04-5393 (RPL)BUILDING & SAFETY DEPARTMENT
P.O. B.Ox 1-504 (760).77.7-7012
Cts 9 8--495'CALLE TAMPICO r" FAX (760) 7.77-7011
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L"A QUINTA, CALIFORNIA 92253•• INSPECTION REQUESTS (760) 777-7153
JUL 2 0 '200 BUILDING PERMIT k
®F LA QIDIFdTIL' .
CIV pp�lFi�ca't.ion—Number . . . 04 O'O�OO535.5 'Date' 7/09/04
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Property Address' 60204 PHILIP CT
APN: 76;4 -:27.0 -999" -174 -300232 -
Application description POOL %RESIDENTIAL
Property Zoning .,MEDIUM.HIGH DENSITY RES
Application valuation 2115,00
Owner Cont'r:actor .
HELEN MASON MC CALLUM POOLS
602'04 PHILIP COURT .46576, VIA CELESTE
LA QUINTA CA 9.2.253 INDIO, CA 92201
1;760)' 775-5685.,
WCC : EXEMPT -
EXEMPT 05/31/05
-CSLB: 8';1,8835 04/30/05
CCC: C53
Permit . . BLDG POOL PERMIT
Additional desc
Permit' -Fee 225.00 Plan Check Fee 146.25
Issue Date . . . . Valuation . . . . 21500
Expiration Date 1/09/05 .
Qty Unit Charge Per..,,Extension
BP;SE FEE- 45.00
20.00 9.0000 THOU - BLDG 2, 00.1-25,,000' 180. 00
---------------------------
Permit . . . . . . MECH POOL
Additional desc` '
Permit Fee 24.:. 00. ` 1dn ,CYi
P.O. Box 1504• ���� /i •
w VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTIONS (760) 777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 6
Applicant:
Applicant's Mailing Address:
Date:
Architect or Engineer:
Architect or Engineer's Address:
Lic. No.:
t3UILDING PERMIT DECLARATIONS
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
C e, and my License is in f II force•and effect. p
icense Class f[9� s cense No.
Data / - C►r 0�11_contractor crl� CICA,I A I A^
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' 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 Contractors' 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).):
U 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 or 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.).
( j 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.).
U I am exempt under Sec. , BA P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of pedury 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:
Cartier 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' compensafion provisions of Section 3700 of the Labor Code, I shall
forthwith comply with thos ions.
ate %"- I`1--OJ--A-
pplicant
ot
WARNING: FAILURE TO SECURE W RKERS' OMPENSATI OVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED OUS D DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, 1 REST, AND ATTORNEY'S FEES.
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
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, indemnity 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
construction, and hereby authorize representatives of this county o ter upon a above-mentioned pr ertIr inspection purposes.
ate_ -f 17 Si re (Applicant or Agent): V
Page 2
Application Number ;04=000053.93
Date. 7/09/04
Qty Unit Charge. Per
Extension
;BASE FEE
15.00
1.00 10.0000 EA ELEC PRIVATE SWIMMING.POOL
30.00
Permit PLUMBING,w':
Additional desc
Permit Fee =33.00 Plan Check Fee
8.25
Issue Date Valuation . .
. . 0
Expiration Date 1/0.9/05
Qty Unit Charge Per.
Extension
'BASE FEE
15.00
2.00 6.0000 EA PLB. FIXTURE:
12.00
1.00 3.000.0,EA PLB=WATER -INST/ALT/REP
3.00
1.00 3..0000 EA PLB GAS'`PIPE 1-4 OUTLETS
3.00
Special Notes,and Comments
POOL/SPA. ALARMS/BARRIERS S,H:ALL BE IN
PLACE AT PRE,= PLASTER ;INSPECTI'QN .
EQUIPMENT ENCLOSURE NOT INCLUDED..
Fee summary Charged Paid Credited
Due
Permit Fee Total 327.00 .00 ;00
327.00
Plan Check Total 16.9.5'0 .00 .00
169.50
Grand Total 496.50 00 00
496.50
cul 09 04 12:32a Joseph mccallum 7607755685 p.3
Trilogyat La QU,'intqMwnte_h0nce, Association
1 '
July 1, 2004
Hugh & Helen Mason
60204 Phillip Ct
La Quinta, CA 92253-7714
Property Address: 60204 Philip Court
Dear Mr. & Mrs. -Mason:
We are pleased to n fonn you'that your plans for installation of a pool, spa, rear, yard, irrigation, and low
voltage lights have , been conditionally' approved by .the Desig�i Review Comn iittee with the following
condition: Please provide drainage plan from rear yard to the 'front yard/street.
1
This approval does not:constitute consent by the `Association f )r the applicant to encroach, trespass, or
build on any property other= than, that .. of the applicant Thi, " approval is related solely to the items
reserved for approval by the CC&R's in accordance with the AichitecturaI Guidelines. The approval does
not extend to the quality of work done by your..'architect, or, coiitractor;.or to., -any structural engineering,
soils engineering, or site grading. and drainage - design. You an; urged to .obtain the services of a state
licensed professional for consultationas needed.
Please be advised that this approval does not relieve you'from obtaining any necessary building permits
from thegovernmental agencies involved. If any ' portion of the ' common area ' is . damaged during
construction, repair of same will-be'done by the'Maintenance Association's contracted landscaper and fees
for the work ,will be deducted `from your. secunty deposit Thank: you for your patience in this matter and
for complying with the.Association's policies and star'idards.
Sincerely,
For the Architectural Committee
Dayton Dickey
Community Manager
Enclosures
Professionally Managed by Action.Property Mznagement, Inc.
29B Technology,Drive; Suite 100,` hv:- CA 92618
949=450-0202 800-400.-2284 949-450-0303fox
www. actionl fe. com-.
OFASPECIRCATIONS- - J
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APPROVED er.
Ran% 0�2.fAeft TA ORAVANO RFUAINA TNF PRfIPERTYOF WCAIW►A
CITY Of LA QUINTA SUB -CONTRACTOR LIST '
JOB ADDRESS
PERMIT NUMBER OWNER BUILDER
This form shall be posted on the job with the Building
Inspection.Card at all times in a conspicuous glace.. • Only persons appearing on this list or their employees
are authorized to work
on this Job. Any changes to:this list' must be approved'
by the 'B,uilding, Division priorto commencement of .work. , Failure to' comply.will result in a stoppage of
work and/or the voidance
of buildin ermit; For,,each applicable. trade,. all information'eequested,below.must be.,completed"by. applicant. "On'F'ile° is,,n6t,an-acceptable,response.
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