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BPOL2015-0169V 78-495 CALLE TAMPICO . D VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT FAX (760) 777-7153 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 7000) of Division 3 e Business and Professions Code, and my License is in full force and effect. License Clas : License No.: 728796 Date: // ' Contracto OWNER -BUILDER 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).: (� 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 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: . Policy Number' 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 s ul become subject to the . workers' compen tion provisions of Section 370 of th Labor Co , Is ll.forthwith comp) wi tho provisions. Date: // Applicant: 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 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 the above information is correct. I agree to comply with all city and county ordinances and stat s relating to building construction, an here by,authorize representatives of thi y to enter upon e e mentioned ert for inspection purposes. Date: Signature (Applicant or A�.n - i Date: 8/4/2015 Application Number: BPOL2015-0169 Owner: Property Address: 50405 MOUNTAIN SHADOWS DONALD BALKE APN: 776030003 6413 N E159TH ST, t Application Description: BALKE / POOL AND SPA REMODEL ADD PUMP, BBQ AND FIRE PIT KENMORE, WA 92253 Property Zoning: a Application Valuation: $20,000.00 C� N Applicant: Contractor: � g S 9 JOHN L CAREY INC DBA BUBBLE SP JOHN L CAREY INC DBA BUBBLE P LLO Z, P O BOX 1046 P O BOX 1046 = U RANCHO MIRAGE, CA 92270 RANCHO MIRAGE, CA 92270 Q 5 (760)341-2336 Llc. No.: 728796 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 e Business and Professions Code, and my License is in full force and effect. License Clas : License No.: 728796 Date: // ' Contracto OWNER -BUILDER 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).: (� 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 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: . Policy Number' 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 s ul become subject to the . workers' compen tion provisions of Section 370 of th Labor Co , Is ll.forthwith comp) wi tho provisions. Date: // Applicant: 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 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 the above information is correct. I agree to comply with all city and county ordinances and stat s relating to building construction, an here by,authorize representatives of thi y to enter upon e e mentioned ert for inspection purposes. Date: Signature (Applicant or A�.n - i •J 2 FINANCIAL .• l, -`DESCRIPTION r p tt ;i ACCOUNT" EY;; �Eh TYg t � AMOLINTt�'� ` PAID " Q?t PAID :DATE N. r a e # r: r �w* BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 F x 'z '.. zr r *s 4 f rv�PAIDBY, #y ,C ','f.s� RECEIPT;; HECK # CLTD BY= eft:>'..�ngMETHODt r���`. R �� Total Paid forBUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 s+i�r s OESCRIPTIONx� ACCOUNTr , 'QTY AMOUNTS °t£PAID FPAID:DATE , �`;� DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 � PAID BY ' f ; METHODS��; ECEIPT" CHECK #'' CLTD BYE; v.._�..