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BPOL2016-0003LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C53 License No.: 916827 Date: �_`���K� 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).: . ( ) 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 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 (760)625-2512 Llc. No.: 916827 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 �t=ekorwhich this permit is issued. ave and will maintain workers' compensation insurance, as required.by Se 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: _ Polity Number: 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, I shall forthwith comply with those provisions. Date: Applicant: c 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 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 state 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 upon the above-mentioned property for inspection purposes. c -- Date: Signature (Applicant or Agent): � III'lllll'llllll,llll ,, C� 17 VOICE (760) 777-7125) A-495 CALLE TAMPICO V FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/11/2016. Application Number: BPOL2016-0003 Owner: Property Address: 55290 CHERRY HILLS DONALD JEANS APN: Description: 775170030 JEANS /POOL SPA FIRE PIT BBQAND COURTYARD WATER FEATURE 2300 DOBBINS LNApplication IRVING, TX 92253 FN!�E�rlo. Property Zoning: Application Valuation: $33,000.00Applicant: Contractor:COMPETITIVE WEST POOL CONSTRUCTION COMPETITIVE WEST POOL CONSTR I P O BOX 5865 P O BOX 5865 rn LA QUINTA, CA 92248 LA QUINTA, CA 92248 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my License is in full force and effect. License Class: C53 License No.: 916827 Date: �_`���K� 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).: . ( ) 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 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 (760)625-2512 Llc. No.: 916827 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 �t=ekorwhich this permit is issued. ave and will maintain workers' compensation insurance, as required.by Se 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: _ Polity Number: 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, I shall forthwith comply with those provisions. Date: Applicant: c 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 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 state 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 upon the above-mentioned property for inspection purposes. c -- Date: Signature (Applicant or Agent): FINANCIAL • a 'DESCRIPTION :ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $2.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00 $0.00 ' DESCRIPTION ACCOUNT QTY AMOUNT= PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 1-4 OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $36.26 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA 101-0000-42404. 0 $181.29 $0.00 PA16 BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA PC 101-0000-42600' 0 $98.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER FEATURE 101-0000-42404 0 $181.29 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY- AMOUNT PAID PAID DATE WATER FEATURE PC 101-0000-42600 0 $98.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for POOL / SPA: $559.82 $0.00 TOTALS: $646.42 $0.00 Description: JEANS / POOL SPA FIRE PIT BBQ AND COURTYARD WATER FEATURE Type: POOL Subtype: Status: UNDER REVIEW Applied: 1/8/2016 SKH Approved: Parcel No: 775170030 Site Address: 55290 CHERRY HILLS LA QUINTA,CA 92253 Subdivision: TR 25397 Block: Lot: 30 Issued: Lot Sq Ft:.O Building Sq Ft: 0 Zoning: Finaled: Valuation: $33,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 NAME TYPE Details: POOL, SPA, FIRE PIT, BBQ AND COURTYARD WATER FEATURE. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. CHRONOLOGY CONDITIONS CONTACTS NAME TYPE NAME ADDRESS1 CITY STATE ZIP PHONE FAX EMAIL APPLICANT COMPETITIVE WEST POOL CONSTRUCTION P 0 BOX 5865 LA QUINTA CA 92248 CHRIS@COMPETITIVE WESTPOOLS.COM CONTRACTOR COMPETITIVE WEST POOL CONSTRUCTION P 0 BOX 5865 LA QUINTA CA 92248 CHRIS@COMPETITIVE WESTPOOLS.COM OWNER DONALD JEANS 2300 DOBBINS LN IRVING TX 92253 Printed: Monday, January 11, 2016 9:20:06 AM 1 of 3CRNAJF SYSTEMS Permit Details PERMIT NUMBER City of La Quints BPOL'P201�6!0BC13 INSPECTIONS PARENT PROJECTS BOND INFORMATION Printed: Monday, January 11, 2016 9:20:06 AM 2 of 3 J - SYSTfnAS CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT•# - CHECK # METHOD PAID BY BY BW SB1473 FEE 101-0000-20306 0 $2.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $2.00 $0.00 BSA: DEVICES, FIRST 20 101-0000-42403 0 $24.17 $0.00 DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 Total Paid for ELECTRICAL: $48.34 $0.00 GAS SYSTEM, 1-4 101-0000-42401 0 $12.09 $0.00 OUTLETS GAS SYSTEM, 1-4 101-0000-42600 0 $24.17 $0.00 OUTLETS PC - Total Paid for PLUMBING FEES: $36.26 $0.00 SWIMMING POOL/SPA 101-0000-42404 .0 $181.29 $0.00 SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $0.00 PC. WATER FEATURE •101-0000-42404 0 $181.29 $0.00 WATER FEATURE PC 101-0000-42600 0 $98.62 $0.00 Total Paid for POOL / SPA: $559.82 $0.00 TOTALS:.4. • 00 INSPECTIONS PARENT PROJECTS BOND INFORMATION Printed: Monday, January 11, 2016 9:20:06 AM 2 of 3 J - SYSTfnAS ATTACHMENTS Printed: Monday, January 11, 2016 9:20:06 AM 3 of 3 fl srsrcMs Bin # City o.f La Quinn Building U Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # 1�j yrj�'� pj 10 Project Address: 5S 2`(01 L,L Owner's Name: A. P. Number: Address: Z O �-�l U-1 Legal Description: City, ST, Zip: J nu Contractor: _ J/ Telephone: Address: PO S0)( 5965 Project Description: City, ST, Zip: CA, 92-L pr(L - � - JI% Ties Telephone: 625-- asr z - State Lic. # :%(rJ�p��- City Lic.