BPOL2014-112878-495 CALLETAiviPIC
LA QUINTA, CALIFORN
4
COMMUNITY, DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number: •.
BPOL2014-1128
Property Address;
55269 RIVIERA
APN:
775153010
Application Description:
POOL REMODEL
Property Zoning:
compensation, as provided for by Section 3700 of the Labor Code, for the performance
Application Valuation:
$15,000.00
Applicant:
RCI
OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
VOICE (760)777-7125
FAX (760).777-7011
INSPECTIONS (760) 777-7153
Date: 12/12/2014
Owner:
r ALEXIS REAL ESTATE HOLDINGS LL
55269 RIVIERA
LA QUINTA, CA 92253
u OEC 1-,'2014 ly
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
Contractor:
RCI
OUTSIDE CITY LIMITS'
LA QUINTA,.CA 92253
(760)323-2220.'
Llc. No.: :LIC -0160979
4 .------------------------------------------ ---
--------.--------------------------------------
LICENSED CONTRACTOR'S DECLARATION
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisi ns apter
I hereby affirm under penalty of perjury one of the following declarations:
'9 (commencing with Section 7000) of Division 3 of the Business and Prof sio C de,
I have and will maintain a certificate of.consent to self -insure for workers'
and my License is in full force and effect.
compensation, as provided for by Section 3700 of the Labor Code, for the performance
License Class: L' ens No.::LIC:010 79
of the work for which this permit is issued.
I have and will maintain workers"compensation insurance, as required by
Xa t -Jate: Z 1 ontractor:
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:
OWNER -B UILDER.DECLARAT
Carrier: \_I Policy Number: _.
I hereby.affirm under penalty of perjury that I am exempt from the Contractor's State
I certify thaf in the perform ce of the work for whic thi rmit is issued, I.
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
shall not employ any person in any nne o to become su j&t t workers'
city or county that requires a permit to construct, alter, improve; demolish,.or repair
compensation laws of California, and agree t , I should be e s 'e to the
• any structure, prior to its issuance, also requires the applicant for the permit to file a
workers' compensation provisions of ection 3 f the bor de, I al forthwith
signed statement that he or she is licensed pursuant to the provisions of the
comply with those provisi ns.
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
ate] Applicant:
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fo
i
permit subjects the applicant to a -civil penalty of not more than five hundred dollars
WARNING: FAILURE TO SECURE -WORKERS' COMPE TION COVERAGE 1 UNLAWFUL,
($500).:
AND SHALL SUBJECT.AN EMPLOYER TO CRIMINAL PE TIES.AND CIVIL FINES UP TO
(� I, as owner of the property, or my employees with wages as their sole
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN A EDITION TO THE COST OF
compensation, will do the work, and the structure is not intended or offered for sale..
COMPENSATION, DAMAGES AS PROVIDED.FOR IN SECTION 3706 OF THE LABOR CODE,
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
INTEREST, AND ATTORNEY'S FEES.
".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
APPLICANT ACKNOWLEDGEMENT
are not intended or offered for sale. If, however, the building or improvement is sold
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
within one year of completion, the owner -builder will have.the burden of proving that
the conditions and restrictions set forth on this application.
he or she did riot build or -improve for.the purpose of sale.).
1. Each person upon whose behalf this application is made, each person at whose
(� 1, as owner of the property, am exclusively contracting with licensed contractors
request and for whose benefit work is performed under or pursuant to any permit
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
issued as a result.of this application -,-the owner, and the applicant, each agrees to, and
State License Law does not apply to an owner of property who builds or improves
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
thereon, and who contracts for the projects'with a contractor(s) licensed pursuant to
employees for any act or omission related to the work being performed under or
.the Contractors' State License Law.).
following issuance of this permit.
(_) I am exempt under"Sec. B.&P.C. for this reason
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.