„- ., �` n ;�w � T ACCOUNT4;` aQTY # MOUNT _ f PAID PAID OATEN , XDESCRIPTIONr . r DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 BY �.. METHOD r RECEIPT # 47, #' CLTD BY �_ ,>PAID M .N f , x LL yCHECK 4 Total Paid for ELECTRICAL: $48.34 $0.00 t €=DESCRIPTIONS g '`�_ ACCOUNTF �' �; QTY' °tw AMOUNTS ° �. PAID _ - �P GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 66”; ;r+ RECEIPT #� `CHECK #F+ BYµ .'CLTD DESCRIPTION ACCOUNTS `�'k4 kCITY 'AMOUNTA�-r� � � PAID = r � q �PAIDrDATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAIDBY „ ; RECEIT #METHD CHECK.2 #f ; ' I CLTD BY . S. T .q ... F .. i - Total Paid forPLUMBING FEES: $36.26 $0.00 s� $ DESCRIPTION,,: .� , ACCOUNT. QTY AMOUNT '_�i, PAID PAID'DATE u" SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $0.00 �' * ` PAID`BY METHOD,'O,, x RECEIPT # CHECK # CLTD BY x: 3 r A �- ,; L E 'DESCRIPTION w � ACCOUNT M ' ` PAID r PAID -DATE r� .ek li xtQTY VAMOUNT, $ SWIMMING POOL/SPA PC 101-000042600 0 $98.62 - $0.00 PAID BY, s' kMETH00 RECEIPTS#ti$g _ a `CHEEK # CLTD BY F t <+ rR Total Paid for POOL/ SPA: $279.91 $0.00 • f 00 v Description: BALKE / POOL AND SPA REMODEL ADD PUMP, BBQ AND FIRE PIT Type: POOL Subtype: Status: APPROVED Applied: 8/4/2015 SKH Approved: 8/4/2015 KKI Parcel No: 776030003 Site Address: 50405 MOUNTAIN SHADOWS LA QUINTA,CA 92253 Subdivision: TR 25429 Block:. Lot: 10 Issued: Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $20,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL REMODEL, SPA, FIRE PIT, AND BBQ[2 INCH GAS PIPING/#8 AWG IN 1 INCH CONDUIT ELECTRICAL] THIS PERMIT DOES NOT INCLUDE ELECTRICAL AT BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. CONDITIONS FINANCIAL INFORMATION Printed: Tuesday, August 04, 2015 5:18:51 PM 1 of 3 S YSTf MS r off. _ •:GL Gr�fOF'F1�F'�4• Printed: Tuesday, August 04, 2015 5:18:51 PM 2 of 3 • SYS7ENIS � ' 4,o-" 6 -. .*. R e �. ��" " ee'«'k!q �.{ •�.b i LTD "3 DESCRIPTION', : CCOUNT ,CITY r;� :AMOUNT kF PAID r PAID.DATE; :°RECEIPT. ;CHECK #'„ -METHODS 3xxr rr g it a Y. BSAS•SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: DEVICES, FIRST -20 101-0000-42403 0 $24.17 $0.00' DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL: $48.34. $0.00 GAS SYSTEM, 1-4 101-0000-42401 0 $12.09 $0.00 OUTLETS GAS SYSTEM, 1-4 101-0000-42600 0 - $24.17 $0.00 OUTLETS PC Total Paid for PLUMBING FEES: $36.26 $0.00 SWIMMING POOL•/SPA 101-0000-42404 0 $181.29 $0.00 SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $0.00 PC` Total Paid for POOL / SPA: $279.91 $0.00 TOTALS:00 MPECTIONS SEQID INSPECTOR ..> <• SCHEDULED COMPLETED RESULT REMARKS",„_ wNOTES z .,INSQ:ECTIONmTYPE r , _ a >: ' ,: -,�,: FINAL” BLD Printed: Tuesday, August 04, 2015 5:18:51 PM 2 of 3 • SYS7ENIS ,•C � �` n' �- y t . " � � P'%A"�' m.,� `' s _ ro '� aew� ;*� .. * kid . A''t :+ e� � ,�rz+ T1�S . • • Pei;1111t�.�ea1�5 y PERMITNUMBER, 4 � P 9 -� B � tO L2'01xfi Y 3 C�ty..of La�Quinta A a 015 `t By z „} �: i �y Fk('v.•Y �a'N �� t �r F �,_ '°` � i' ab=.�tna V 's:'" �' tri "C.. �' �_�" :. `xit xafwe=--� ',• b Y°' '�T £i .. �'' 3}Nq.3"- A„ ,.`�.l. S'- s.a...,•.- '."i.,=sY�.u�iia.'eay._�.. ....�'L'...'r...,.i...a,.:.