13-1531 (RPL)P.O. BOX 1504 4
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 13-00001531
Property Address: 53405 AVENIDA MENDOZA
APN: 774-092-020-8 -000000-
Application description: POOL - RESIDENTIAL
Property Zoning: COVE RESIDENTIAL
Application valuation: 16000
Applicant: Architect or Engineer:
----------------- I
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm oder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7 001 f' Division 3 of the Bu 'Hess and Professi nals Code, and my icense is in fu I force and effect.
License CI ss: License No.: 583
D S Contract/ V��
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 apermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 1 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.).
(_ 1 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' StateLicenseLaw.).
1 ) I am exempt under Seca , 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 Address: '
V
LQPERMIT
Owner:
ROPER MORRIS CONSTRUCTION
51200 CALLE PALOMA
LA QUINTA, CA 92253
Contractor:
MORRIS CONSTRUCTION
50855 WASHINGTON ST,
LA QUINTA, CA 92253
(760)272-9292
Lic- No.: 867583
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/02/13
-------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, forthe performance of the work for which this permit is
issued.
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 EXEMPT
1 certify that, in the performance of he ork for which this permit is issued, I shall not employ any
person in any manner s to b o e su ' t to the workers' compensation laws of California,
nd agree that, if I s u bec s the workers' compensation provisions of Section
70 of the Labor d I shall f rt i -comply with those provisions.
Date: V 1 pplicant:� r
WARNING: FAILURE TO SECURE KERS' COMP SATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI (NAL PENAL 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 Director of Building and Safety 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 a bovin motion is correct. I agree to comply with all
city and cou y ordinances and state laws relating to it g co and hereby authorize representatives
of this c ter upon the above-mentioned pro rt for in n urposes.
Date: Signature (Applicant or Agent) '
Application Number . . . . 13-00001531
Permit . . . . POOL 2013
Additional desc .
Permit Fee . . . . 178.75 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 0
Expiration Date 5/31/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
178.75
Special Notes and Comments
POOL AND SPA AT FRONT YARD [DENISE
POELTLER ENGINEERING] THIS PERMIT DOES
NOT INCLUDE POOL OR EQUIPMENT
ENCLOSURES. ALARMS AND BARRIERS REQUIRED
TO BE INSTALLED AT PRE -PLASTER
INSPECTION. 2010 CALIFORNIA BUILDING
CODE.
December 2, 2013 12:33:09 PM AORTEGA
-----------------_---------------------
Other Fees .. . BLDG STDS ADMIN (SB1473)
1.00
- PLAN CHECK, POOL,
97.24
Fee summary Charged Paid Credited
---------- ---------- ---------- ----------
Due
-----------------
Permit Fee Total 178.75 .00
.00
178.75
Plan Check Total .00 .00
.00
.00
Other Fee Total 98.24 .00
.00
98.24
Grand Total 276.99 .00
.00
276.99
LQPERMIT
Bin #
City �C of La numta
Building &r SafetyDivision
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
13- 15$1
Project Address: S3 Yo r A -v. AUS 20 2%+)—
Owner's Name: _4AMt 4
A. P. Number: ' . 7 % 01O • Od-p
Address:
Legal Description:
City, ST, Zip:
Contractor: 0 e r
Tele hone:
Address: 100 $6S P f A-Stry nf4 9- C d J l✓
Project Description:
City, ST, Zip: b* GIA!"K QaaS 3
001 �tdiYu�fi ow
Telephone: 60-a7a- gag
lJ
i}i:'::::::«ti':>t.:4:rii:::<n>4}:;S•:v::;�:.j:::}: :iY. +' k.
State Lie. # : (0 % S-9 3
City Lic. #; 10 4133 1
Arch., Engr., Designer:
NOV 2 +
Address:
CI TY ng
City, ST, Zip:OMWIN
[A
MUNITY pE
Telephone:
}:' :::, : }"}::'::}`: :}`
>::c:s:::<;;->}a:<:<<.?;>;>:<>z::<..<:>.:
''''`" ^' ' `}}}' %"' ''
Construction Type: Occupancy:
yP �/ 61%
State Lic. #
Project type (circle one) N Add'n Alter Repair Demo
Name of Contact Person: Q Q f?jj/�s
Sq. Ft.:
# Stories:
# Units:
Telephone #,of Contact Person: -7 (p 0 - d% �k ' 94 903—
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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:-
'"' Review, ready for corrections ue
Developer Impact Fee
Planning Approval
Called Contact Person i r
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
nip
12121Uri - AaiD'E to dna w�toWr*V 0. ���
NA CITY OF LA QUINTA-SUB-CONTRACTOR LIST
JOB ADDRESS PERMIT NUMBER ��J- l� ( OWNER-P` brt&,cs(BUIWER
This form shall be costed 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 work
on this job. all
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 voidance
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 or ::::...
Tr / n
....:.....:.. .
:.:;::::>::_:-:::::. :::: ::.::.....:.. ..
State..:Contractor s License
::
'..:: : " ' ' :. Workers Coniperisataon insuranc':" :: '>;. ';•:.::::.::
City'.Biisr)e5s License>':..::
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund; CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12) . "- �I4�114' W,0 &Q �- J.Ct v Al
/{,gH6517$
N I�.
S�Gusi�t i�(�ioub\
sWL1030�t,�'
.10 !
W-0-7 5-1 %
CONCRETE (C-8)
FRAMING
STRUCT.`S7EEL (C-51) tVllfI 14c,b�cu('6
�W c l o3p
MASONRY (C-29)
PLUMBING' IC-36j'16
a
l
S
s
LATH; PLASTER (C 35)
DRYWALL (C-9)..::-.• .:
HVAC. (C-20).:.::'
j
11
ELECTRICAL.(C=10)': .': �+rl%00 �p0'l Core
C-s3
��a��o
��
a� �it�urp�rlCG
�a►3o2o12.g2
s ly
SHEET.METAL (C43)'' =:
FLOORING (C-,T:!-!5)
GLAZING (C-17)".` ::...,.
INSULATION'(C72) . .:
SEWAGE.DISP-(0--421' `.
PAINTING (C=33) -
y
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C713)
LANDSCAPING (C=27)
onn1 if- cam►
t
i,
10
51 G
u
F.
y
n® II llll,�L ----- -----ZIL------o } `�" in
Q-
-ill
m0mml