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BPOL2017-0128LICENSED 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 Professions Code, and my License is in full force and effect. License Class- C53 License No.: 614611 :Date- 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.). ( ) 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 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 Lender's WORKER'S COMPENSATmN 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 3700wf the Labor Code, for the performance of the work for which this permit is issued. ,- Dave 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 INSURANCE COMPANY Policy Number: WWC325615 I certify that in the performance of tie work for which this permit is issued, I shall not employ any person in any manner so zs to become subject to the workers' compensation laws of California, and agree tha-, if I should become subject to the workers' compensation provisions of Section 3:00 of the Labor Code, I shall forthwith comply with those provisions. Date: t Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applic4tion 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 I certify that Ihave read this application and stare 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 city to enter upo he above -mention d pr perty for inspection purposes. Date: Signature (Applicant ci Age TAti � Q" VOICE (760) 777-7125 78-495 CALLE TAMPICO D LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 8/16/2017 Application Number: BPOL2017-0128 Owner: Property Address: 53663 VIA DONA GEIS APN: 777420019 53663 VIA DONA Application Description: GEIB / REMODEL POOL SPA BBQ AND FIRE PIT LA QUINTA, CA 953 Property Zoning: i u Application Valuation: $50,000.00 Applicant: Contractor: MC INTYRE POOLS & SPAS INC MC INTYRE POOL_ &SPAS INCA - 83-695 AVENUE 45 83-695 AVENUE 45 o �. INDIO, CA 92201 INDIO, CA 92201 (760)342-3612 LIC. No.: 614611 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 Professions Code, and my License is in full force and effect. License Class- C53 License No.: 614611 :Date- 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.). ( ) 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 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 Lender's WORKER'S COMPENSATmN 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 3700wf the Labor Code, for the performance of the work for which this permit is issued. ,- Dave 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 INSURANCE COMPANY Policy Number: WWC325615 I certify that in the performance of tie work for which this permit is issued, I shall not employ any person in any manner so zs to become subject to the workers' compensation laws of California, and agree tha-, if I should become subject to the workers' compensation provisions of Section 3:00 of the Labor Code, I shall forthwith comply with those provisions. Date: t Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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 Building Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this applic4tion 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 I certify that Ihave read this application and stare 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 city to enter upo he above -mention d pr perty for inspection purposes. Date: Signature (Applicant ci Age Application..Number: BPOL2017-0128 Property Address: 53663 VIA DONA APN: 777420019 Application Description: GEIS / REMODEL POOL SPA BBQ AND FIRE PIT Property Zoning: Application Valuation: $50,000.00 Applicant: MC INTYRE POOLS & SPAS INC 83-695 AVENUE 45 INDIO, CA 92201 Owner: GEIB 53663 VIA DONA LA QUINTA, CA 9.253 Contractor: MC INTYRE POOLS & SPAS INC 83-695 AVENUE 45 INDIO, CA 92201 Date: 8/16/2017 (760)342-3612 Llc. No.: 614611 --------------------------------------------------------------------------------------------- Detail: REMODEL POOL WITH SPA, BBQ, AND FIRE PIT AT REAR YARD [JEFFEREY A. COLLINS ENGINEERING) THIS PERMIT [DOES NOT INCLUDE EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILCING CODE. DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $2.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 DESCRIPTION ACCOUNT QTY AMOUNT DEVICES, FIRST 20 101-0000-42403 0 $25.33 DESCRIPTION ACCOUNT QTY . AMOUNT DEVICES, FIRST 20 PC 101-0000-42600 0 $25.33 Total Paid for ELECTRICAL: $50.66 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.67 DESCRIPTION ACCOUNT QTY AMOUNT GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $25.33 Total Paid for PLUMBINGIFEES: $38.00 DESCRIPTION ACCOUNT QTY AMOUNT SWIMMING POOL/SPA 101-0000-42404 0 $190.00 DESCRIPTION ACCOUNT QTY AMOUNT SWIMMING POOL/SPA PC 101-0000-42600 0 $103.36 Total Paid for POOL / SPA: $293.36 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 1 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 0 Bin # # Stones: #.Units: Cit/ Of La Qu' inta . Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # t ect Address: Gr l� — Owner's Name: FAA.. Number:Address: 3 663Ual Description: Contractor. C -To t S Address: — 6q-5 City, ST, Zip:�(( 1/j S .. { S Telephone: Project Description: f-eymCly 1W SQa City, ST,.Zip: Q)c0. CI4 020 to 4 Telephone: 70V — . N a_ State Lic. # City Lic: # I S Arch., Engr., Designer .. . Address: City.; ST, Zip: Telephone: Construction Type: Occapancy: Title 24 Calcs. State Lic. #: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: ke e Sq. Ft.: # Stones: #.Units: Telephone # of Contact Person: U — S' Estimated Value of Project: ) V APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd. TRACIMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs.. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plait Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'" Review, ready for correctionstissue Electrical Subcontactor List Called Contact Person Plumbing: Grant Deed Plans.picked up S.M I. H.O.A. Approval Plans resubmitted Grading I14 -HOUSE". ''a Reyiew, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person .LP.P. Pub. Wks. Appr Date of permit issue Ifta" School Fees 2017 - _ • "wwi l Y DEVELO- PI July 31, 2017 Mr. and Mrs. Robert Geib 901 Jefferson Bensenville, IL 60106 RE: Lot 36D at 53.663 Via Dona Remodel: Plan review by Gerry Tarsitano (Golf Club) Dear Mr. and Mrs. Geib: This correspondence shall serve as notification that The Hideaway Design Review Committee (DRC) received additional review comments from Gerry Tarsitano on behalf of the Golf Club. The Club's comments regarding your most recent plan submittal are as follows: • No access to the rear yard can be provided on the golf course property • A construction fence will be required on the rear property line during construc-ion • All dirt and debris from the demolition and construction must be maintained within the property boundaries • No grade changes can extend past the rear Transition Area line • Any and all damage that may occur to the golf course that require repair will be reimbursed by the homeowner (including any grade changes, landscape restoration, or irrigation replacement) Please contact Brook Marshall at 760-219-8057 or by email at DRCFacilitator@g:-nail.com with any questions or to schedule your Pre -Construction Meeting once a Building Permit has bean obtained. Sincerely, THE HIDEA WA Y DESIGN RE VIE W COMMITTEE Title: cc: RGeib@geibind.com EE Peter Jacobs DRC File Date: Pursuant to Cal. Civil Code, any rejection by the DRC may be appealed to the Board of Directors for the Association_ If you wish to pursue an appeal, please contact the Association's property manager directly K* ei6 At st%4met - 663 u:a 0007, 2'Isa-A. CA RESI- EN -38, I OT ■ LJ !1