13-0761 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:' —13=00000761
Property Address:__ 57545 -BLACK DIAMOND
APN: 762-340-015- -- -
Application description: POOL - RESIDENTIAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 25000
Tit!t 4-,,4,- Q"
Applicant: Architect or Engineer:
AM --
BUILDING & SAFETY DEPARTMENT
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 of the Business and Professionals Code, and my License is in full force and effect.
LicenseClass:
B C53 — License No.: 185102
Daie4!! �, Tf _ Contractor:
�y 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).:
(_ 1 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.).
1 _ 1 1, 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.).
1 _ I 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:
LQPERMIT
Owner:
THOMAS HUMPHREYS
57545 BLACK DIAMOND
LA QUINTA, CA 92253
Contractor:
CALIFORNIA POOLS
PO BOX 2889
PALM DESERT, CA
(760)771-6141
Lic. No.: 185102
& SPAS
92261
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/19/13
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 GREAT AMERICAN Policy Number WC260048201
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
/ G_' 33700 of the Labor Code, I shall to i h comply with those provisions.
_� 1at7d 3 -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 Director of Building and Safety 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. 1 agree to comply with all
city and county ordinances and state laws relating to building c nstruc ' n, and hereby authorize representatives
of thisGcounty tt9ent_er upon the above -menti
-ironed propert r s ion purposes.
Date: ,R/f " 3 Signature (Applicant or Agen
I-- . .
Application Number . . . . . 13-00000761
Permit . .
. POOL 2013
Additional desc .
Permit Fee . . .
. 00
Plan Check
Fee
.00
Issue Date . . .
. 6/19/13
Valuation
. . .
. 0
Expiration Date .
. 12/16/13
----------------------------------------------------------------------------
Special Notes and
Comments
POOL REMODEL PER ATTACHED APPROVED
PLANS, STEEL, PLUMBING. 2010 CALIFORNIA
BUILDING CODES.
-----------------------7----------------------------------------------------
Other Fees . . .
. . . . BLDG
STDS ADMIN (SB1473)
1.00
PLAN
CHECK, POOL
97.24
Fee summary
-----------------
Charged Paid Credited
----------------------------------------
Due
Permit Fee Total
.00
.00
.00
.00
Plan Check Total
.00
.00
.00
.00
Other Fee Total
98.24
.00
.00
98.24
Grand Total
98.24
.00
.00
98.24
LQPERMIT
Bin #
City of La Quinta JUN 1.8 20 3
Building 8L Safety Division CITY OF LA Q N
P.O. Box 1504, 78-495 Calle Tampico COMMUNITY DEVE 0
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: �% �"� rA a>uD
Owner's Name: O M
A. P. Number:
Address:
Legal Description:
City, ST, Zip: ga 5
Contractor: C lIC9RrJtt� P
Telephone: ,�L;;v;::?.:s<;%.<.;:5;::s.
Address: 3 N i{ Sh0
Project Description:
City, ST, Zip: P a
Telephone: %
:ii}.iiiY ti�X•.'.Vj::v',.<�>:�'�.:>�:'��,'.{;k }f�:,t�{irr:;.
::..: .; :.;r:;....: 1 .a: ;. s
<.>:.:::zk?:�...v>rr:>::::>`<:>::','>%>
�1�, I✓] �
S l �E l L U W1 I N .
State Lic. # : Sl O City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone: {>';: «.::;':°•;..::,:<r.?:r;<:;
F:ti� C.. i . N Yrii �:i?:::vi:i?i�2, :i ii iii?'.� :n;i \��
State Lic. #: .;:.xs,�;•?::::;:<::; ,,;•;;;y;:!yn<;><.�s:�
N: �c.
Name of Contact Person:
Construction Type: Occupancy:
Project circle one New Add'n Alter Repair Demo
J type � )� P
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: -�^ '7_
Estimated Value of Project: 2.5
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
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 corrections/issue
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 eorrectionstissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Flgz;l I I Muni if hN 11 ra-,
I ti i Permit Fees
APPRpvEDtr I.
