13-0901 (RPL) Illllllllllllllllllllllll 79
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T4ht
P.O. BOX 1504 VOICE(760) 777-7012
78-495 CALLE TAMPICO ��� FAX(760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 7/17/13
Application Number: 13-00000901 Owner:
Property Address: 81628 ANDALUSIA TD DESERT DEVELOPMENT
APN: 764-670-021- - - 81570 CARBONERAS
Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253 ID d
Property Zoning: LOW DENSITY RESIDENTIAL A
Application valuation: 43000 U II
Contractor: JU "'`� �0+•
Applicant: Architect or Engineer: BUBBLE SPRINGS
P.O. BOX 1046 TA
RANCHO MIRAGE, CA 92270 �frEn�
\ (760)34
LiC. No.. :: 728 728796
-- - -- - -- ---- --- -- - - -- --- ----- ----- - - - - - --- --- -- -- -- - - --- --- --- - - --- -- --- - - - ----- -- -- ------ -- ---- -
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affi m under penalty of perjury tha m licensed and provis' s of Chapter 9(commencing with I hereby affirm under penalty of perjury one of the following declarations:
Section 70 01 of Division 3 of the Busi d Professional Code my License is in full force and effect. _ 1 have and will maintain a certificate of consent to self-insure for workers'compensation,as provided
License CI ss: 53 D35 icen 728796 �4_sv.
r by Section 3700 of the Labor Code,for the performance of the work for which this permit is
uedDate_ Contracto e and will maintain workers'compensation insurance,as required by Section 3700 of the Labor
� ode,for the performance of the work for which this permit is issued. My workers'compensation
O NER-BUILDER DECLARATION � insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EVEREST NATL Policy Number 76001635131
following reason(Sec.7031.5,Business and Professions Code: Any city or county that requires a permit to _ I certify that,in the performance o e work for which this permit is issued,I shall not employ any
construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for the person in any manner so as come subject to a work ompensation laws of California,
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that,if I should ec me subject to th or
compensation provisions of Section
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 3700 of the labor Cod ,I all forthwith co ly wit to a visions.
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).: Date / Appli�a
(_1 1,as owner of the property,or my employees with wages as their sole compensation,will do the work,and 1� -
the structure is not intended or offered for sale(Sec.7044,Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL
Contractors'State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees,provided that the DOLLARS($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If,however,the building or improvement is sold within SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. .
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.). APPLICANT ACKNOWLEDGEMENT
(_1 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
7044,Business and Professions Code: The Contractors'State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon,and who contracts for the projects with a contractor(s)licensed 1. Each person upon whose behalf this application is made,each person at whose request and for
pursuant to the Contractors'State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_) I am exempt under Sec. ,B.&P.C.for this reason 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.
Date: Owner: 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
CONSTRUCTION LENDING AGENCY permit to cancellation.
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state th4buil '
theLirmation is corre I agree to comply with all
work for which this permit is issued(Sec.3097,Civ.C.). city and county ordinances and state laws relating tn,and h y aut ize representatives
of this cou ty t enter upon the above-mentioned prpurp
Lender's Name:
Date Signature(Applicant or Age`nt)
Lender's Address: N\ �
LQPERMIT
Application Number . . . . . 13-00000901
Permit . . . POOL 2013
Additional desc . .
Permit Fee . . . . 178.75 Plan Check Fee .00
Issue Date . . . . Valuation . . 0
Expiration Date . . 1/13/14
Qty Unit Charge Per Extension
1.00 178.7500 EA MISC POOL/SPA 178.75
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Permit . . . ELECTRICAL 2013
Additional desc .
Permit Fee . . . . 23 .83 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 0
Expiration Date 1/13/14
Qty Unit Charge Per Extension
1.00 23 .8300 LS ELEC FIXTURES, FIRST 20 23 .83
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Permit . . . PLUMBING 2013
Additional desc .
Permit Fee . . . . 11.92 Plan Check Fee .00
Issue Date . . . . Valuation .0
Expiration Date 1/13/14
Qty Unit Charge Per Extension
1.00 11.9200 LS PLBG GAS SYS, 1-4 OUTLETS 11.92
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Special Notes and Comments
POOL, SPA, FIRE PIT, and BBQ '[2 INCH GAS
PIPING/#8 AWG IN 1 INCH CONDUIT
ELECTRICAL) THIS PERMIT INCLUDES
ELECTRICAL AT BBQ. EQUIPMENT SHALL BE
INSTALLED IN ACCORDANCE WITH
MANUFACTURER SPECIFICATIONS.- ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE-PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
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Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00
PLAN CHECK, POOL 97.24
Fee summary Charged Paid Credited Due
-------- -------- ---------- ---------- ---------- ----------
Permit Fee Total 214.50 .00 _ .00 •214.50
Plan Check Total .00 .00 .00 .00
LQPERMIT
Application Number . . . . . 13-00000901
Other Fee Total 98.24 .00 .00 98.24
Grand Total 312.74 .00' .00 312.74
LQPERMIT
Bin.#
City. Of !.d Qu1(1td
Bumlog a Safety Division
Permit# P.O.Box 1504,78-495 Calle Tampico
La.Quinta,CA 92253-:(760)777-70 1
Building Permit Application and Tracking Sheet
Project Address: (/jI Owner's Name:. o � h
A.P.Number. HOZ a v5icc ��YI Address:
Legal Description: City,ST,Zip: _
Contractor: Telephone: 12-
,est''s .
.0 :?
Address: P U- 13(-)x
//0(./(
/y// 7 Project Description:
City,ST,Zip: ; •Q/! � o /`Q i�G� 7 G Z/V ( 1
Telephone: 27f.7,10 7 ren
State Lic.#: 72 7g -City Lic.
Arch.,Engr.,Designer:
Address:
City.,ST,Zip:
Telephoner Construction Type: Occupancy:
Y '
State Lic.#: - /m. » Y ,
-a n`% Project type(cimde one) ew Add'n Alter Repair Demo.
Name of Contact Person: bn urze -Sq.Ft.: #Stories•. #Units:
Telephone#of Contact Person: &G . 2: 7 6o 7 Estimated Value of Project: d—
APPLICANT: DO NOT WRITE BELOW THIS UNE
# Submittal Req'd 'Reed TRACMG
PERMrr FEFS'
Plan Sets Plan Check submitted �� Item Amount
Structural Cafes. Reviewed,ready for corrections Plan Chcck Deposit. .
Truss Calcs. Called Contact Person Plan Check Balance
Tette 24 Cala. Pians picked up Construction
Flood plain plan Pians resubmitted.*. Mecharilcal
Grading plan 2`°Review,ready for correcuo fissu Electrical
Subcontactor List Called Contact Person Plumblug
Grant Deed Plans picked up S.M.I.
H.O.A.Approval Plans resubmitted Grading
IN ROUSE:- Review;ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person
Pub.Wks.Appc ' Date of permit issue
School Fees
ED
BU NTA Total Permit Fees
APPROV oEPr, • JUL 15 2013
FOR CON STRV . �
N OF LA QUINTA
DAM By COMMUNMY DEVELOPMENT