14-0778 (RPL)f�'�ftrGv
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: 6/'10/14
Application Number:. 147.00000778- Owner:
Property Address: 80546 HERMITAGE MILLER DOUG & MARCIA
APN: 762-210-005- - - 5125 SWASHBUCKLER
Application description: POOL - RESIDENTIAL DECATUR, IL 62521
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 12000 I k1TWFYINANCEPEPT' Contractor: Applic :Architect or ngineer: VACATION POOLS INC
((//,I//��P.O. BOX 10940 INDIo, cA 9220201:
(760)775-0468
Lic. No.: 856835
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I a" ensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busin Pr fessionals Code, and my License is in full force and effect.
Licensee Class: C53 License No.: 856835
v., Date:rl/ �7�/'y Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt 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 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:
LQPERA1IT
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.
_ 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 STATE FUND Policy Number 1948584-2014
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 t become s jec the workers' compensation laws of California,
and agree that, if I sho be ome subje t e workers' compensation provisions of Section
700 of the Labor C e, I s all f rth h o ply with those provisions.
6-- � t -
Dat : �— -Applicant:'
WARNING: FAILURE TO SECU ORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,0001. 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, 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 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 sAthatthee info atio is correct. I agree to comply with all
city and county ordinances and state laws relons ctio and herebyauthorize representatives
th/iJ��countytoyenter upon the above -mention echo purposes.
Datb! �� / ` Signature (Applicant or A
L
I Application Number . . . . . 14-00000778
Permit . . . ELECTRICAL 2013
Additional desc STUB ONLY
Permit Fee . . . . 23.83 Plan Check Fee
.00
Issue Date Valuation . . .
. 0
Expiration pate 12/07/14
Qty Unit Charge Per
Extension
1.00 23.8300 LS ELEC DEVICES, FIRST 20
----------------------------------------------------------------------------
23.83
Permit POOL 2013
Additional desc .
Permit Fee . . . . 178.75 Plan Check Fee
.00
Issue Date . . . . Valuation . . .
. 0
Expiration Date . . 12/07/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
--------------------------------------- ------------------------------------
178.75.
Permit . . . PLUMBING 2013
Additional desc STUB ONLY
Permit Fee . . . . 11.92 Plan Check Fee
.00
Issue Date . . . . Valuation
0
Expiration Date . . 12/07/14
Qty *Unit Charge Per
Extension.
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS
11.92
----------------------------------------------------------------------------
Special Notes and Comments.
SPA ADDITION AT EXISTING POOL AT REAR
YARD INCLUDING ELECTRICAL AND GAS FOR
FUTURE BBQ ISLAND [POOL ENGINEERING INC]
THIS PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. ALARMS AND BARRIERS REQUIRED
TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2013 CALIFORNIA BUILDING
CODE.
June 9, 2014 10:50:47 AM AORTEGA
w
------------------------------
Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
1.00
PLAN CHECK, ELECTRICAL
23.83
PLAN CHECK, POOL
97.24
PLAN CHECK, PLUMBING
23.83
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
LQPERMIT
Application Number . . . . .
Permit Fee Total 214.50
Plan Check Total .00
Other Fee Total 145.90
Grand Total 360.40
LQPERMIT
14-00000778
.00 .00 214.50
.00 .00 .00
.00 .00 145.90
.00 .00 360.40
VACATION POOLS, INC.
P.O. Box 10940
-� Indio, CA 92202
Ph. (760) 775-0468, Fax(760) 775-0469
License # C-53-856835
Aso
Ammsmwo
Ammmiiiiilmap
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CITY OTr-LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE!P1%1111114 BY -Aa_ I
SPA-" 1W "40 VW%,S
Mew Pavers
(90 SOL. ft.)
Stub Gas and Electric
for future Outdoor
Cooking Center.
NOTE:
Landscape elements (Trees,
Shrubs, Vines and Lawn) and Patio
Furniture shown for illustration only.
Unless by separate bid.
CONTRACTOR cannot assume responsibility
for damage to curbs, sidewalks, driveways,
cement slabs, sewers, lawns, trees, fences,
retaining walls, Sprinklers, wires, valves,
telephone or shrubs.
When access is made through a neighbor's
property it is understood that you, the
owner, have that neighbor's permission and
assume full responsibility.
DATE 516N
Q
MILLAR RE5I0ENGE
80-546 HERMITAGE
LA QUINTA, GA Q2255
DATE: 05.05.14 REVI5ED:
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico .
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: r7 b e"All
Owner's Name: 4�
A. P. Number:
Address: ?Q 7-4
Legal Description:
City, ST, Zip:
Contractor: CiQ��GlL �
Telephone:
Address:
Project Description:
City, ST, Zip: /U&
Telephone: 7 G —775`04/0
'':<:•>'::<;;a> asst;>;,:.:> :>;:
State Lic. # :
City Lic.:#.
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:
`'rlr:>':'::i%i'ffiii�L��i•�:�i.
>
Construction Type: Occupancy:
Repairau Demo
roJect type circle one): New Add'n Alter
Name of Contact Person:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project: 0 0 V
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES.
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
'Plan Check Deposit
Truss Cala.
Called Contact Person
Plan Check Balance.
Title 24 Cales.
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 Decd
Plans picked up
S.M.I.
H.O.A. Approval
l
Plans resubmitted
Grading
IN IIOUSE:-
'rd Review, ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
PGA WEST.
FAIRWAYS ASSOCIATION
June 4, 2014
Doug and Marcia Millar
5125 Swashbuckler Lane
Decatur, IL 62521
Re: Architectural Application — 80546 Hermitage
Dear Homeowner:
The Architectural Committee has reviewed your request for the installation of a new spa and pavers in the
rear yard of your residence. I am pleased to inform you that the Architectural Committee has approved
the application as submitted.
Please note approval of architectural change plans by the Architectural Review Committee does not
include any right of access by Owner's contractor or subcontractor through golf course property.
To request permission to access Owner's Lot through golf course property the Owner must contact
golf course management at PGA WEST at 760-564-7111, to obtain the proper documentation
including a temporary access license permit. Access without written permission could be deemed
criminal trespass.
If you have any questions, please contact Cassie Gertz at 760-776-5100 Ext. 6345 or email
Cassie.GeqZ@hLannemenffmst.com.
Sincerely,
For the Architectural Committee
PGA WEST Fairways Association
poc�iati
nald, CCAM, PCAM
Manager
Architectural Committee
The Club at PGA WEST
Post Office Box 1690 • La Quinta, California 92247 • Phone (760) 776-5100 • Fax (760) 776-5111 • www.pgawestfairways.com