Date: Owner:
I certify that I have read this application and state that the above ftformation is
CONSTRUCTION LENDING AGENCY I agree to comply with all city and county ordinances and tate relating to
I hereby affirm under penalty of perjury that there is a construction lending agency for construction, and hereby authorize representatives of thi city to er upon h
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). ' mentioned property for inspection purposes.
i
Lender's Name: Date: LILISIgnature (Applicant or Agent):
Lender's Address:
A
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:101-0000-42404
0
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$0.00:
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MAIDMATE=
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SWIMMING POOL/SPA PC
„: 101-0000-42600
0
$98 62
.0
`?PAID-6Yr "
..,>„ ����'METHOD���aCLTDBY=
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Total Paid fo�,POOL /"SPA ; ", w
$279.91 ¢`$Os00
Description: POOL REMODEL
CONDITIONS
Type: POOL Subtype:
Status: APPROVED
Applied: 12/11/2014 AOR'
Approved: 12/12/2014 KHE
Parcel No: 775153010 Site Address: 55269 RIVIERA LA QUINTA,CA 92253
Subdivision: TR 21381-2 CM 064/031 CM 067/001 Block:
Lot: F-42
Issued:
Lot Scl Ft: 0 Building Scl Ft: 0
Zoning:
Finaled:
Valuation: $15,000.00 Occupancy Type:
Construction Type:
Expired:
No. Buildings: 0 No. Stories:.0
No. Unites: 0
CA
Details: REBUILD SPA WITH REBAR & STEEL, PER ENGINEERING ADD FIREPIT & BBQ. ATTACH GAS LINE TO MAIN. ALARMS/BARRIERS SHALL
BE IN PLACE AT -PRE -PLASTER INSPECTION. 2013 CODES.
CONTRACTOR RCI
OUTSIDE CITY LIMITS
Printed: Friday, December 12, 2014 8:22:45 AM 1 of 2
sysrr•Ms
CONDITIONS
CONTACTS
.. NAME TYPE ;: NAME
--'ADDRESSl �r
CITY °" STATE
ZIP PHONE ;FAX. EMAIL �.
APPLICANT RCI
OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
CONTRACTOR RCI
OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
OWNER ALEXIS REAL ESTATE HOLDINGS LL
55269 RIVIERA
LA.QUINTA
CA
92253
FINANCIAL
•'
•
" "ACCOUNNT
""AMOUNT
-
CLT D.
DESCRIPTION ,-;' -
QTY
PAID
:PAID DATE
.;RECEIPT# CHECK#"' METHOD PAID BY,
9
x BY -1
BSAS SB1473 FEE 101-0000-20306
0 $1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
:$0.00
BSA:
Printed: Friday, December 12, 2014 8:22:45 AM 1 of 2
sysrr•Ms
INSPECTIONS
SEQID INSPECTION TYPE ,INSPECTOR SCHEDULED: COMPLETED
DATE DATE
I RESULT REMARKS NOTES
_
FINAL"
WPAIDDATE
T.RECEIPT#
CLTD
DESCRIPTION
ACCOUNT
CITY
:AMOUNT
PAID
CHECK# .,
METHOD
_. ,PAID BY
.
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
Total Paid for POOL / SPA: $279.91 $0.00
TOTALS: $365.51 00
INSPECTIONS
SEQID INSPECTION TYPE ,INSPECTOR SCHEDULED: COMPLETED
DATE DATE
I RESULT REMARKS NOTES
_
FINAL"
REVIEWS
"
REVIEW TYPE;_ REVIEWER _ SENT DATE DUE DATE RETURNED STATUS. REMARKS NOTES
DATE
Printed: Friday, December 12, 2014 8:22:45 AM 2 of 2 C
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City .of La Quinta .
Building ai: Safety Division
P.O. Box 1504, 78-495 Calle Tampico..
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Dt.���i• 1�2g
Project Address: Tjrj —2 )2 U j
Owner's Name: q A
A. P. Number:t
Address:e—c,
Legal Description:.
City, ST, Zip: . r
Contractor: L
•
Address: 1,
Project Description:
City, ST, Zip:LJ
Telephone: O'I
?7 t
Girl"
State Lic: #: 0 S
City Lic.
Arch., Engr., Designer:40016
AVATCW GIA ;v(,t TO AIN Mb
Address:
City, ST, Zip:
hone:
>>
. OccuTele aneY
onstructi n Type:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo .
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT. WHITE BELOW THIS LINE
H
Submittal.
Req'd
Rec'd
TRACKING
PERMIT FEES,
Plan Sets
Plan Check submitted
Itcm
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calm
Called Contact Person
Plan.Chcck Balance.
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan"
t
Z°" Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Dccd _
Plans picked up
S.M.I.
H.O.A. Approval
-
Plans resubmitted
Grading
IN IfOUSE.
'rd Reyierv, ready for carrcctionsCssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
-
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees