BRES2019-01301 VOICE (760) 777-7125
78-495 CALLE TAMPICO C` D �i - Oulia
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 6/17/2019
Permit Type/Subtype: BUILDING RESIDENTIAL/ADDITION Owner:
Application Number: BRES2019-0130 JASON AND KIETH DUDUM
Property Address: 81630 SHACKLETON WY 81630 SHACKLETON WAY
APN: 767690034 LA QUINTA, CA 92253
Application Description: DUDUM / 400SF GARAGE ADDITION
Property Zoning:
Application Valuation: $80,000.00
z� D
Applicant: Contractor:
CLIFF WHALL- DISCOVERY BUILDERS CALIFORNIA INC DBA D DISCOVERY BUILDERS CALIFORNIA INC DBA DB
53965 HUMBOLDT BLVD JUN 17 2019 14605 N 73RD STREET
LA QUINTA, CA 92253 SCOTTSDALE, AZ 85260
CITY OF LAQUINTA (480)624-5200
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 915336
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:: BUJ /] License No.: 915336
Ift jler—
OWNER-BUILDER DECLARATi
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, 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
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 N
Lender's
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
ofIra.,
far which this permit Is issued.
have and will maintain workers' compensation insurance, as required by
Se0 of the Labor Code, for the performance of the work for which this permit
s ..y workers' compensation insurance carrier and policy number are:
Carrier: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Policy
Number: UB4K0552021914G
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.
Appli6qt.
WARNING: FAILURE TO SECURE WORKERS' COMPEN5ATI ERAGE 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 as a result of this application , the owner, and the applicant, each agrees to, apd
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 city to enter upon the
above -mentioned property for inspection purposes. i -,—%
• Sig (Applicant orAgen[�.
Date: V6/17/2O19
Application Number:
BRES2019-0130
Property Address:
81630 SHACKLETON WY
APN:
767690034
Application Description:
DUDUM / 400SF GARAGE ADDITION
Property Zoning:
Application Valuation:
$80,000.00
Applicant:.
CLIFF WHALL- DISCOVERY BUILDERS CALIFORNIA INC DBA DB
53965 HUMBOLDT BLVD
LA QUINTA, CA 92253
Owner:
JASON AND KIETH DUDUM
81630 SHACKLETON WAY
LA QUINTA, CA 92253
Contractor:
DISCOVERY BUILDERS CALIFORNIA INC DBA DB
14605 N 73RD STREET
SCOTTSDALE, AZ 85260
(480)624-5200
Uc. No.: 915336
Detail: DUDUM / 400SF GARAGE ADDITION TO ADD (1) ADDITIONAL ATTACHED 1-CAR GARAGE [ENGINEERED DESIGN]. THIS PERMIT DOES NOT INCLUDE
ALTERATIONS AT OTHERAREAS OF THE DWELLING. 2016 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
CITY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF
101-0000-42400
0
$68.84
DESCRIPTION
ACCOUNT
CITY
AMOUNT
ADDITION, EA ADDITIONAL 500 SF PC
101-0000-42600
0
$19.21
DESCRIPTION
ACCOUNT
CITY
AMOUNT
ADDITION, FIRST 100 SF
101-0000-42400
0
$134.48
DESCRIPTION
ACCOUNT
CITY
AMOUNT
ADDITION, FIRST 100 SF PC
101-0000-42600
0
$188.92
Total Paid for ADDITION: $411.45
DESCRIPTION
ACCOUNT
QTY
AMOUNT
101-0000-42600
($100.00)
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HOURLY CHARGE - INTERWEST PLANS EXAMINER
101-0000-42600
1
$100.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW
101-0000-42600
1
$125.00
Total Paid for BLDG CITY STAFF - PER HOUR: $125.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS 561473 FEE
101-0000-20306
0
$4.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $4.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,OOOSF
101-0000-42403
0
$160.10
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RESIDENTIAL, FIRST 1,OOOSF, PC
101-0000-42600
0
$52.83
Total Paid for ELECTRICAL - NEW CONSTRUCTION: $212.93
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PLAN CHECK DEPOSIT - GARAGE/CARPORT
101-0000-42600
1
$100.00
Total Paid for PLAN CHECK DEPOSIT - GARAGE/CARPORT: $100.00
DESCRIPTION
ACCOUNT
CITY AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0 $10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SMI - RESIDENTIAL
