13-1407 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Tit!t 4
BUILDING & SAFETY DEPARTMENT v
BUILDING PERMIT
Application Number: 13-00001407
Property Address: 52645 AVENIDA OBREGON
APN: 773-284-019-6 -000000-
Application description: POOL RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 14000
Applicant: Architect or Engineer:
Yv
- - LICENSEDCONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I dam licensed unCer provisions of Chapter 9 (commencingwith
Section ZOOOhof.Division 3 of the Business'and Professionals Code, and myLicense is infulFforce and effect.
/ Cic se Class. 'C53 License Nord 946375
Date: Contractor:
OWNER -BUILDER. DECLARATION ,
,hereby affirm under, penalty.of perjury that I am exempt.from the Contractor's State License Law for the -
following reason -(Sec. 7031-.5, Businessland Professions Code: Any city or county that'requiies a permit to
construct,' alter, improve, demolish, orrepair any structure, prior to;its issuance;•also requires the applicant for -the
permit,to file a signed statement that he'.or,she is licensad pursuant to; the. provisions of'the Contractor's State '
License:Law (Chapter.9,(commencing.wht Section 7000)of Division 3 of therBusiness and P,rofi:ssions.Code) or
that he:bi she is exempt therefrom and the basis for. the alleged exemption.: Any violation of Section7031 .5 by .
any applicantfor' a'permitsubjects,the applicant to a civil penalty of more tan fve
f nohihund dollars (
dre5500)::
(_ 1 I, as owner of the property, y 6i memployees with wages as their sole compensation, will do the work, and
the structure isnot intended or offered for sale (Sec.7044;"Business and Professions Code: The
ContradtoWs 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'orher own employees, provided that the
Ji Iproverrmen;s 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 buidenof proving .that he.or she did not build or
- improve for, the, purpose of sale.l. - - -
. (_ 1 11 as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Sec.
7044, Business and'Pmfessions 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). icensed '
pursuant to the Contractors' State License Law).
(_) I am exempt under Sec. , BAP.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING',AGENCY
I hereby affirm under penalty of perjury that there is a construction lendingagency for the performance of the
work for which this permit•is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 11/05/13
Owner:
RW REAL ESTATE, INC.
P.O. BOX 447
LA QUINTA,1CA 92253
1 D
I'
Contractor: C
NOGUES , JULIO CESAR NOV 0 5 2013
46625 DESERT VILLA #1
INDIO; . CA 92201 CITY OF; LAQUINTA
(760) 397-7699 FINAibCEDEPT.
Lic. •No.: 946375
------------------
WORKER'S COMPENSATION DECLARATION
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 ofthe-work for which this permit is issued.'My-workers' compensation
insurance carrier and policy number are:
Carrier EXE PT' Policy.Number EXEMPT
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'tne workers' compensation provisions of Section
. / 3700, of, the bor; Code, I shall forthwith' comply with those provisions. '
.Date: - 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
.0
DOLLARS (5100,000). IN ADDITION-TO•THEOST 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 restrictionssetonthis application::. - -
1: Each person upon whose behalf this. application is made, each, person at whose request for
. whose benefit work is -performed under or. pursuant to an''y;permit.issued as a result of this application,
the owner, and the•applicant, each agrees.to, and shall`deferidy 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 1 have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances d state laws relating to building construction, and hereby authorize representatives
of this -county to enter u n the above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
Application Number . . . 13-00001407
- Permit. . . . POOL 2013
" Additional desc .
Permit Fee 178.75 Plan Check Fee
.00
Issue Date . . Valuation . . . .
0
Expiration Date 5/04/14
Qty- Unit Charge Per..
Extension
1.00 178.7500 EA MISC POOL/SPA
178.75
Specia. Notes "and Comments.
POOL; ' SPA .:[10 L. F. OFA -i: 1/_2 INCH'GAS
LINE]y -EQUIPMENT"SHALL'- BE' INSTALLED' IN `
ACCORDANCE,:WITH"MANUFACTURER"
r
'i SPECIFICATIONS "AliARMS AND'BARRIERS
REQUIRED .TO BE 'I•NSTALLED AT-,-PRET;LASTER
ORNIA UILDING
INSPECTION; 2010-CALIFB
_. ..
-
CODE '.
-- - - -- -.------------- - - - - ---- - - - - -- - - -- --- -- ----------------
Other'.Fees - : ... BLDG STpS_ ADMIN (S_hIA73)
1..00•
P ';CHE OOL �-
> LAN CK P
-• 9,7:.24
Fee summary :.Charged;: Paid Credited
Due
=-- ------------- ---------- ---- ---=-----"--
Permt Fee Total. 178.75 .00' 00 ..
