13-1083 (RPL)4 P.O. BOX 1504 �VOICE 760 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/29/13
Application Number: 13-00001083 Owner:
Property Address: 57927 INTERLACHEN DENNIS INGRAM
APN: 762-230-013- - - 57927 INTERLACHEN
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 39700
Contractor: >°
Applicant: Architect or Engineer: MCINTYRE POOLS & SPAS, INC D d
83695 AVENUE 45
/ I760) 2- 92201 #�„,%ta�'
(760) 342-3612 , AN iP 9
LiC. NO.: 614611 1
C11'1r 00 l.A cif
UCEN;
I hereby affirm under penalty of perjury that I am
Section 70001 of Division 3 of the Business and
License Class: C53 /
Dat., - Zq-f 3LContractor:
T, rOR'S DECLARATION
.SPT,/. r provisions of Chapter 9 (commencing with
a Code, and my License is in full force and effect.
cense No.: 614611
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of pe ury t/hal am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Bu iness �d Professions Code: Any city or county that requires a permit to .
construct, alter, improve, demolish or re it any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement th t h r she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commenci ith 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 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 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 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.).
( 1 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:
LQPERMTT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 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 WESCO INS CO Poligy NumbeJ WCA1843029
Icertify that, in the performance of
person in any manner so as to bi
and agree that, if I should becorr
_ 3700 of the Labor Code, I shall
_f
Date: __/ Applicant:
d
Itch this permit is issued, I shall not employ any
the workers' compensation laws of California,
workers' compensation provisions of Section
with those provisions.
WARNING: FAILURE TO SECURE ORKER COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI INAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 1$100,000). IN ADDIT ON TO HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR C DE, TEREST, 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 o/ee
o the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes nullk is not commenced
within 180 days from date of issuance of such permit, or ce
at
k for 180 days will subject
permit to cancellation. '
I certify that I have read this application and state that the above infor tI agree to comply with all
city and county ordinances and state laws relating to building cons on, onauthorize representatives
of this county to enter upon theabove-mentioned property for inspe n
Date: IF- Z / igna�(Applicant or Agent):
Application Number . . . . . 13-00001083
Permit . . . POOL 2013
Additional desc .
Permit Fee . . . . 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 2/25/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
----------------------------------------------------------------------------
178.75
Permit . . . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date 2/25/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
-
11.92
---------------------------------------------------------------------------
Special Notes and Comments
POOL, SPA (125 TOTAL L.F. OF 1 1/2 -GAS
LINE TO EQUPIPMENT & 1 INCH GAS LINE TO
STUB OUT FOR FUTURE BBQ]. EQUIPMENT
SHALL BE INSTALLED IN ACCORDANCE WITH
MANUFACTURER SPECIFICATIONS. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
-------------------------------_---------------------------------------------
Other Fees . . . . ... . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, POOL
97.24
Fee summary, Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Fee Total 190.67 .00 .00
190.67
Plan Check Total• .00 .00 .00
.00
Other Fee Total 98.24 .00 •.00
98.24
Grand Total 288.91 .00 .00
288.91
LQPERMIT l
If
Oty of La. Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico 406 -9 9,
Building Permit Application and Tracking '?013
Permit #
Project Address: 67 -
927 --Eigley-lochen
Owner'sName:
A. P. Number:
Address: 137- 927 Xvilerletchen
Legal Description:
0
0
City, ST, Zip:
Contractor: AC
1:�
ielephone:
Address:
4S
Project Description:
Arch., Engr., Designer:
Telephone:
Construction Type: Occupancy:
State Lie. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stoties:--Tf[Units:
Telephone # of Contact Person: (76 0
25-0 - 3-6 2 q
lEstimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
Plan Sets
Plan Check submitte
Item
Amount
Structural CaIcs.
Reviewed', read o corrections
Plan Check Deposit
Truss CaIcs.
Called ContaAeL..--1---1'
Plan Check Balance.
Title 24 CaIcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitt.ed
Mechanical
Grading plan
2"'. Review, ready for correctio
Electrical
Subcontactor List
C.alled Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.l.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
CITY Of- LA UL
I I IlIrk
r
BUILDING
'r-1
Total Permit Fees
J
August 8, 2013
Dennis Ingram
ho
PGA WEST II RESIODEN'. UL ASSOCIATION, INC.
v 39755 BERKE, Y DRIVE STE A
PALM DESERT, CA 92211
PHONE (760) 776-5100 • FAX (760) 776-5111
Reference; 57-927 Interlachen, Ca Quints, CA 92253
ArchiteLtural Change Request -- Pool/Spa, Pavers
Dear Dennis Ingram:
The Architectural Committee met on 'August 5, 2013 'and reviewed and approved your
architectural plans &Wtilto the following conditions being met.
• The contractor shall ensure the make-up water for the automatic water feed device be
tapped ahead of the main dwelling shutoff. Existing hose bibs cannot: be used for this
purpose.
0 A Covenant and Maintenance Agreement will be required, one will be 'sent to you for
proper execution as soon as it is prepared by counsel.
• Your contractor must meet with Bob Pantanella, Director of Community Services prior to
any work commencing on this project, Mr. Pantanella's phone number Is 760-5641032.
• All other PGA WEST II Residential Association Architectural Rules & Regulations slated
5/20/2013 pertain to this project
• 5 Foot setback from back of bond beam to property line Is required by the
association and is the responsibility of the .homeowner to verify property line.
The drawing provided does not depict the property line, a new drawing mast
be provided to the Association prior to any work commencing, showing the
property lines and proper setbacks with proposed Improvements.
• .
When you have decided on the contractor, they must sign all necessary forms and
,.t4,.provide them to the Association for approval prior to work commencing.
• Neighbor comment forms; filled out by the neighbors, are required prior to work
commencing on the property.
v/e`sr & he um e / on/ 9W-40_1 M"WOMM with the"tact W
Ru/09- It ie FbA 'M*�_ _e a. - -- _ _ - -- -
RLSO-the ow e ' fu s /bi/i ti_ & Vermy all ex/sti conditio Th
Co rr�r a®'s ac/slo With rqgarge d_eS1_qa WL11 b a, !�/case r to t
IL
AlMkiteotara/&das rpr al'/r+edukeef sUbmi[ta/s~
s c 0#aoC Wis Urnaqa. $ hine L@n4§_qM at 76U/346 3999 and Joanne Rose,
Association Manager at 760/776-5100 ext. 320 prior to any irrigation modifications associated
with this change. Damage to the landscaping, i.e._ shrugs, trees, -flowers and turf is the
responsibility of the contractor. The original landscaping must be brought back to its original
condition when the project is completed.
06/Z0 39dd . S -100d 3�]AINIOW ZE8EZVE09L 60:80 EZOZ/LZ/80
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