APN: 623480003 Property Zoning: Application Valuation: $15,000.00 Applicant: Contractor: NEW IMAGE FINANCIAL GROUP INC DBA RAMMEL NEW IMAGE FINANCIAL GROUP INC DBA RAMMEL 1800 EXECUTIVE DRIVE 1800 EXECUTIVE DRIVE PALM SPRINGS, CA 92262 PALM SPRINGS, CA 92262 (760)320-7010 Llc. No.: 665655' 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: C53 License No.: 665655 Dater /Contractor OWNER- LDER 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).: (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.). (_► 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 Name: Lender's Address: 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' compensati , as provided for by Section 3700 of the Labor Code, for the performance of the w for which this permit is issued. C— 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: REPUBLIC UNDERWRITERS INSURANCE COMPANY Policy Number: RU W 1005040 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 3700 of the Labor Code, I shall forthwith comply with those provisions. r t Applican 4 r/ 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 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 asa 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 elating to building construction, and hereby authorize representatives of this city to ter upon the ab mentioned property for inspection purposes. Date: _!�5 r— iSignature (Applicant or Agent) Date: 5/16/2017 Application Number: BPOL2017-0066 Owner: Property Address: 48420 BIG HORN DR GEORGE LA BORDE APN: 623480003 Property Zoning: V► Application Valuation: $15,000.00 Applicant: Contractor: NEW IMAGE FINANCIAL GROUP INC DBA RAMMEL NEW IMAGE FINANCIAL GROUP INC DBA RAMMEL 1800 EXECUTIVE DRIVE 1800 EXECUTIVE DRIVE PALM SPRINGS, CA 92262 PALM SPRINGS, CA 92262 (760)320-7010 Llc. No.: 665655 Detail: 4' ADDITION TO EXISTING POOL AND SPA AT REAR -YARD. [DENISE POELTLER ENGINEERING] THIS PERMIT DOES NOT INCLUDE NEW EQUIPMENT OR EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. PER 2016 CALIFORNIA BUILDING CODE DESCRIPTION ACCOUNT . II QTY I AMOUNT . BSAS S131473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT GUNITE ALTERATION 101-0000-42404 0 $190.00 DESCRIPTION ACCOUNT QTY. AMOUNT GUNITE ALTERATION PC 101-0000-42600 0 $103.36 Total Paid for POOL / SPA: $293.36 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE S02-0000-43611 0 $5.00 Paid f $ Tota Pai or TECHNOLOGY ENHANCEMENT FEE: 5.00 TOTALS: n 3 12'-0" POD D e ry, f) voppct,j 60'' p ryLe PC; C M� I Al 5 (p&Ujj0,0%/ pj&-&Wf4� FOK t:,Tu�%A EQ. Se& pWu-- may, tN/(- 06 391-7" -5 FAcAC] l F L EXISTING CONCRETE CITY OF LA QU14FA*/ BUILDING & SAFETY DEPT. APPROVED FOR CONSTRUCTION DAT6 13Y-- qu Know wtaft below caliBllb*myou dig. 1.t i CONDITIONS OF APPROVAL AND DISCLAIMER I'll 1. The applicant agrees that all work performed must be in substantial compliance with the plans as approved by the ARC. In the event that any work performed is not in substantial compliance with approved plans, the applicant understands that he/she may be required to correct, alter, and/or remove the non -conforming work or improvement(s) as required by the ARC, and will be responsible for any and all costs associated therewith. 2. No materials may be stored in the street or HOA common areas at any time. 3. Construction hours are: Monday through Saturday 7:OOAM to 5:OOPM 4. Any dirt/debris in the street must be removed and washed clean every day. 5. The Owner will be responsible for any damage to the common areas (including streets) caused by the contractor during construction. PLEASE NOTE THAT THE APPROVAL OF THE PROPOSED PLANS BY THE ASSOCIATION DOES NOT CHANGE OR ABROGATE THE APPLICANT'S OBLIGATION TO OBTAIN ALL NECESSARY PERMITS AND/OR COMPLY WITH ALL APPLICABLE GOVERNMENTAL REGULATIONS, AND IDENTIFY OR COMPLY WITH