101-0000-20308
0
$10.40
Total Paid for STRONG MOTION INSTRUMENTATION SMI: $10.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS:
W
AL1FORMA -
Project Address: t <
APN #:
Applicant Name; ,•
,tf,p�
Address:_�5_3 [ e, - - t-^
City, ST, Zip: �1 ✓,
Telephone:
Email: `1A V_e-
Contractor Name:
Address:
City, St, Zip Svc
Telephone:Z�_
Email:
State Lic: q N 1�-,33<n City Bus Lic:
Architect/Engineer Name:
Address:
City, St, Zip
Telephone:
Email:
State Lic: City Bus Lic:
Property Owner's Name'J&5,, , -�
Address:8` - '
City, ST, Zip. L >k '�d4 l ��•l-cam
Telephone: —`7�'7
Email: /_ A. , ,
ERMIT # M201 1 `+ 0130
LAN LOCATION:
roject Description:
Valuation of Project
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction
Grading:
Bedrooms: 1 Stories:
SF
SF
SF
SF
Occupancy:
# Units:
�w Commercial / Tenant Improvements:
Total Building SF
Construction Type: Occupancy:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
C�Ela - e10sMl�
OFFICE USE ONLY
#
Submittal
Required
Received
Plan Sets
Structural Calcs
Truss Calcs
—
Title 24 Calcs
Soils Report
Grading Plan (PM10)
Landscape Plan
�Suontractor List
Grant Deed
HOA Approval
School Fees
1
Burrtec Debris Plan
-
Planning approval
Public Works approval
Fire approval
City Business License
THE MADISON CLUB OWNERS' ASSOCIATION
April 5, 2019
Mr. Keith Dudum and Mr. Jason Dudum
3505 Mt Diablo Blvd.
Lafayette, CA 94549
RE: Lot 42B at 81630 Shackleton
Revisions to Architecture and Site Plan (Garage/Pool)
Dear Mr. J. Dudum & Mr. K. Dudum:
This correspondence shall serve as notification from The Madison Club Design Review Committee ("DRC') that
your requests to modify garage at the front of the home and the pool at the rear of the lot were reviewed at the
March 29, 2019 meeting. The requests were approved in concept subject to the following comments being
addressed in a revised plan submission_
1. The committee is recommending approval of the request to encroach into the front easement area with the
new garage mass as there is no impact to the community due to the size of the easement area and the
existing berms which will provide screening_
2. The response letter provided by Scott Birdwell indicated that the pool modification was not being
submitted for review; however, once in the field the committee noted that the pool has been dug. The new
pool location has not been formally approved and a Variance Request has not been received_
3. The response letter noted that a lot line adjustment was being pursued with the Golf Club. Please note that
any modifications to the existing Lot Diagram, including the location of the Private Area and Transition
Area must be approved by the DRC and the Board of Directors. Square footage added to the rear of the
property should be considered additional Natural Area space until such approvals are formally considered.
4. The height of the new garage should be reduced to 16' to lessen the impact of the mass as viewed from the
street. This should have no impact on the usage of the garage_
5. Copies of the Garage Permit and Pool Permit must be provided once obtained by the City of La Quinta.
6. While the request to add a carport has been omitted, the request to extend the side yard property line wall is
still valid as the lights from the vehicles may negatively impact the neighboring property based on the
proposed location of the guest parking.
We look forward to receiving your full, revised modification submittal package. Please contact the Association
Office with any questions regarding this matter_
Sincerely,
iVI DISON CLUB DESIGN REVIEW C011LVITTEE
By: G I w
Title:
G 11 fiC I `i Date: ' I
(
cc_ T. Jenkins
B. Payton
DRC File
Pursuant to Cal. Civil Code, any rejection by the DRC may be appe aced to 1he Board of Direclors for the Assoriolion_ If you Irish !o pursue an
appeal, please contact the Awoeinlion 's property manager so that you may be put on the near( meeting agenda.
5.1035 MERIWETHEA WAY, LA QuurrA, CA 92253 TEL 760 391-4564 FAx 760 391-4591