04-3402 (RPL)BUILDING & SAFETY DEPARTMENT
P.O. Box 1504 (760) 777-7012
78-495 CALLS TAMPICO - FAX (760).777-7011
LA QUINTA, CALIFORNIA 92253 INSPECTION REQUESTS.(760) 777-7153
BUILDING PERMIT
Application Number .
. . . .x.04-00003402,.'. Date
4/12/04
Property Address . .
... . . 60282 POINSETTIA PL
APN:
764 -270 -999 -184 -300232 -
Application description
. POOL - RESIDENTIAL
Property Zoning..
MEDIUM"HIGH DENSITY RES
Application valuation
22000-
2000Owner
Owner
Contractor
LAWRENCE & MARY KIMSEY
JONES CUSTOM MASONRY.POOL,
BOB
23543 GINGERBREAD DRIVE
2595 GIBSON STREET
MURRIETA-
CA 92562 RIVERSIDE
CA 92503
:(909) 354-7223
r
— WCC: NO
WC:. EXEMPT
-.06/30/05
G$LB.:" 57:8.370:
06/30/05
,
Y 4 2 , ; CCC: C29=C53 "
;
_
------------------ ---:-.--=_---- --------------------
Permit, �BLDG-s,-P.OQL=PERMIT
;
Additional desc L
Permit Fee
X25:0 -0'A Plan Check Fee
146.25
Issue Date
Valuation . .
21840
Qty Unit Charge.
-Per
Extension
BASE FEE
45.00
20.00 9.0000
THOU BLDG 2,001-25,_000
180.00
Permit
WALL/FENCE PERMIT
Additional"desc
Permit Fee . . . .
15.00 Plan Check Fee
.00
Issue Date . .". .
Valuation
160.
. Qty Unit Charge
Per
Extension
-BASE FEE
15.00
-----------.-----------------
Permit . ... .
------------------------------------------------
MECH POOL
Additional desc ..
Permit Fee
24.00 Plan Check Fee-.
6.00
Issue Date
Valuation
0.
Qty Unit Charge.
Per
Extension.
BASE FEE
15.00
1.00 9:0000
EA MECH FURNANCE <=100K
9.00
Permit .. . . . . .ELEC
POOL PERMIT -RES-
P.O. Box 1504
� VOICE (760) 777-7012
78-495 CALLS TAMPICO FAX (760) 777-7011
LA QU[NTA, CALIFORNIA 92253 FAX
777-7153
BUILDING & SAFETY DEPARTMENT
Application Number: 0 ✓ 7V 01 Date:
Applicant:
Applicant's Mailing Address:
1.
\LELTJ I8 c) CAL t ��q zso3
Architect or Engineer:
Akl� -
Architect or Engineer's Address:
Lic. No.:
BUILDING PERMIT DECLARATIONS
LICENSED CONTRACTOR'S DECLARATION
1 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 'censeis in full foice and effect70
/ticense CI _ cense No.
ntractor h1`� ocvjes CJ--sMnt'
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, atter, improve, demofish, 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, howeyer, 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.).
U 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
1 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 maintairrworkers' 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 Carifomia, and agree that, if I should become subject to ft workers' compensation provisions of Section 3700 of the Labor Code, l shall
forthwith comply with those provisions.
�te "icant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS U LAWFUL, AND�FIALL 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.
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.).
Lenders Name
Lenders 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, indemnify and hold harmless the City of La Oulnta, 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 1 have read this application arnd state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county to enter upon the aai6r oned property for inspection purposes.
gate ature (Applicant or Agent):
Page 2
Application Number
04-00003402
Date 4/12/04;
Additional desc
Permit Fee . . . .
45.00 Plan Check
Fee
11.25
Issue Date . . .
Valuation
. .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 30.0000
EA ELEC PRIVATE SWIMMING
POOL
30.00
-------------------------------------------7--------------------------------
Permit . . . . . .
PLUMBING
Additional desc
Permit Fee
33.00 Plan Check
Fee
8.25
Issue Date
Valuation
. .
. . 0
Qty Unit Charge
Per
Extension
BASE FEE
15.00
2.00 6.0000
EA PLB FIXTURE
12.00
1.00 3.0000
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, 10 L.F. 42"
EQUIPMENT WALL,
CITY STANDARD. ALARMS/BARRIERS.SHALL
BE
IN PLACE AT PRE -PLASTER
INSPECTION
Fee summary Charged
-----------------
Paid Credited
Due
----------
Permit Fee Total
---------- ----- - ----
342.00 .00
.00
----------
342.00
Plan Check Total
171.75 .00
.00
171.75
Grand Total
513.75 .00
.003-.-7-5�
Maintenance Association
T•Trilogyat I,a Quinta
April 2, 2004
LAWRENCE E. & MARY I. KIMSEY
23543 GII�TGE"READ DRIVE
MURRIETA, CA 92562
Property Address: 60282 POINSETTIA PLACE
Dear MR. & MRS. KIMSEY:
We are pleased to inform you that your plans for installation of a pool, spa, wall, and satellite disks have
been conditionally approved by the Design Review Committeedpe Flu r drn e he cab gs. Please be advised
dvise cut d that
the gate has been denied, as additional information is need
approved must drain to a bubbler box at curb.
This approval does not constitute consent by the Association for the applicant to encroach, trespass, or
build on any property other than that of th.e .a ppectural Guldeainessl,he approval eto the ydoes
reserved for approval by the CC&R's in accordance with the Architecturalextend to the quality of work done by your architect; or contractor, or to any structural engineering..
not site .grading and drainage design. You are' urged to obtain the services of a state
soils engineering, u
licensed professional for consultation as needed.
Please be advised that this approval does not relieve you from obtaining any necessary building permits
ved.
on area is dged during
from the govenimental agencies invol. if any
Association's ation'f the s contracted landscaper and fees
construction, repair of same will be done by the
f'or the work will be deducted from your security deposit. Thank you for your patience in this platter and
for complying with the Association's policies and standards.
Sincerely,
For the Architectural Committee
--cyton Dickey, CCM_
Association Manager
Enclosures
Professionally Managed by Acdon Property .Management, Inc.
298 Technoloq' Drive, Suite 100, Ir+,ine, CA 926118
949-450-0202 800-400,2284 949-450-030311ax
www. action -online: corn
h+
CITY OF LA QUINTA 8UB-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 cons icuous place. 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 Building Division prior to commencement of work. Failure to comply will result in -a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed
by applicant. "On File" is not an acceptable response.
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