04-7469 (RPL)P.O. Box 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING PERMIT
BUILDING & SAFETY DEPARTMENT
(760),777-7012
FAX (760) 777-7011
INSPECTION REQUESTS (760) 777-7153
Application Number . .- . .. 04-00007469 Date 11/24/0
'Property Address . . . . . 79810
TANGELO
APN: 772-230-008-
- -
Application description POOL
- RES.IDENTIAL
Property Zoning . . . . . . . LOW DENSITY RESIDENTIAL
Application valuation . . . .
12000
Owner
'":.Contractor
------------------------
JEFF PENCE
--------------------
DOLAN CONSTRUCTION,
----
J.A.
79810 TANGELO
---7=4-040 HIGHWAY 111,
STE #L-207
�LA QUINTA CA-922--5�3
PALM DESERT
CA 92260
�
(760) 340-0905
WCC: STATE FUND
NOV 4�
204
P
WC:: 2290020047
01/01,'05
CSLB. 645369
05/3.1!06
CCC: B
----------- -
---------------------------
--------------------
Permit
� I�IE�C�H� P OOL
Additional desc .
Permit Fee 24.00
Plan Check Fee
6..)0
Issue Date . . . .
Valuation . . .
. 0
Qty Unit Charge Per
Extension
BASE
FEE
15.)0
1.00 9.0000 EA MECH.FURNACE
<=100K
9.)0
-------------------------------------.----;---------- ----.---------------------
Permit BLDG POOL PERMIT
Additional desc ,
Permit Fee .. 135.00
Plan Check Fee
87.75
Issue Date . . . .
Valuation
•120)0
Qty Unit Charge Per
Extensi'Dn
BASE
FEE
45.00
10.00 9.0000 THOU BLDG
2,001-25,000.
90.00
------------7----------------------------------------------------------------
Permit ELEC POOL PERMIT -RES
Additional desc
Permit Fee 45.00
Plan Check Fee
3.75
Issue Date
Valuation . . .
0
Qty Unit Charge Per
Extension
BASE
FEE
15.00
1.00 30.0000 EA ELEC
PRIVATE SWIMMING POOL
30.00
Permit . . . . . . PLUMBING
Additional desc
Permit Fee 27.00
,;Plan Check Fee
5.25
P.O. Box 1504
78-495 CALLS TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Applicant:
Applicant's Mailing Address:
C&If 4 4
"
BUILDING & SAFETY DEPARTMENT
Architect or Engineer:
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: It
Architect or Engineer's d eSS:
Lic. No.:
t$UILUING 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 he Business and Professionals
Code, and Licen, is in full force and elle f
License Class
M1, ens No. lO
Date �� T O� Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the ollowing reason (Sec. 7031.5, Businss.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 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 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 or 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
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 he Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insurance carrier and-odcy number are:
Carrier �7C1 F Policy Number 4.4—rff Abd �pV'7
_ I certify that, in the performance of the work for which this permit is issued, I shall not employ arty person in any manner so as to become subject to the workers'
compensation laws of California, and agre I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provi ns.
Date JiZC Applicant
WARNING: FAILURE TO SECURE WORK ' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THO SAND 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.
I hereby affirm under penalty of perjury that there is a construction lending Ig age cyorJthe peAGENCYING
performance of he work for which his permit is issued (Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
APPLICANT
IMPORTANT Application is hereby made to the Director of Buildin and SaACKNOWLEDGEMENT
Aand
set forth on this
1. Each person upon whose behalf this application is made, each person atwh sle request and for Morse benefit work isnperformed under or pulrsuant 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 his 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 i I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this county ter on e a ve-mentioned property for inspection purposes.
Date Signature (Applicant or Agent):
Page L
Application
Number
04-000074.69
Date 11/24/04
Issue Date
. .
Valuation-
0
Qty Unit
Charge
Per
Extension
BASE FEE.
15.00
1.00
6.0000
EA PLB FIXTURE
6.C-0
1.00
3.0000
EA PLB,WATER INST/ALT/REP
3.C10
1.00
3.0000
EA PLB GAS PIPE 1-4 OUTLETS
3_00
Special Notes
and Comments
RELOCATION.OF
SPAS.
RELOCATION/REMODEL
OF EXISTING
SPA. ALARMS/BARRIERS
SHALL
BE IN PLACE
PRIOR TO
PREPLASTER
INSPECTION.
EQUIPMENT
ENCLOSURE NOT
INCLUDED IN
PERMIT.
Fee summary
Charged , 'Paid Credited
Due
Permit Fee,Total
231.00 .00 .00
231.00
Plan Check.
Total
102.75 .00 .'00
102.75
Grand Total
333.75 .00 .00
333.75.