�� ,. BOND INFORMATION ATTACHMENTS . � City ofLa Qu- to Bulfdtng 8L Safety Dit+UM P.O. Box 1504,78-495 Caffe Tampico LA Qui l4 CA 92233 -:(760) 777-7012 Building Permit Application- and Tracking Sheet Y PemUt # T_)p Project Address:(J� O ' Owner's Name:.,,, Address: ,�jQ = ( d UVItLiI h fl) Bln. # City ofLa Qu- to Bulfdtng 8L Safety Dit+UM P.O. Box 1504,78-495 Caffe Tampico LA Qui l4 CA 92233 -:(760) 777-7012 Building Permit Application- and Tracking Sheet PemUt # T_)p Project Address:(J� O ' Owner's Name:.,,, Address: ,�jQ = ( d UVItLiI h fl) A. P. Number. Legal Description: Contractor. ��bb1Q I'I Cita,, ST, Zip: Telephone: '� ° . Address: 0 • 1.tLiPmject Description: - n City, ST, zip: I 2 Z 7 D Telephone: 6 ++ N I State Lia #: 1 Z City Lic- # b -J 11 - '500- ` w \ Arch., Engr., Designer. Address: City, ST, Zip: ' Telephone: State Lic. #: Construction Type:. G(� Q Occup�gy: Project type (circle one): New Add'u Alter Repair Deem Name of Contact Person: I Sq. Ft.: # Stories: # Unitg Telephone # of Contact Person: p I I 1 Estimated Value of Project: oQQ APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Rcq'd ' Rec'd TRACMG PERMIT FEES Plan Sets Pian Check submitted Teem Amount Structural Cale& Reviewed, ready for corrections Plan Check Deposit. . Truss ala Called Contact Person Plan Check Balance Title 24 Cala. Plans picked up Construction Rood plain plan Pians resubmitted ' Mecharilcal Giading plan 2' Review, ready for correctionsfkssue Electrical Subcontactor List Called Contact Person Pl-bing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review; ready for eorrectionsRssae Devdoper Impact Fee Planning Approval Called Contact Person A,I,Py, Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees PAINTED COVE AT LA .QUINTA HOME OWNERS ASSOCIATION CIO Desert Management 42427 Rancho Mirage Lane I Rancho Mirage, Ca 92270 P- 760.862.1202 F- 760.862.1210 July 31, 2015 Donald & Rose Marie Balke 6413 NE 159th St. Kenmore WA 98028 , I RE: Architectural ApprovaG- 50-405 Mountain Shadows ' Acct. #: 47-00010 Dear Donald & Rose Marie Balke: Thank you for submitting an Architectural Application to convert to desert landscape. The Board of Directors has reviewed the application submitted and has approved your request to upgrade your Pool/Spa, plaster addition of a new and file decki g, including the BBQ Island and fire pit, You may begin your project effective immediately. However, you must adhere to the sp your application to the Board of Directors. In addition, you must adhere to the follot Wngworrks houm based on the guidelines set forth by the City of La Quinta: Monday - Friday 7:00 am to 5:30 pm; Saturday 8:00 am to 5: 0 pm; Sundays and Holidays, no work allowed. Please be sure to contact our office when your project starts and when 4 is completed, in addition, a copy of the final inspection certificate must be sent to our office immediately atter gain e ng signed off by the city. . sincerely, . Lori Virga Community Association -Assistant Manager On behalf of the Board of Directors Painted Cove at Le Qulnta Homeowners Association - CC: HOA File / BOD i . • ,S rt y ' • '{ i m ' > O � Fi O 1 X ' ' _ j G� mei al p, • Cf Oo 'D fJ A .. N 1+ Q ((j D ,O Gl ,J D ' y *•t V F ..�: ' a a 7m N CD m +'. m b - g • m m s �T, .7 � •ate a �; � � � p s • ;u • � f' a'{. -•i. � c ey � Y: t • ' -. t ,, l y • ` • ...- t� r .' t .. 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P .� • _ , f 0 Ul cit LL 0.0 0 44 U ca Balke Residence ©- O ` Don & Rose Marie Balke k 0 0® �-WBubblesprfts@)msn.com 0PO Box 1046 H o° o o Rancho Mirage, Ca 92270 50-405 Mountain Shadow Road j� j�jj(�,, Bubblesprings@msn.com r �� `•° La Quinta, Ca 92253yu��� bRON�+� 760.341.2336 office 760.837.9018 fax ' ° �� 206.369.7980 206.979.2657 , ' POOL CONSTRUCTION t