RPL (14-0070)P.O.`' BOX 1504
78-495.CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
Property Address:
APN: .
.Application description:
Property Zoning:
Application valuation:
14-00000070
52487 MERIWETHER WY
767-200-998-32 -330762-
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
75000
Applicant: Architect or Engineer:
t4k
r
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of, the Business and Professionals Code, and my License is in full force and effect.
License Cl . C53 License No.: 614611
Date:/� 7 - Contractor
7� 1
OWNER -BUILDER DECLARATION
1 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
1 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:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 1/29/14
Owner:
SCHUMACKER ROB
.,2995 WOODSIDE RD STE 400
WOODSIDE, CA 94062 .
1
Contractor:
MCINTYRE POOLS & SPAS, INC. I
FE -1 0 4 21004 I
83695 AVENUE 45
INDIO, CA 92201
CIT �►, �7M7A
(760) 342-3612
Mi 4
171.
Lic. No.: 614611
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 WESCO INS CO Policy Number QWCA1843029
1 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,
Ind agree that, if I should become s •blect to.the workers' compensation provisions of Section
700 of the Labor Code, s II t 't omply with those provisions. ,
Date: O" w Applicant: �, r
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
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 the above inforr ation is correct. I agree to comply with all
city and county ordinances and state laws relating to building cons fiction, and hereby authorize representatives
of this cou ty o/enter upon the above-mentioned propert f i e urposes.
`Date: �I11 Signature (Applicant or Agent .
I
Application Number . . . . . 14-00000070
Permit . . . POOL 2013
Additional desc .
Permit Fee 357.50 Plan Check Fee
.00
Issue Date Valuation
0
Expiration Date 7/28/14
Qty Unit Charge' Per
Extension
2.00 178.7500 EA MISC POOL/SPA
-----------------------------------------------------------------------------
357.50
Permit PLUMBING 2013
Additional desc FIRE PIT GAS PIPING ONLY
Permit Fee . . . . .11.92 Plan Check Fee
.00
Issue.Date Valuation . . .
. 0
Expiration Date 7/28/14
Qty Unit Charge Per
Extension
1.00 11.9200 LS- PLBG GAS SYS, 1-4 OUTLETS
11.92
Special Notes and Comments
POOL, SPA AND FIREPIT AT REAR YARD
W/COURTYARD WATER FEATURE [DENISE
POELTLER ENGINEERING] DWELLING
ENGINEERING DESIGN FOR LOCATION OF WATER
FEATURE - ALL OTHER INSTALLATIONS SHALL
COMPLY WITH SPECIFICATIONS SHEET. THIS
PERMIT DOES NOT INCLUDE EQUIPMENT
ENCLOSURE. ALARMS AND BARRIERS REQUIRED
TO BE INSTALLED AT PRE -PLASTER L'
INSPECTION. 2013 CALIFORNIA BUILDING
CODE.
January 29, 2014 1:11:17 PM AORTEGA
----------------------------------------------------------------------------
Other Fees . . . . . . . BLDG STDS ADMIN (SB1473)
3.00
PLAN CHECK, POOL.
97.24
PLAN CHECK, PLUMBING
23.83
Fee summary Charged Paid Credited'
Due
Permit Fee Total 369.42 .00 .00
369.42
Plan Check Total .00 .00 .00
.00
Other Fee Total 124.07 .00 ..00
124.07
Grand Total 493.4'9 .00 .00
493.49
M
U
M
Bin #
City d La Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico `
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Pe/mit #
c
Project Address:_ 1 G� �Pr- �. ��
Owner's Name:
A. P. Number:
Address:- — 1 U 7
Legal Description:
City, ST, Zip: 1,0 a
Contractor:
t C
Telephone: fi
P' > :ri.
Address: -
Project Description:R201
- S
City,'ST,.Zip: C�
Telephone:
4�[
State Lic. # : 7 G (� City Lie. #, S
,
Arch., Engr., Designer. .
Address:
City; ST, Zip:
Telephoner " t
State Lie. #:Project
Construction Type: Occupancy:
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 WRITE BELOW THIS LINE
tr
Submittal
Req'd
Rec'.d
TRAC MG
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 correctionstissue
Electrical
Subcontactor ListCalled
Contact Person
Plumbing . .
Grant Deed
Plans picked up
S.M.L
ILOAL Approval
Plans resubmitted
Grading
IN HOUSE:-
'"` Reyiew, ready for correctiou
Developer Impact Fee
Planning Approval
Called Contact Person \
A.I:P P.
Pub. Wks. Appr
Z
Date of permit issue
School Fees
Total Permit Fees
1.t