#: joyyO3j Arch., Engr., Designer: Address: City, ST, Zip: Telephone: Construction.TyOccupancy: Project type (circle one -New Add'n Alter Repair Demo State Lic. #: Name of Contact Person: C 14)z — Sq. Ft.: #`Stories:' `# Units: Telephone # of Contact Person _S -] Estimated Value of Project: u APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACE NG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. 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 Znd Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. 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 Total Permit Fees r PGA WEST. RESIDENTIAL ASSOCIATION, INC. February9, 2015 41tvv" tin , Mr. Donald Jeans 2300 Dobbins Lane�'� , 1(d d54q Irving, TX 75063rqogr Re: Custom Home to be built Dear Mr. Jeans, - Page 1 f2 Ef M4, 6wrnit&—, The Architectural Committee has reviewed your final submittal of drawings plan checked and approved by the City of La Quinta. The proposed custom home and related site development is as shown on submittals inclusive of a color board and drawings submitted by Andrzej W. Weber Architect. Sheets: Title Sheet & Sheet 2 dated 6/18/14; G1 & G2 dated 6/16/14; 3, 4, 5, 6, 6-1, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 & T-24 dated 10/31/14; GN, GD, S-1, S-2, SD -1, SD -2 & SD -3 dated 6/9/14; HFX1 & HFX2 dated 11/1/13; G1 & G2 dated 10/10/14; A-1 & A-2 dated 1/25/15. The project is acceptable in accordance with the Architectural Guidelines and the Association's CC&R's. The following comments and/or requirements are pertinent to the execution of this project: 1. Provide the HOA with a copy of the city permits for pool/spa, site walls, and street work. 2. The review of the mailbox is based on design shown on elevation. 3. Contact the HOA prior to starting the foundation to verify setbacks. 4. The HOA recommends a chain link fence with windscreen to prevent loose debris and materials from blowing into street and lake. 5. The homeowner and contractor should review the Custom Home Guidelines in reference to the various schedules, milestones and inspection requirements. 6. The project time period is 9 months. 7. The -Association is not. responsible- for locating easements and underground utilities on the site. The lake transfer pipe easement is to be marked and, if necessary, protected. 8. The contractor and homeowner must make provisions throughout the project for traffic control to prevent traffic disruption and accidents. The construction employee parking and vehicles must park on one side of the street. 9. The contractor is not allowed to stockpile any material, equipment or construction debris in the street. All debris must be cleaned up daily. 10. The owner and contractor must maintain a dust free construction site to avoid a project stop notice. If the vacant adjacent lot is used, a letter from the lot owner must be provided. Any encroachment onto the adjacent is to be repaired. Watering the lot for dust may also require rock transition areas at curb. Dirt on street should be broom cleaned before washing. Page 2 of 2 11. The street gutters cannot be used for concrete wash out and the contractor is responsible for keeping the gutter clear and free of debris. 12. All exterior house and yard lighting is to be compatible with the nightscape and not cause problems for the adjacent neighbors and is subject to review after installation. 13. The HOA will, with the homeowners' permission, excavate the west section of lake transfer pipe and cover with concrete for protection. Utility contractor's excavation in vicinity of pipe within or outside the easement, including the street, to be careful and notified. 14. The pool. landscape. irrigation. yard lighting and paver/hardscape are pending a submittal and review. 15. Before ANY excavation occurs it is mandatory that the contractor and/or the owner meet with Bill Bobbitt. Landscape Manager and Steve Herthel. Architectural Committee Chair, as well as contact Dig Alert and locate all underground utilities. 16. All setbacks, height limitations, equipment and new utility locations are to be per city and HOA requirements. -- 17. Submittals of details and finishes of the site walls, paved system and pool/spa are pending review. 18. Upon completion of the project, the homeowner is required to provide a signed copy of the city inspection card and the Contractor Certification letter (enclosed). 19. ALL insurance certificates must be current and inclusive of all Association requirements. The certificate must state that the Association is named as Additionally Insured and is Certificate Holder. Additionally, the certificate that we have does not include Auto Coverage and states that the liability policy expires March 25, 2015. Please provide proof of auto insurance. We reserve the right to make a final inspection of this change to make sure that it matches the original request. An approval is based only on the aesthetics of your proposed plan and should not be taken as any certification as to the construction worthiness or structural integrity of the proposed change. We appreciate your cooperation in submitting this request for approval. If I may be of further assistance, please contact me at the HOA office, (760) 771-1234, Extension 19. Cordially, Kelly McGalliard Operations Manager For the Architectural Committee KM/bvf Enc. 1 Cc: Architectural Committee I ■ � a H 3 V 3 8 3 1 8 8 3 d o r g � a I PROPERTY LINE a � • iwwV+ T -U 10 ^� NII II 11 II icArno p - >m 61!000 m n o D y=Z i 01,N JEANS RESIDENCE CA -C-53 # 916827 COMPET/T/VE .55-290 CHERRY HILLS 78-150 CAVE TAMPICO SUITE 101 LA QUINTA LA QUINTA. CA 92253 YY EST 760.6252512 POOLS 1 a ATMIU0 AJ 10 YT13 JnBG YMAZ S ®HRMS C13VO 99A i�tOlT��dRT2� ��