BPOL2019-011878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Permit Type/Subtype:
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
T4tit 4 4.0 Qal#�
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT.
POOL/PRIVATE
BPOL2019-0118
54015 AVENIDA HERRERA
774213013
PEDERSEN / POOL COURTYARD
$16,000.00
Applicant:
KEITH GOODYER - KANCUN POOLS AND SPAS INC
80-554 WILLOW LN
INDIO, CA 92201
n as
V
JUN 10 2019
CITY OF LA QUINTA
DESIGN & DEVELOPMENT DEPARTMENT
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.: 987g7
Date: a ContractorI IF
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.).
(_) 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 Name -
Lender's Add
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 6/10/2019
Owner:
NANCY M. FLAKE
54015 AVENIDA HERRERA
LA QUINTA, CA 92253
Contractor:
KANCUN POOLS AND SPAS INC
80-554 WILLOW LN
INDIO, CA 92201
(760)567-7377
Llc. No.: 987978
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: EXEMPT 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 Inrovvi]islons.
Date: W '�' ! Applicant: C
WARNING: FAILURETO SECURE WORKERS' COMPENSATION COVE RA 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 entergon the
above -mentioned roperty for lnspeCtion purposes.
Date: O Signature (Applicant or Agent)-.
Date: 6/10/2019
Application Number:
BPOL2019-0118
Property Address:
54015 AVENIDA HERRERA
APN:
774213013
Application Description
PEDERSEN / POOL COURTYARD
Property Zoning:
Application Valuation:
$16,000.00
Applicant:
KEITH GOODYER - KANCUN POOLS AND SPAS INC
80-554 WILLOW LN
INDIO, CA 92201
Owner:
NANCY M. FLAKE
54015 AVENIDA HERRERA
LA QUINTA, CA 92253
Contractor:
KANCUN POOLS AND SPAS INC
80-554 WILLOW LN
INDIO, CA 92201
(760)567-7377
Llc. No.: 987978
Detail: POOL AT EAST COURTYARD [DENISE POELTLER ENGINEERING] WITH 40 LF OF CITY STANDARD CMU GARDEN WALL. THIS PERMIT DOES NOT INCLUDE
EQUIPMENT ENCLOSURE. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2016 CALIFORNIA BUILDING CODE.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$53.37
DESCRIPTION
ACCOUNT
CITY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$66.71
Total Paid for BLOCK WALL: $120.08
DESCRIPTION
ACCOUNT
CITY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA
101-0000-42404
0
$200.12
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SWIMMING POOL/SPA PC
101-0000-42600
0
$108.87
Total Paid for POOL / SPA: $308.99
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
TOTALS-44
Nancy M. Pederson
Gregory Pedersen
5310 Broadmoor Bluffs Drive
Colorado Springs, CO 80906-7920
June 5, 2019
City of La Quinta
Building and Safety
78495 Calle Tampico
La Quinta, CA 92253
To Whom It May Concern:
This letter is written to confirm that I am the deeded owner of the following property located in
the La Quinta Cove are of La Quinta:
54015 Calle Herrera
APN 774213013
La Quinta, CA 92253
The Title Deed was not updated with my surname when I got married. My husband Greg
Pedersen has all rights and title, to and in the operation, use and/or maintenance of this
property. The contract he entered into for the construction of a swimming pool with Kancun
Pools and Spas Inc. is valid, as they have the required permission to construct the pool per
contract. Please call with any questions.
Sincerely,
I
Nancy .Flake Pedersen
T: 804-652-9911
ta QaiKra
GEM nf,h, DESERT -
05
PERMIT # W2,C) • v r r
PLAN LOCATION:
Project Address: 54015 Avenida Herrera
Project Description: Pool, Remodel, Add't, Elect, Plumb, Mech
APN #: 774213013
Construction of a new swimming pool only, no spa,
New pool pump, filter, propane heater
Applicant Name: Greg Pedersen
Address: 54015 Avenida Herrera
City, ST, Zip: La Quinta, CA 92253
Telephone: 804-652-9911
Email:
Valuation of Project $ 16,000.00
Contractor Name: Kancun Pools and Spas Inc
New SFD Construction:
Address: 80554 Willow Lane
Conditioned Space SF
City, St, Zip Indio CA 92201
Garage SF
Telephone: 760-567-7377
Patio/Porch SF
Email:
Fire Sprinklers SF
State Lie: 987978 City Bus Lic:
Arch/Eng Name: The Flying Buttress
Construction Type: Occupancy:
Address:77725 Enfield Lane
Grading:
City, Sr, Zip Palm Desert CA 92211
Telephone: 760-772-4411
Bedrooms:
Stories:
# Units:
Email: drpfly@aol.com
State Lic: City Bus Lic:
Property Owner's Name: same as above
New Commercial / Tenant Improvements:
Address:
Total Building SF
City, ST, Zip
Construction Type: Occupancy:
Telephone:
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
-ro--7: TVV
;CA License 987978 C-53
f•
KAtN
P O O L S & 5 P A S _
NOTICE OF CANCELLATION
Not later than midnight I HEREBY CANCEL THIS TRANSACTION
Date
Client's Signature
Proof of Delivery of Notice of Cancellation completed by Client and sent to the Contractor ** via: `-
ly
❑ Telephone ❑ Fax ❑ Email ❑ First Class Mail, Certified Return Receipt Requested Q)
** Upon receipt, Contractor will send on acknowledgement to the Client
NOTES:
* We suggest contacting a residential electrician to confirm the existing electrical service is adequate for the
addition of a swimming pool pump
i. The proper hydration (curing) process takes a minimum of 28 days. The pool will be brushed and
vacuumed as needed during this first month at no additional charge; continued pool maintenance is
available. Once filled, the pool should not be entered for a minimum of on 10 days, and not heated for a
minimum of 28 days to avoid possible surface damage. Continued pool service and maintenance is
available after startup
2. No additional equipment, equipment repair or modifications are included unless specified Under 'General
Scope of Work' listed above
3. Because the propane service would have to be in the Owner's name, Kancun Pools is limited to making the
connection between a new tank and pool heater
WARRANTIES
* The plaster finish comes with a 5-year manufacturer's warranty against material failure
Q The pool work comes with a one-year warranty covered by Kancun Pools & Spas Inc
■ Automation (i.e. pumps, filters, heaters) come with a one-year manufacturer -supported warranty.