COURSE HOMEOWNERS ASSOCIATION
October 25, 2004
Mr. Jeff Pence
79810 Tangelo Street
La Quinta CA 92253
Reference: 79 -810 -Tangelo Street ~
Architectural Application
Dear Mr. Pence:
The members of the Architectural Committee have reviewed.the application to move the spa and
grant approval to that project with the following:conditions:
1. All traces of construction material and debris should be cleaned up daily including the
street and the common areas should be returned to the condition they were before the
project was started:
2. A backyard landscape plan must be submitted for approval.
Upon completion of this improvement project you will be required to provide ,the Association a
written Notice of Completion. If you have any questions, please call.
Sincerely,
On behalf of
The Citrus Course HOA Architectural Committee
�az�b�r�r �nzrce�ler .
Barbara Vanscoder, CCAM
Association Manager !
cc: Chair
;File
P.O. Box 12920 Palm Desert; CA 92255 - 75061 Mediterranean,. Suite B, Palm Desert, California
760.346.9000 • FAX 760.346.9997 www.citruscoursehoa.com
APPENDIX III. ARCHITECTURAL E& LANDS HOMES APPROVAL REQUEST
FORM F ALL
f Tract No. oC. ` el i0—t ®�
Date of Request: Lot
Name of Owner/Applicant:
Address: 1 ��
Local Telephone Number 22S "3�` f 7 Other Telephone Number:
D vide a complete narrative description of the proposed modifion and include
Description of rovement: (Please pro
drawings as appropriatek���, P
Estimated Completion Date: f f
Starting Date: .�
FOR POOL, SPA, WATER FEATURE, AND/OR DECK INSTALLATIONS: I
p Applicant requests approvalLca iomm�la on of landscape materials and/or co dance with Step 6, Paragraphs a and'bn
systems as part of this appy
on page 13 related to Demolition/ Replacement of Landscape, Irrigation System,
Walls, and Hardscape.
Estimated date 'of demolition/7
•
p Applicant requests approval of demolition of wall and/or hardscape as part of this
ith Step 6, Paag raphs a and b on page 13 related to
application in accordance w
Demolition/ Replacement of Landscape, Irrigation System, Walls, and Hardscape.
Estimated date of demolition:
THE APPLICANT UNDERSTANDS AND AGREES TO THE FOLLOWING:
1. The modifications will be made in strict compliance with the approved plans and specifications
submitted with this application. Should any changes be required at any time during the project, those
changes must be approved by the Architectural and, if applicable,
the Landscape Committee and noted on
The Architectural and, if applicable, Landscape Committee may grant variances from the
this application.
requirements these Architectural/Landscaping Rules, provided that such variance is reasonably necessary
in order to carry out the general purpose and intent of the Governing Documents or is necessary to avoid,
ting and
extensive hardship, expense or impossibility ofonform
li
e in
include payment of the applicable variance ppcation feeC The granting of ane. Any variance anuest shall b
y variance (shall not
constitute a waiver of any Architectural/Landscaping Rules or hinder the enforcement thereof; nor shall any
variance be permitted which violates any of the use restrictions -contained within the CC&Rs.
on harmless from all liability related to any
2. Owner shall
hold thereon, Ass any, common area property -and/or golf course, wherever located within
residences, improvements
31 RESTATED ARCHITECTURAL & LANDSCAPING RULES I2121]031
M:,GGD,,AHOA1GOvMCS W RCS6.13o%96-flaAL-rt8rm
.,,
Architectural & Landscaping Approval Request Form for New and Existing Homes, page 2
the Citrus Course Community, resulting from the installation/construction of this improvement or modification.
Applicant shall advise Association office promptly upon completion of the work.
3. Any application shall be deemed incomplete, and the Architectural and, if applicable, Landscape
Committee shall disapprove, any and all plans and/or specifications submitted to itfor approval if the Owner
fails to deliver the required fee and security deposit referenced herein.
4. Applicant shall comply with the Architectural & Landscaping Rules,5tandards and Guidelines for the
Citrus Course Homeowners Association, and furnish copies of these provisions to the contractor(s) engaged
by Owner for the improvement. Applicant further understands that it is Owner's responsibility to ensure that.
his/her contractor(s) also complies with these provisions.
5. In the event Applicant desires to use power excavation equipment, he/she shall indicate with the
application which areas have:
Landscape materials will be required to be removed/replaced and/or
Walls and hardscape will be required to be removed/replaced.
Applicant shall include Contractor's construction schedule, so that construction activity may be monitored by
Association. -
6. The modifications will be made in strict compliance with the approved plans and specifications
submitted with this application. Should any changes be required at any time during the project, those
changes must be approved by the Architectural and Landscape Committees and noted on this application.
7. Applicant shall secure proper building permits, if required 'by the local governmental entity.
Applicant understands thatthe City of La Quinta may not approve any plans which have not yet
been approved by the Association's Architectural Committee.
