BPOL2015-011078-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA3 .2253
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: BPOL2015-0110
Property Address: 80040 CEDAR CREST
APN: 762051024
Application Description: KISIELICA / POOL, EQUIPMENT WALL, AND FIRE PIT
Property Zoning:
Application Valuation: $18,500.00
Applicant:
CLASSIC POOLS & SPAS
79-461 AVENUE 40
INDIO, CA 92203
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: C.10. C License No.: 634338 /
Date: V l % f Contractor:
OWNER-BUILTION
I hereby affirm under penalty of perjury t t I a xempt from the Contractor's State
License Law for the following reason (Sec. 7031'.,, 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 Address:
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECtIONS (760) 777-7153
Date: 6/3/2015
Owner:
STEVE AND AMY KISIELICA
Contractor:
CLASSIC POOLS & SPAS
79-461 AVENUE 40
INDIO, CA 92203
(760)345-8302
Llc. No.: 634338
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.
1 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 should become subject to the
workers' compensation provisions of XNALPOEfNAALITI
r Code, I shall forthwith
comply with ose rovisions.
Date: S Applica
WARNING: FAILURE TO SECURE WOROVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TND 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 apstatereilding
construction, and hereby authorize representatives of above•
mentioned grope for inspection purposes.
Date: Signature (Applicant or Agen
DESCRIPTION
FINANCIAL
ACCOUNT QTY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID.
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT #.
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY-
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for FENCE OR FREESTANDING WALL $108.77 $0.00
.DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS
101-0000-42401
0
$12.09
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNTQTY
AMOUNT
PAID
PAID DATE
GAS SYSTEM, 1-4 OUTLETS PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PLUMBING FEES: $36.26 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA
101-0000-42404
0
$181.29
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
SWIMMING POOL/SPA PC
101-0000-42600
0
$98.62
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for POOL/ SPA: $279.91 $0.00
TOTALS: $425.94 00
Description: KISIELICA / POOL, EQUIPMENT WALL, AND FIRE PIT
Type: POOL Subtype: Status: APPROVED
Applied: 6/1/2015 SKH
Approved: 6/3/2015 MFA
Parcel No: 762051024 Site Address: 80040 CEDAR CREST LA QUINTA,CA 92253
Subdivision: TR NO 25499-2 CM 82/193-200 Block: Lot: 1
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $18,500.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: POOL AND FIRE PIT ONLY WITH 16 LF AT 5 FOOT HIGH EQUIPMENT WALL. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH
MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013
CALIFORNIA BUILDING CODE.
__j Applied to Approved
CHRONOLOGY
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
CLASSIC POOLS & SPAS
79-461 AVENUE 40
INDIO
CA
92203
CONTRACTOR
CLASSIC POOLS & SPAS
79-461 AVENUE 40
INDIO
CA
92203
OWNER
STEVE AND AMY KISIELICA
Printed: Wednesday, June 03, 2015 8:42:06 AM 1 of 3 V?WSYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
FINAL" BLD
Permit
Details
ity
La Quinta
Q 1 i 0
of
CLTD
DESCRIPTION
ACCOUNT QTY
AMOUNT
PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY
ABY
WALL/FENCE - FIRST
101-0000-42404
0
$47.86
$0.00
100 LF
WALL/FENCE - FIRST
101-0000.42600
0
$60.91
$0.00
100 LF PC
Total Paid for FENCE OR FREESTANDING WALL
$108.77
$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
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
FINAL" BLD
Printed: Wednesday, June 03, 2015 8:42:06 AM 2 of 3 CIR" SYSTEMS
ATTACHMENTS
Printed: Wednesday, lune 03, 2015 8:42:06 AM 3 of 3 C
SYSTEMS
FAMF
PGA WEST
May 18, 2015
Steve & Any Kisielica
350 W. Hubbard Ste. 250
Chicago, IL 60654
Reference: 80-040 Cedar Crest, La Quinta, CA 92253
Architectural Change Request — Pool, Firepit, Putting Green
Dear Steve & Amy Kisielica:
The Architectural Committee met on May 14, 2015 and reviewed and approved your architectural
plans with the following conditions being met.
• The contractor shall ensure the make-up water for the automatic water feed device be
tapped ahead of the main dwelling shutoff. Existing hose bibs cannot be used for this
purpose.
o A Covenant and Maintenance Agreement will be required, one will be sent to you for
proper execution as soon as it is prepared by counsel.
• Your contractor must meet with Bob Pantanella, Director of Community Services prior to
any work commencing on this project, Mr. Pantanella's phone number is 760-564-1032.
• Your contractor must meet with the Golf Course Superintendent, Son
Maddern; 3oanne Rose, Association Manager, Luis Umana with Sunshine
Landscape prior to any work commencing on this property, please call 3oanne
Rose to arrange this meeting at 760-346-1161 ext. 147.
a All other PGA WEST II Residential Association Architectural Rules & Regulations dated
May 20, 2013 pertain to this project.
Review by the Cominittee is only for genera/ conformance with the Architectural
Ru/es rt is the resoonsibX& of the owner. to fu//v understand and conform to .the
ArclWectura/ Ru/es criteria whether or not al/ deficiencies are noted during review. It
is also the owner's fu// responsibility to fie/d verify a// existing conditions The,
committee's decision with regard to prroject design will be final Please reefer to the
Architectural Ru/es for a// required submittals,
Please contact Luis Umana, Sunshine Landscape at 760/346-3999 and Joanne Rose, Association
Manager at 760/346-1161 ext. 147 prior to any irrigation modifications associated with this
change. Damage to the landscaping, i.e. shrubs, trees, flowers and turf is the responsibility of
the contractor. The original landscaping must be brought back to its original condition when the
project is completed.
Approvals given by the Architectural Committee are good for only six months from the date
on the approval letter. If construction has not commenced within six months after the project
approval date, a new application must be submitted.
Page II PGA WEST II Residential Association
Architectural Committee Approval Kisielica, Pool, Firepit & Putting Green
Upon completion of your project, please complete and return The Notice of Completion of
Architectural Change, along with the Permit from the City of LaQuinta sign off.
For additional information or questions, the Board has directed that you contact Joanne Rose,
CCAM, Association Manager, at 760/346-1161, Ext. 147.
Sincerely,
PGA WEST R Residential Association
Joanne Rose, CCAM Association Manager for
Architectural Committee
Cc: unit
Peters & Freedman
Bin #City
Of % Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quints,CA 92253 - (760) 777-7012.
Building Permit Application and Tracking Sheet
Permit #
Project Address: i Cr LC±
Owner's Name: ftVe, K1
A. P. Number: -7r✓ 2_ ( p
Address: u4Djre
Legal. Description:
City, ST, Zip: LaQunAiD2
Contractor:d S S PCLS
Telephone:
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Address:
Project Description:
City, ST, Zip:2O I
08 N
Telephon
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State Lic. # :
City Lic. #;
, �so L Lit'14
Arch., Engr., Designer.
d
Address:-III CoEm-ld L , 130
City., ST, Zip: Pawn C CR ;Z2
hone,+.4 1
State Lic. #: 3
a>s:Tel
<;Construction
Type: Occupancy'W
Project type (circle one): ' ew Add'n Alter Repair Demo
Name of Contact Person: r'
Sq. Ft.:
# Stories:
ifUnits:
Telephone #,of Contact Person — �
Estimated Value of Project: Soo
P'
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Req'd Recd TRACMG PERMIT FEES
Plan Sets
PIan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
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 correctionstissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:
''' Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
Schodl Fees
Total Permit Fees