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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_ c`l.l5 ►► I f-kI , !,'A 'ib ' ' DOME til (.tn.1 'TlGNOO C l,)& SES 1 O �IJC.G L.J r,(— nXIS11>J6, food✓ %_7C-7t; "e:AJV Avg 1Y I a a•-% firtr. � A,- 61 �I-� ��JtL�,3ir" � I XiSra•y9I.AwQ�€ T`v 17�r►�r�i,.� �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 '