FOR CONSTRUCTION
DA 1�/By UC
TA
OP
Uk
PGA WEST
FAIRWAYS ASSOCIATION
March 8, 2013
Thomas and Joanna Humphreys
Re: Architectural Application — 57545 Black Diamond
Dear Thomas and Joanna Humphreys:
RECEIVED
JUN 18 2013
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
The Architectural Committee has reviewed your request for the modification to the rear yard pool and
spa. I am pleased to inform you that the Architectural Committee has approved the application as
submitted.
Enclosed is 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.
If you have any questions, please contact Cassie Gertz, Operations Manager at 760-776-5100 Ext. 345 or
email Cassie.Gertz@Managementtrust.com.
Sincerely,
For the Architectural Committee
PGA WEST Fairways Association
CCAM, PCAM
ager
Enclosure: Exhibit C — Compliance Review Request
cc: Lot File
Architectural Committee
Post Office Box 1690 - La Quinta, California 92247 - Phone (760) 776-5100 - Fax (760) 776-5111
LJ li-st, M9
l,A,J05CAPE_
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�1
RECEIVED
JUN 18 2013
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT
PD REmAiPJ
PREPARED FOR:'f`+koyAc.,_ 1.1-u iy1 ��¢.,�•�� Q
STREET Sl -'544; 13%A-cC- DI/IftyNbCIN (* Cq%1%MTb► I Filter Pump Eiev. PI
RES. PHONE
BUS. PHONE
EX ISM to �atomep;c
-ra R n%c-\ 3 nil
CITY OF LA QUINT,
31 fit nme" — _ _
APPROVEDC:Il
FOR CONSTRUCTION
°A 9'0 13Y 5�
Map Bk. Ref. ® O
Hose Sib Elec. Meter Gas Meter Actuator
Return Orap Alm• Eye. Vec. Fla. Cleaner Air Light
Rail mer ball Stub Injector
GENERAL SPECIFICATIONS
Size —14�9 — x �17- - , Volume 1-32 Gallons
Surface ca 14
Square Feet, Perimeter Feet
Depths: Minimum
' Feet, Mpximum �� Feet
EXCAVATION • Elevation
at_&�(krIKA
f&juO *)i9
Grading Hrs.
Debris
Dirt
Trees
Deep End Ramp
Access
Other
STEEL • Special
R. S. Beam
PLUMBING • Pipe Size:
Suction Returns —
Filter E3Sr1.5�'! �!
Pump JAS � AuX,4 H. P.
Heater :"�`�
-- BTU Vent by
Fill Line AuTn Ft.
Skimmer #
Gas line by ,ilSTiw►
Length Ft.
Backwash to
—Stub: p Yes ❑ No
Spa QAiSEd /A
r
Special
GUNITE • Special
-- - --
Rope Rings
Grab Flpils __,._ Seats
COPING • Color and,or
type ► 61, aw-IL
Special
TILE •
Special
ELECTRICAL • By
�-
- Up To Ft
Lights L Qb
# . 9 Watt
Time Clock
Special
Special
DECKING • By G
Up to Sq. Ft..
Color y; !
Texture r
Special
FENCE • By
To Meet Local Code
PLASTER
• SPECIA NOTES •
Pool Cleaner S2-"ae2Rt�t/
Adjust. Ret.
Chlorinator
Rails
Diving Board
Slide
Notes: nJ
rj'T
BALL exi-c
wia ,9,vU&4& T, kg_- riga --
i-tl;'I z-S�a31 Ml,a_k -r
enWrunnu P00hS a sans
CONTRACTOR'S LIC NO. 1851
OWNER: To determine approx. elevation of pool on day of
excavation. To wet down concrete shell at least twice daily
for seven days.
OWNER: Approves plan, pool and equipment locations.
Signed Date '