12-0544 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
A
1-2=-00000544
�79985`DOUBLE EAGLE WY
775-250=002- -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
20000
"`&t!t 4 4 Qumt
Architect or Engineer:
P% � k
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.
Licenn§e,oass: C53 License No.: 916827
�6{e: , � ntractor:
/ - BDECLARATION
I hereby affirm under penalty of perjury that I a21N�R-UILDER
t 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 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 _ 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.).
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/15/12
Owner:
SIMPSON JOHN DAVID
79985 DOUBLE EAGLE WAY
LA QUINTA, CA 92253
Contractor:
COMPETITIVE WEST POOL CONSTR a
PO BOX 5865
LA QUINTA, CA 92248 "
(760)625-2512
Lic. No.: 916827 MAY �� 212
CITY OF QUINTA
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.
JI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
7� Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier PRAETORIAN INS Policy Number 238140852011
_ 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
3700 of the Labor Code,.l shall forthwith comply with those provisions.
(Saw •a Ml— A cant:
WARNING: FAIL E TO SECURE WORKER OMPENSATION 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, 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. I agree to comply with all
city and county ordinances and ate laws relating to building construction, and hereby authorize representatives
of thi county to enter upon t above-mentioned property for inspection purposes.
to S Ia'�Sig tura (Applicant or Agent):
Application Number . . . . . 12-00000544
Permit BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 207.00 Plan Check Fee
134.55
Issue•Date . . Valuation . . .
. 20000
Expiration Date 11/11/12
Qty Unit Charge Per i
Extension
BASE FEE
45.00
18.00 _ 9.0000 THOU BLDG 2,001-25,000
----------------------------------------------------------------------------
162.00
Permit ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . . . 45.00 Plan Check Fee
11.25
Issue Date . . . . Valuation . . .
. 0,
Expiration Date 11/11/12
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
6.75
' Issue Date Valuation . . .
. 0
Expiration Date 11/11/12
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 6.0000 EA PLB FIXTURE
6.00
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
-------
REMODEL POOL: REMOVE DECKING, REPLACE
W.PAVERS. BUILD NEW SPA INSIDE EXISTING
SPA.. NEW PLUMBING, GAS, ELECTRIC.
ALARMS/BARRIERS SHALL BE IN PLACE AT
PRE -PLASTER INSPECTION. EQUIPMENT
ENCLOSURE NOT INCLUDED. 2010 CODES.
--------------------------7-------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
----------------- ---------- --------
Permit Fee Total 279.00 -.00 .00
279.00
LQPERMIT
1.
Application Number . . . . . 12-00000544
Plan Check Total 152.55 .00 .00 152.55
Other Fee Total 1.00 .00' .00 1.00
Grand Total 432.55 .00 .00 432.55
LQPERMIT
Bin #
City of La Quinn
Building a Safety D'nriaion
P.O. Boz 1504, 787495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #I `
n ,Gj4i i
1 d
Project Address: "] 9 - 9 5 DoU JEjjt4a Owner's Name: J p "A Si'M Plot
A. P. Number: Address: -79 - 9 aS Dodgfe EA(I le,
Legal Description: City, ST, Zip: 1A IU11 A CA °) a;LS3
Contractor: S oa �N Telephone:
Address: Po&o—)( 5865 Project Description: 94MOO eC U%A 14
City, ST, Zip: 44 CA- ?2Z W I 'FlAvees ice D IQ; Ve W
Telephone: 62 a5i Z_ *3V t I D New SPS i oS& o la 'SPA
State Lic. 10W 03 WAA m V 1 tJ + E 1 eC,' # A& 1
Arch., Engr., Designer: N
Address:
City, ST, Zip:
Telephone: Construction Type: R WO JQ Q Occupancy:
State Lic. #: Project type (circle one): -New Add'n Alter Repairmo
Name of Contact Person: C µJets Sq. FL:
# Stories:
#Units:
Telephone # of Contact Person Estimated Value of Project: a0,000
APPLICANT, DO NOT WRITE BELOW THIS UNE
#
Submittal
Req'd
Recd
TRACMG PERMff FEES
Plan Sets
!.J
Plan Check submitted It,. Amount
Structural Cafes.
I
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Energy 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.L
H.O.A. Approval
Plans resubmitted Grading
M HOUSE:-
'"' Review, ready for corrections/issue Developer Impact Fee
Planning Approval
Called Contact Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
J:.
PGA WEST II RESIDENTIAL ASSOCIATION, INC.
IV A_� k . .
39755 BERKEY DRIVE STE A
PALM DESERT, CA 92211
FTM PHONE (760) 776-5100 • FAX (7 0) 776-5111
April 18, 2012
Mr. John Simpson
79-985 Double Eagle
La Quinta, CA 92253
Reference: 79-985 Double Eagle, La Quinta, CA 92253
. Architectural Change Request — Remodel Pool & Spa, Patio Pavers
Dear John Simpson:
The Architectural Committee met on April 12, 2012 and reviewed and approved your architectural
plans with the following conditions being met.
• 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 760-564-1032.
• If at any time in the future pavers need to be removed due to irrigation line issues, it will
be your responsibility to remove and re -install the pavers.
• All other PGA WEST II Residential Association Architectural Rules & Regulations dated
8/1/07 pertain to this project.
Review by 'the Committee is on/y for general conformance w/th the Architectural
Ru/es It is the responsibility of the owner to fu//y understand and conform to the
Architectural Ru/es criteria whetlier or not a// defidencies are not ed during review. It
is also the owner's fu// resvonsibi/ity tv field verifjY a// existing conditions. The
Committee's derision with regard to gM ect design will be final. - Please refer to the
Architectural Ru/es for al/ reuuired submittals.
Please contact Luis Umana, Sunshine Landscape at 760/346-3999 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. shrubs, 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.
Approvals given by the Architectural Committee are good for only six months from the date
on the approval letter. If construction has not commenced within six months after the project
approval date, a new application must be submitted.
Upon completion of your project, please complete and return The Notice of Completion of
Architectural Change.
a
Page II, Simpson April 18, 2012
Architectural Approval Remodel Pool & Spa, Pavers
For additional information or questions, the Board has directed that you contact Joanne Rose,
CCAM, Association Manager, at 760/776-5100, Ext. 320.
Sincerely,
PGA WEST H Residential Association
Joanne Rose, CCAM Association Manager for
Architectural Committee
Cc: unit
Peters & Freedman