INDIVIDUAL PROPERTY LINES. An architectural deposit of $1,500 is required for projects in the rear yard i.e., pools, spas, landscaping, room additions, patio covers, barbeque, etc. Front yard installations i.e., gates, walkways, landscaping, walls, driveways, etc. require a deposit if $500.00 at the time of submittal for projects under $3000 in cost and $1500 for projects over $3000. The deposit is refundable after the final inspection of the project by a member of the ARC once it has been determined that no damage was caused to the common areas. Agreed &Accepted: Date: I., "FOR ASSOCIATION USE ONLY" Additional Conditions of Approval: Your request has been approved by the architectural committee as submitted via email Please ensure that your vendor follows the rules of the association. All dirt/debris in the street must be removed and washed clean every day, failure to do so may result in the Board dispatching a vendor to clean them. The cost will be your responsibility and will be deducted from the security deposit. Architectural Committee: VAonka Dee"& Date: 4/26/17 ( X ) Approved ( ) Denied Denied/further modifications to design are needed 2 HIDDEN CANYON HOMEOWNERS ASSOCIATION 40 ARCHITECTURAL AND LANDSCAPE DESIGN REVIEW APPLICATION FORM Some applications, _approval may take up to thirty (30) days. Owner's Name: OrP.C� tzq em—, t��CAi id �Cj Date: Hidden Canyon Address:` % `u- n it BTU `y Mailing Address:J-4=1416 8G%4 11 74 y �� c-PS� Phone: — — Projected Start Date: E-Try\ Detailed Address: Projected Completion Date: ON- E-'I Description of Modification: For Landscape Approvals provide the following information if applicable: 1. A plan with 1/8" = 1'- 0" scale, north arrow. 2. DG color and size or other ground cover information. 3. Stepping stone or paver type, size and color information. 4. Stepping stone size and material type. 5. Latin and common plant names, size and quantity. 6. Show planting plan with five year diameter of proposed plant material. , 7. Boulder and or river cobble color and size. If cobble is used for drainage purposes, provide drainage information. 8. Lightingmanufacturername and fixture type with bulb wattage. Contractor's Name: 1"C N M rr-- L L N T Contractor's License Number: 4.7 6 S� Contractor's Telephone Number: I -32D :JDA 0 ADD THIS SECTION DEMOLISH THIS SECTION .•EXISTING .POOL AND.SPA Fs -1 - Fil Cp�cx . AC AC EXISTING CONCRETE ',:'"•�//% '/ , /! //ice% �/i%•/' ! i` � ;' j /' AFJlA ji Cory CTION Niue uLI riv , //a `5 ;fi/g6` Greg�R"a $NI#�'`/r6 250=1.985 . EQ. r Bin # ��ermit 9t h Project Address: �lv City. of La Quinta Building & Safety Division 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-701,2 Building Permit Application and Tracking Sheet , hair h Owner's Name: C% A. P. Number: Address: C 8 , Y1- `Legal LegalDescription: -7:f City, ST; Zip: Contractor: Address:1 . - ( 1 Telephone: Po Project Description: G City- ST, Zip: pal fm- Tel Telephone: ehnc P o . -3 Zo 7. 0 ;:»>;:: : « State Lic. # : 66 � S City Lic. Gy Arch., Engr., Designer: Address: City, ST, Zip: Telephone: n Co tructi s on Type: aneY Occupancy: •C53 State S to Lac. # 'nProJect tYPa(circleone • New AddAlter Repair Demo Name of Contact Person: �V(� V` �5... I 0 7p...... Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 6 0 — 51 ` 6 9 Estimated Value of Project: S 0 Q APPLICANT: DO NOT WRITE BELOW THIS LINE it Submittal Req'd Rcc'd 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 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" Review, ready for corrcclionsh sue Electrical Subcontact'orList Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 1I.O.A. Approval Plans resubmitted Grading IN HOUSE:- Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Conlact.Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, I Total Permit Fees