--
17875 .
,,•
Plan, Check Total ..00:; .00:. .00
,..
00
Other Fee To6il .98..2.4 00' 00''
98 24
_ _
- Grand Total 276..'99` .00: 00 -
276.99
,.. .
- . LQPERMIT
Bin #
QC.I.,a...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: D
Owner's Name:
A. P. Number:
Address: V o -y-
Legal Description:
City, ST, Zip: U t 0,�Av- 2, '-l-7
Contractor: Ulrtelephone:
Address: 90569 Wk N)W n
Project Descr iption: EipL NNP S?/A
City, ST, Zip:
I hJ (0 Lft q2230-1
AvLic o* h PA5 L-4 &-)V—
Telephone: JQ M7
.. .... .. ....
....... ...
State Lic.#:C-53
City Lie. #-, J()
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
..:::: ..........
onstruction Type: Occupancy:
Project type (circle one):(, eD- Add'n Alter Repair Demo
State Lic. #:
k�.
Name of Contact Person: JV L-10 N(\n(VV
Sq. Ft.:#
z2o
Stories:
# Units:
Telephone # of Contact Person: 3C(^[ --7 6 q
Estimated Value of Project: V. (got)
APPLICANT: DO NOT. WRITE BELOW THIS LINE
Submittal'
Reqld
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural CaIcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance.
Tide 24 Cates.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
21 Review, ready for correctionslissue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE—
3d Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Ca lied Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
K M A
LA 0
1 1. 1
1Total Permit Fees
FOR CONSTRUCTION
DATE ____BY_&_1_
6 .
GARAGE
RAISED 6"
O
0DRIVEWAY
zm
20'
GAS LINE
DRIVEWAY
5' '
.D
O
O�
m
C �
CITY OF LA QUINTA�
BUILDING & SAFETY DEPT.
APPROVED
13' TO CURB BY OTHERS
FOR CONSTRUCTION
DATE%o (3BY
KANCUN
pool and spa construction
POOLS
TITLE
&
SPAS INC
LA QUINTA CALIFORNIA 92253
SIZE
CAGE CODE
DWG NO REV
------------INC
A4
------------------
SCALE
T
SHEET
AVENIDA STREET
r2�7SVCl� OGS'
CITY- OF LA QUINTA SUB-CONTRACTOR L T '
JOB ADDRESS
PERMIT NUMBER /3 `�y0%• OWNER /��K BIaILDERU�
�t�SA�C iU6� �c
This form shall be. posted on the Job with the Building
Inspection Card at all times in.a conspicuous place. Only persons appearing on this list or their employees are authorized to wi
on this job. Any-changes to this list must be approved by. the Building Division prior to commencement of work. Failure to comply will result:in a stoppage of work and/or the voidar
of building permit. For each applicable trade, all information requested below must be completed by applicant. "On File" is not an acceptable response.
..
Trade Classification"
Contractor ::::-:::.::::::>:
:::::>:>`'>??':':`:<':'S ate:.0 '
tors License :
Woikeis GampensaLon'•Insurahce::•:; ::. • ::::. '<::::..'
Gity.Business License:::::.
Company Name
Classification
License Number
Exp. Date
Carrier Name
Policy Number,
Exp. Date
License Number
Exp. Dai
(e.g. A. B, C-8)
(xxxxxx) .
(xx/xx/xx)
(e.g. State fund, CalComp),
(Format Varies)
(xx/xx/xx)
(xxxx)
(xx/xx/x
.9k
9
:EARTHWORK (C-12) :'...
C, o
C--53
'-1637 5
�_ . _�.� .
i z I
CONCRETE (C-8)
-
STRUCT STEEL (C 5])
—
U� r� 6cx S
_ _
C 53
7
_
Sal �
��--
2
� .i
•1 <'
MASONRY (C.29)
5
-�
26r
1030-) L
f , . Y
LAY
LATH, STER (C 35).—
-. ;•,.'
DRYWALL (C79)......
D`
ELECT
�.
C
9-6
7.
SHEET:METAL
ELOO4RING
INSULATION (C72)
SEWAGE.'DISP; �(G-..421' ' �•
p
PAINTING (C=33)
O
ERAMIC TILE. (C-54).
CABINETS (C-6) `
FENCING (C-13)
a
LANDSCAPING
o(7L (C-53)
w). �Io Lu.&-53
q�163�7" '
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10g2�1
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