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BPOL2015-024878-495, CALLEJAMPICO Twit 4edfv Q" VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 12/1/2015 Application Number: SPOL2015-0248 1111111 IIIII IIII IIII Owner: Property Address: 81646 RICOCHET WAY 51 MCGOWEN JEFF & VICKI APN: 767630023 81646 RICHOCHET WAY Application Description: MCGOWEN/POOL AND SPA AT REARYARD LA QUINTA, CA 92253 Property Zoning: Application Valuation: $20,000.00 Applicant: MCGOWEN JEFF & VICKI "; i j� �b� - "� M ply iih Contractor: JEFF M'C GOWAN CONCRETE 81646 RICHOCHET WAY j a , i�:j 78905 MORNING STAR WAY LA QUINTA, CA 92253 "` " ; LA QUINTA, CA 92253 0 I' (760)200-5138 Llc. No.. 772649 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: C-8 License No.: 772649 i Date: I L 1 1 1 Contractor OWNER -BUILDER 6ECLARATION 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).: ( 11, 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.). ( 11, 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 Na Lender's 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' comp sation, as provided for by Section 3700 of the Labor Code, for the performance of tht Pork for which this permit is issued. &116hoave and will maintain workers' compensation insurance, as required by Secfthe Labor Code, for the performance of the work for which this permit is is workers' compensation insurance carrier and policy number are: Carrier: _ Policy 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: ; �/ / J Applicant: 4A4A (tL= WARNING: FAILURE TO SECURE WORKERS' O P SATION 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. /) /i /J Date: �� Signature (Applicant or Agent G a / � • a 0 .. A X '; Y s � a .�. zty, •. AY iF 5,�.7',,y3' `�€ _ xa&"2"4fD6SCRRIP�ION ` s �4TY� 'PAID z� . .. `. AV „ AMOUNT PAIDsDAEr BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/1/15 �+��'�'`"C^ ��C � n `kPAID BYs A byy METFOD ' a� . �i: �r �� �"d.�"�"Y RECEIPT #: ' CHEEK # ��GLTD BY j, .- _. .�i, . ,`.' - .. fid`` MCGOWEN JEFF ,& VICKI DEBIT, R11199 SGU Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $1.00 }'* :• t k'$"` F - 5?•l,. M' ry DESGRIPTION�. CCOUNT�$ r"+S" v;.?- �QN�i,` F^ FAIU r""f'i"fs; `s -" ,� 1t. - %0j W, :; , P?pID,DATE WALL/FENCE - FIRST 100 LF 301-0000-42404 0 .$47.86_ . $47.86 12/1/15 „ " ',; x PAID."BYE,:' t 4v METHOD ,- RECEIPT#. ,, �`Sx. jiffCHECK<LTDBY :or a...:�_" �� 4 K ;, MCGOWEN JEFF & VICKI DEBIT R11199 SGU 3 r a5 AMOUNT.h', x PAID„ A. I.:�DAfiE a.DESCRIPTION: µ...:...AC�N�s qT� , ., WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91. $60.91 12/1/15 o- ',� a > .,rvF �� .�,- ,�3, .mss + �� "i •? � "} P��` � Y � � M. .. ' Sk` C1i CK # Guppy . � r, v • 110000:632=i ' MCGOWEN JEFF & VICKI DEBIT R11199 SGU Total Paid for FENCE OR FREESTANDING WALL: $108.77 $108.77 uu`f)ESCRIPTION x ' ACCOUNT AMO (fix AID 1 DAT �T.:. .�.. rPAID SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 12/1/15 �;PAYID BY y � MET ODS R EIPTs# jw C EEK # ITA BY :, asa..a vx" F 'MCGOWEN JEFF & VICKI DEBIT R11199 SGU `.v DESCRY TIONx�CCO NT�� �QT �. � f. AMOUNT: p'4'.�. F4r � AID P }, SWIMMING POOL/SPA PC 101-0000-42600 0 $98.62 $98:62 12/1/15 `' "y pC 3z PAIf)•BYr�� KS:,.x�� X 3 METHOD. t �v...,�". 3 ik r RECEIPTWA x s °cs CMECK`�w� r CLTD BY MCGOWEN JEFF & VICKI DEBIT R11199 SGU Total Paid for POOL / SPA:: $279.91. $279.91 • Description: MCGOWEN/POOL AND SPA AT REARYARD Type: POOL Subtype: Status: APPROVED Applied: 11/30/2015 MFA Approved: 12/1/2015 LUR Parcel No: 767630023 Site Address: 81646 RICOCHET WAY LA QUINTA,CA 92253 Subdivision: TR 31202-1 Block: Lot: 23 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $20,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 ACTION DATE Details: POOL AND SPA AT REAR YARD [DENISE POELTLER ENGINEERING] THIS PERMIT DOES INCLUDE 6 LF OF EQUIPMENT ENCLOSURE WALL. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2013 CALIFORNIA BUILDING CODE. Printed: Tuesday, December 01, 2015 3:31:35 PM 1 of 2 RA.J Lam/ SYS TEIviS ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES TELEPHONE CALL LUIS URIBE 12/1/2015 12/1/2015 SPOKE WITH JEFF, PERMIT IS APPROVED AND READY TO BE ISSUED. CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT MCGOWEN JEFF & VICKI 81646 RICHOCHET WAY LA QUINTA CA 92253 (442)300-2867 CONTRACTOR JEFF MC GOWAN CONCRETE 78905 MORNING STAR WAY LA QUINTA CA 92253 (442)300-2867 OWNER MCGOWEN JEFF & VICKI 81646 RICHOCHET WAY LA QUINTA CA 92253 (442)300-2867 Printed: Tuesday, December 01, 2015 3:31:35 PM 1 of 2 RA.J Lam/ SYS TEIviS Printed: Tuesday, December 01, 2015 3:31:35 PM 2 of 2 c SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BYCLTD s BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 12/1/15 R11199 DEBIT MCGOWEN JEFF & SGU VICKI Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $47.86 12/1/15 R11199 DEBIT MCGOWEN JEFF & SGU 100 LF VICKI WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $60.91 12/1/15 R11199 DEBIT MCGOWEN JEFF & SGU 100 LF PC VICKI Total Paid for FENCE OR FREESTANDING WALL: $108.77 $108.77 SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 12/1/15 R11199 DEBIT MCGOWENJEFF & SGU VICKI CK SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $98.62 12/1/15 R11199 DEBIT MCGOWEN JEFF & SGU PC CK VICKI Total Paid for POOL / SPA: $279.91 $279.91 TOTALS: Printed: Tuesday, December 01, 2015 3:31:35 PM 2 of 2 c SYSTEMS Bin # ..City of La Q uin to Building 8i- Safety Division 78-49.5 Caffe Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # �p�� ��W" Project Address: �ij I C �'' Owner's Name: e i„�/ �/�% 7. A. P. Number: Address: g16 q Legal Description: City, ST, Zip�: R- U 111j - - - A 22 53 r. C � Z — moZ �'rContract Telephone: ............:....:................:......:::: Address: (0 L� (02i G w Project Description: City, ST, Zip: ft t A NA A 6,ol l q22 3 -� 14 '1 Q k3 &c, IL le h c Telephone: ne• W P ( Q Z" Z 7 State Lic. # : 77Z (PY if City Lic.:#. Arch., Engr., Designer: Address: City, ST, Zip: Telephone: ancY Occupancy: :Con tr uction Type: i U State teLic. #: Project type (circle one N dd'n Alter Repair Demoo Name of Contact Person: [—. F� I�� O LAJ i-\ N Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: 7b Q _ q Q —2-0 f b' Estimated Value of Project: 2- O p p Q APPLICANT: DO NOT WRITE BELOW THIS LINE H Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Deposit Truss Cafes. Called Contact Person Plan Check Balance Title 24 Cafes. 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.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE-.- 'r0. 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 Rancho Santana HOMEOWNERS ASSOCIATION ARCHITECTURAL REQUEST FORM AND AGREEMENT DATE: ! i �Oto� i6 OWNER'S NAME::e.R-e Mcl owa+i RANCHO SANTANA ADDRESS:I-I PHONE: '"I� L: 300-2 V1 EMAIL: MGC.�OLI�QYi�AYiL:r of�� BRIEF DESCRIPTION OF CHANGE: .we, wt 11 do 0corex-/13W Ocr- - 4t4Z-0a0-2i3fk7 Please attach a detailed drawing or blueprint of your plans) and samples of any/all materials being used. Approval is requested for the above improvement according to the plans attached. The Association will act on this request and provide written response of decision within 45 days of submission of this request to the Management office. 1 further understand and agree to the following: 1. No work will be commenced in regards to this project until I have received written approval from the Association. 2. All work will be done at my expense; all future upkeep will remain my expense; expeditiously once commenced and will be done in a good workman -like manner by a licensed and insured contractor. 3. All work will be performed in a timely manner to minimize interference and inconvenlence to other homeowners. 4. 1 assume all liability for all costs associated with this request and for costs associated with any repair to the common area occurring as a result of implementing this improvement. S. I will be responsible for the conduct of all persons, agents, contractors and employees who are connected with this work. 6. 1 acknowledge that Building Permits for home improvements may be required by the City of La Quinta for the requested change. The cost of permits and responsibility for obtaining them shall be my responsibility. 7. I acknowledge that a decision by the committee is not final and that the Board of Directors may reverse or modify a decision upon the written appeal of any owner made to the Board of Directors. 8. 1 acknowledge that the Association may require a deposit to be submitted with this application if the following changes are being requested: Pool/Spa, Room Addition/Enclosure, Detached Structure/Casita $1000 (refundable deposit) • Landscaping/major renovation, Patio Decking/Extension $500 (refundable deposit) I HAVEAND AGREE TO ARCHITECTURAL REQUEST AGREEMENT AS STATED ABOVE Owner Signature: G Date: 11161012016 FOR OFFICE USE ONLY. This application was proved (] Disapproved ❑ Conditionally Approved by the Committee on Notes: Zn -71 seep -Top" r.� BUILDING & SAFETY DEPT APPROVED FOR CONSTRUCTION 111 ATE.fl//­`b"3 By (D . . ......... ..... ...... iZ Zn -71 seep -Top" r.� BUILDING & SAFETY DEPT APPROVED FOR CONSTRUCTION 111 ATE.fl//­`b"3 By (D . . ......... ..... ......