ACCEPTANCE:
Terms of this Contract have been read, understood, and are hereby accepted as indicated by signature below.
Each payment will be made as outlined in the Schedule of Payments as listed on page 3. You are permitted to
proceed with construction as outlined.
7�j
Client i na
�e
Kancun Pools and as Inc.
Page 7 of 7
a: 80-554 Willow Indio, CA 92201 p: 760-397-7699 e: kancunpools@gmail.com w: www.kancuninc.com
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P O O L 5 v 5 P A 5
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Existing slab
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13 ft.
15 in.
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License C-53 987978 1
P/L Existing wooden fence @ + 6'0"
y` _ LP tank
c
rs' °' 1 Y2" yellow poly
pipe with trace wire
PRIVATE RESIDENCE
HOUSE NOT TO SCALE!
54015 Avenida Herrera La Quinta, CA 92253
APN: 774213013
I
0
M
20 ift.
GARAGE
10 ft. 0 in.
21 ft. 4 in.
Construct block wall @
+4'0" built to match new
wall and painted to match
house
T
O
C
C
A
4 ft. 4 ft.
L
L
EXISTING DRIVEWAY E
L
NConstrict a 6" x 8" x 16" gray block L
wall, Painted to match house, with L
rolled concrete cap per City O
TOC stands d. 40 If total @ +5' 0" N
2016 California Building Code
( BASED ON 2015 IBC)
2016 California Mechanical Code
( BASED ON 2015 UMC )
2016 California Plumbing Code
( BASED ON 2014 NEC
2016 California Electrical Code
(BASED ON2014NEC)
2016 California Energy Efficiency Standards
PROVIDE LOCATION OF ANTI-ENTRAPMENT/VORTEX COVERS MEETING
CURRENT STANDARDS OF THE AMERICAN SOCIETY FOR TESTING AND
MATERIALS (ASTM) OR THE AMERICAN SOCIETY OF MECHANICAL ENGINEERS
(ASME). IDENTIFYA MINIMUM 3 FEET SEPARATION BETWEEN ALL DRAINS
AND NOTE HYDRAULICALLY BALANCED
NOTES:
1. ALL EQUIPMENT SHALL BE SEISMICALLY ANCHORED
2. ALL GFCI OUTLETS SHALL BE WEATHER RESISTENT
3. ALL OUTLETS SUPPLIED BY SINGLE-PHASE, 15A AND 20A, 125V OR 240V
BRANCH CIRCUITS FOR SWIMMING POOL PUMP MOTORS ARE REQUIRED TO
HAVE GFCI PROTECTION
4. PROVIDE 36" WORKING CLEARANCE FOR THE POOL EQUIPMENT MOTORS IS
REQUIRED
• INSTALLATION OF POOLSYSTEMS AND EQUIPMENT WILL
COMPLY WITH SECTION 114-MANDATORY REQUIREMENTS
• EXIT ALARMS TO BE INSTALLED ON ALL DOORS WITH DIRECT
ACCESS TO THE POOL
• SECONDARY BOUNDARY TO BE POOL GUARD WATER SENSOR
ALARM NSF CERTIFIED TO ASTM F 2208-08
• POOL HEATER, POOL EQUIPMENT SHALL BE INSTALLED PER
MANUFACTURER'S RECOMMENDATIONS AND IN ACCORDANCE
WITH LOCAL REGULATIONS
CITY OF LAQUINTA
BUILDING DIVISION
REVIEWED FOR
CODE
COMPLIANCE
DATE rjS/Zo I BY
[m
LH-40
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1 /8" = 1
AVENIDA HERRERA
' 0"