BWFE2016-024278-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BWFE2016-0242
Property Address:
53255 EISENHOWER DR
APN:
774085013
Application Description:
D'ANNA / BLOCK WALL
Property Zoning:
Application Valuation:
$8,000.00
Applicant:
CRYSTAL BLUE POOLS AND PATIOS
31166 ORANGE AVENUE
NUEVO, CA 92567.
�Y'°&,�u'au�nfw
DESIGN & DEVELOPMENT DEPARTMENT
BUILDING PERMIT
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 an rofessions Code,
and my License is in full force and effect.
License Class: C53, B. C-8, C27 License o.: 84
DSte' �2 (�' Contract
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt fr m 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).:
(_ 11, 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 1, 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
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
Lender's
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12 /2016
Owner: 4
JESSE D'ANNA
Z
vn o
C-" 1
G O
Contractor: e0
CRYSTAL BLUE POOLS6ATI05:
31166 ORANGE AVEN
NUEVO, CA 92567 y
(951)906-2761
Llc. No.: 846843
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 ,k for which this permit is issued.
of;
. ave and will maintain workers' compensation insurance, as required by
Se ion 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: SOUTHERN INSURANCE COMPANY Policy Number: OWC1005100
I certify that fn 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 shoo become subject to the
workers' compensation provisions of Section/PENALTIES
Labor Code, I shall forthwith
comply wit j hose rovisions. ,/
D�t Applic n5`t
WARNING: FAILURE TO SECURE WORKERS' CON COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIM 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 Building Official 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 I s relating to building
construction, and hereby authorize representatives of this c' to t r upon the
above -menti ed pybperty for inspection purposes.
Date3+� Z Signature (Applicant or Age
Date: 12/12/2016
Application Number: BWFE2016-0242
Owner:
Property Address: 53255 EISENHOWER DR
JESSE D'ANNA
APN: 774085013
Application Description: D'ANNA /BLOCK WALL
Property Zoning:
Application Valuation: $8,000.00
Applicant:
Contractor:
CRYSTAL BLUE POOLS AND PATIOS
CRYSTAL BLUE POOLS AND PATIOS
31166 ORANGE AVENUE
31166 ORANGE AVENUE
NUEVO, CA 92567
NUEVO, CA 92567
(951)906-2761
----------------------------------------------
Llc. No.: 846843
--------------
---------------------------------
Detail: 230LF OF 5/6' GARDEN WALL INSIDE NORTH, EAST, AND SOUTH PL, (2)PILASTERS, AND 4' EQUIPMENT WALL. [CITY SPECIFICATIONS] PRECISION
CONCRETE BLOCK SHALL BE COVERED WITH STUCCO,.PAINT, OR TEXTURED COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY. 2013 CALIFORNIA
BUILDING CODES.
s
DESCRIPTION
FINANCIAL INFORMATION
ACCOUNT QTY
AMOUNT
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404 0
$45.60
DESCRIPTION
ACCOUNT QTY
AMOUNT
WALL/FENCE'--FIRST 100 LF
101-0000-42404 0
$50.67
DESCRIPTION
ACCOUNT QTY
AMOUNT
WALL/FENCE - FIRST 100 LF PC
101-0000-42600 0
$63.33
Total Paid for BLOCK WALL:
$159.60
DESCRIPTION
ACCOUNT
QTY
AMOUNT
BSAS SB1473 FEE
101-0000-20306
0
$1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:
$1.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
1 $5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
IA
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CISe�� e
Qin 1`!
Permit ,#
�2�1 OL
Project Address: �� ZSs°
Qty of La Q uin to
Building 8F Safety Division
. . 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-701,2
Building Permit Application and Tracking Sheet
�e n tri
� VV u_xOwner's Name: JJ
A. P. Number:
Address:
Legal Description:
City, ST, Zip: �� C-A X22 J
Contractor:
s
T elePhn: �
o e
Address: 1'h , l
2,k O z
Project Description:
X,k, �
City_ ST, Zip: ' ' LQ✓
l�� 22
��
Telephone: 60-a -
S
State Lic. # : q
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
0 ne:
Construction TY ecu e•
Occupancy:
P P cY:
State ,.
S t Lic. •
. New Add'n Alter Repair. Demo
type (circleone),
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units: a F•
Telephone # of Contact Person: —
. % '��}
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rcc'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Cli*eck Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance.
Title 24 Cafes.
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.
I-I.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"! Review, ready for correctionsrssue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Ms. Appr
Date of permit issue
School Fees,
Total Permit Fees