13-0902 (RPL)I['_ , �l�
V
' P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000902
Property Address:
81553 RUSTIC CANYON DR
APN:
764-280-999-54 -300236-
Application description:
POOL - RESIDENTIAL
Property Zoning:
MEDIUM HIGH 'DENSITY RES
Application valuation:
10000
TAi!t
4
OICE (760) 777-7012
-lam Qumw �r VFAX 760 777-7011
BUILDING 8i SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT -
Applicant: Architect or Engineer:
1
LICENSED CONTRACTOR'S DECLARATION
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 Class: B C53 License No.: 552140
lo td: Contract `
OWNER -8 LDER �EOCLA ATIONI hereby affirm under penalty of perjurythat I am exempt fr m the ctor's State License Law for the
following reason (Sec. 7031.5. Business and Professions Co 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 Codel 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 1$5001.:
1 — I 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 ISec. 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 contractorls) licensed'
pursuant to the Contractors' State License Law.).
( 1 I am exempt under Sec. , 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: '
LQPERMIT
Owner:
BRADLEY
81553 RUSTIC CANYON DRIVE
LA QUINTA, CA 92253
Contractor:
CAL•PACIFIC POOLS
P.O. BOX 1804
PALM SPRINGS, CA 92263
(760)327-8649
Lic•. No.: 552140
I
Date:
7/17/13
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, rovided
for by Section 3700 of the Labor Code, for the 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 r
• f Code, for the performance of the work for which this permit is issued. My workers' compensation
1• insurance carrier and policy number are:
Carrier WESCO INS Policy Number WWC3057132
I 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 the workers' compensation provisions of Section
QQ 3700 of the Labor Code, I shall forthwith comply with those provisions. .
11 b) ,J' Applicant<� -
v -
WARNING: FAILURE TO SECURE WORKERS' COMPENCOV
S TION E GE IS UNLA UL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN CIVIL F UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF C NSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - r
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 information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property inspection purposes.
Dat 'L• t Signature (Applicant or Agent):
i
Application Number . . . . 13-00000902
Permit . • . POOL 2013
4
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
Special Notes and Comments
POOL (SPA EXISTING) - EQUIPMENT SHALL BE
INSTALLED IN ACCORDANCE WITH
' MANUFACTURER SPECIFICATIONS. ALARMS AND
BARRIERS REQUIRED TO BE INSTALLED AT
PRE -PLASTER INSPECTION. 2010 CALIFORNIA
BUILDING CODE.
----------------------------------------------------------------------------
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
Bin #
Qty da Quin' to
Building &r Safety Division
P.O. Box 1504,'76-49S Calle Tampico
[a.Quinta, CA 92253 -'(760) 777-7012
Building Permit 'Application and Tracking Sheet
Permit #
Project AddresS G 1�� Owner's Name:. Q ,
A. P. Number: Address: 45 e„ Cir, /60
Legal Description: r ' City, ST, Zip; La CA ct
Contractor: ezi 9a Ci7'j C �f GC S Telephone:
Address: %�a, Project Description:
Ciiy, ST, Zip: ` �C4 /1? c l of 6 3
�j//7/7
Telephone:70- c.,)� -2l "7 . of r'>:' :.
`�.;�,;-
State Lic. 9: -55 1; / L%G City Lic. #.: "" a
Arch., Engr., Designer.
Address:
•I
City, ST, Zip:
Telephone: .° Construction Type:. Occupancy:
State Lic. #•� :`�>':r� � •
'»iu Project type (circle one): New Add'a Alter Repair Demo
Name of Contact Person: e%7%/e r eR rim Sq. Ft.: # Stories: #Units:
Telephone # of Contact Person: 6 : ,� '7 5 a Estimated Value of Project (30
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd'Rec'd
TRACKING
EERMITFEES-
Plan Sets
Plan Check submitted
[R�
Amouat
Structural Cales.
Reviewed, ready for corrections
Plan Clicck Deposit. .
Truss C21cs.
Called Contact Person
Plan Cheek 13alhnce
Title 24 Cates.
Plans picked up
Construction
Flood plain plan
Pians resubmitted
Mcchariical
Grading plan
Z'` Review, ready for correc6o s ue
Electrical
Subcoatactor List
Called Contact Person
Piumbing
Grant Deed
Plans picked up
SALL
H-O.A. Approval
Plans resubmitted
Grading
IN UOUSE:-
'^` Review, ready for correctionsftssue
Developer Impact Fee
Planning Approval
Coiled Contact Person
AJ. P,P,
Pub. Wks. Appr •
Date of permit Issue
School Fees
Total Permit Eees
Irle3 5APEFf DEPT.
/APPROVE®
FOR CONSTRUCTION
DATE BY.
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