8. Owner shall pay a refundable security deposit and non-refundable administrative and/or variance
request fee to the Citrus Course Homeowners Association, as set forth in the Fee and Security Deposit
Schedule (Appendix I) to process this Architectural and Landscape Approval Request Form and the security
deposit as specified in the-4ssociation'sArchitectural & Landscaping Rules, Standards and Guidelines, the
terms of which qfe ncorpof"ated herein by this reference
Signatures:
of xAer t�� ' � Tom'^ Date
Owner Date
Neighbor Comments: (The comments of any owners of any home adjacent to the property lines of the
applicant's Improvement shall be required.)
I/We, the undersigned, have reviewed the plans and specifications for the above requested improvement and
I/we either: (1) do not object to this improvement; or (2) object with the following comments:
M:%GGDoc9HGA1GOVMCSW2C'86-130198•fl0ALrt8fin 32 RESTATED ARCHITECTURAL & LANDSCAPING RULES (M(M)
I
FRtGW.IWOAWVMC SWtC'98.130iiiD-MALaIM ` . 38 RESTATED ARCMIfOTURAI d IANDS01PiNG RULES (2/Zm3)
Show plumbing lines including sites <<,
Location of light junction'tioxes for all lights (both pool and spa)
Location of future lighting stubs with junction box locations ., -"i ,=
w
Location of p -trap (I required)
Elevations relative to surrounding area (use cross section, if necessary)
Location of fight switches
Location of all return fittings (specify type of fitting, eyeball, etc-)
Location of cleaner sub plumb, if any .
POOL AND DECK SPECIFICATIONS
Location of skimmer(s) (not to be located in raised bond biim) -
Location of deddng, specifying color and finish. Give square footage
- r
Specify. drainage in al affected arms °
Specify all masonry materials and firishes +
Specify brand, type and capacities of all pool equipment '
Show all steps In d"ng,
Indicate fooling in decking (if required)
Show pool depths
-
Show steps, ledges, angel seats, swim -outs
Location and height of rated bondbeam(e) .' •; '
SPA SPECWICATiONS °
Spa dimensions, including detall on dam walL Is it a deep end spa? ,
Spa step locations
Number of spa jets, location and heights
Bench heights -in spa
Spa airline location and termination, incWding air -blower and switch location �..
Nr bar .. ' /ti ;;! t
FRtGW.IWOAWVMC SWtC'98.130iiiD-MALaIM ` . 38 RESTATED ARCMIfOTURAI d IANDS01PiNG RULES (2/Zm3)
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FRtGW.IWOAWVMC SWtC'98.130iiiD-MALaIM ` . 38 RESTATED ARCMIfOTURAI d IANDS01PiNG RULES (2/Zm3)
(Lq8 in3q &4UI) ,cfnil 117, -c: i:!lrVrJ n.d:ntti, 'g+, 5n ritx7Saf,J !�
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,_mow...,... -.....•.._..,;,r.,.. .....•�,,......._---�_......�_............-.,._._.._.M
v '� ?`flLi°rfi i3ff i .1 lla�1�1 �a.s�, u1i' 'a In Liwk. ,
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Ey.:.1FCl.ljwJ.=t1l a-!AAlrtwlR-lPAG.tT.;:?A, at n'Ari.-LV;?.(Y_yUi,WTWjlwOiYOi f/5�7fV.��:l.•i!'.1
APPENDD( V. — OiECKLTST FOR POOL, SPA, WATER -MATURE, AND/OR DECK
INSTALLATIONS ;
KA000aeAHOAtG0VWCSIARC96-1396-U0AL r M 37 RESTATED ARCMTWTURAL 8 LANDSOWMG RULES MA")
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GENERAL DIFORMATION
Contractor's construction schedule f s
Location of Landscape which will be required to.be iemoved / replaced to allow access by
excavation equipment
Location of Hardscape (such as perimeter or lot line wall) which will be required to be removed
replaced to alow access by excavation equipment
l' .
GENERAL PLAN REQUIREMENTS -
Pool location and dimensions on plan, indudng setbacks and clearances to residence, existing
lot Ones, walls, building on scaled ste plan
North directional arrow _
Access arrow , • .
Width of access
Pool dimensions, Including radius points, width, length, etc..
Wall / Fence / Gate location, including type and height . �j (3 cL a
Location of all pool equipment, pursuant to city and county code, including screening material
and height
Indicate any existing obstructions, overhead lines, concrete walkways, patio, etc.
Indicate pool decking and/or hardscape features and extent
Indicate permanent barbecues, showing dimensional scaled plan, elevations, and materials/
colors, induding appliances
s ;
Indicate overflow line; if included
Indicate any easements on Property tiff
Owner sign -off on plans-
lans-Show
Showthe choice contract / plan .. • rr,
Overlay for landscape - • fu�
= ELECTRICAL /STUB LOCATIONS
Electric meter location. Type of panel:
Gas.rrieter location Ck':
Gas barbeque and/or fire -pt stub location
R
Hose bib location (fill ine). Must be unobstructed. L
KA000aeAHOAtG0VWCSIARC96-1396-U0AL r M 37 RESTATED ARCMTWTURAL 8 LANDSOWMG RULES MA")
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