13-0724 (RPL)4 P.O. BOX 1504 f 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
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
13-00000724
57598 BARRISTO CIR
762-500-025- - -
POOL - RESIDENTIAL
LOW DENSITY RESIDENTIAL
25000
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: C53 -C27 /LiiccenseNo.: 823017
Date: ( ' 1 - I .Contractor•
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 a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 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 thathe 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' State License Law.).
1 _ 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:
STEVE REVIS & DAVID SEIFERT
57598 BARRISTO CIR
LA QUINTA, CA 92253
(
Contractor: D
MCRAE POOL & SPAS
79105 DESERT STREAM DR
LA QUINTA, CA 92253 ,1(�r{y�l
(760)774-6343
Lic. No.: 823017 Copy
Date: 6/06/13
z � Zo�3 ID
------------------------------------------------
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
��.,i,s,sued.
"�r'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 X121 Policy Number EXEMPT
�JI 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
3700 of the Labor Code, I shall forthwith comply with thou provisions.
Oate:6-11N ) Applicant: s —
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 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 for inspection purposes.
Dat Signature (Applicant or Agent):
r I .
Application Number . . . . . 13-00000724
Permit . . . POOL 2013
Additional desc .
Permit Fee . . . . 178.75 Plan Check
Fee
.00
Issue Date . . . . Valuation
. . .
. 0
Expiration Date . . 12/03/13
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC POOL/SPA
178.75
----------------------------------------------------------------------------
Special Notes and Comments
RESIDENTIAL POOL/SPA - INSTALL NEW POOL
& SPA IN REAR YARD. 30 FT. 2 INCH GAS
LINE FROM GAS SERVICE TO POOL EQUIPMENT.
2010 CALIFORNIA BUILDING CODES.
----------------------------------------------------------------------------
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
Building u Safety Division 20
P.O. Box 1504, 78-495 Calle Tampico CITY OF LA
La Quinta, CA 92253 - (760) 777-7012 QUI
COMMUNITY DEVELO
Building Permit Application and Tracking Sheet
M);
Permit #
1�-7Z4
Project Address:,57'-,S-5?,? 23AWs
Owner's Name:
A. P. Number:
Address: S7 -S79 B4 gcRZM
Legal Description:
City, ST, Zip: 22X3
Contractor:AAC2,4 r-- 4001,& 1,164-C
Telephone:—?
Address:
Project Description: 'n rl r _AJ
Arch., Engr., Designer:
Telephone:
......
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# stories:
#Units:
Telephone # of Contact Person: 2Y2
1 Estimated Value of Project: 7W
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Ree'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item Amount
Structural Cates.
Reviewed, ready for corrections
Plan Check Deposit
Truss CaIcs.
Called Contact Person
Plan Check Balance
Title 24 Cates.
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
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
I 3rd
.!o� ettionslissue,
CAI—, AM'!, LA QUINTA
Developer Impact Fee
Planning Approval
P.P.
Pub. Wks. Appr
Date of perm it'l "-,Lx %J EJ)T
School Fees
FOR CQNSTR, jr,—,—,
--,f3Y
Total Permit Fees
CITY OF LA QUINTA'SUB-CONTRACTOR LIST '
JOB ADDRESS S7 ' S�I�A.I?,�.I PERMIT NUMBER OWNER 5,�� BUILDER AIC
This form shall be posted 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. Any changes 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.
CIa sification77F
C
ontractorTrade
:Contractor License ... ...
satiorarsuiance
City Busres LicenWoe
Company Name
Classification
(e.g. A, B, C-8)
License Number
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xz/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK 1C-121 ..
1
C
qU(xxxxxx)
JV
O
j
6'712 7
b --21i(
CONCRETE (C-8)''
e'
,
%
7.6
FRAMING ;l0-5)
)'
STRUCT:`STEEL- 10-51)'-
MASONRY (C-29)
MASONRY
PLUMBING (C-36)
C (
G (
/
G /
//
LATH; PLASTER (C-35)
DRYWALL (C-9) . ..:
HVAC (C-20)< . '. .
ELECTRICAL. (C=10)' ; .:
/ C (
��
!i
ROOFING'
SHEET METAL (C-4'31 '
GLAZING (C-17)
INSULATION' (C-72)
SEWAGE DISP:- (C-42)
PAINTING (C-33)'-:
CERAMIC TILE (C-54)
CABINETS (C-6)
FENCING (C-13)
LANDSCAPING (C=271.
POOL (C-53)
/ [ /
/ (
lIle
F-7.
June P, 2013 r"
._ e—
Home. Owner:
/Owners Association
Steve Revis
David Seifert
57-598 Barristo
La Quinta, CA 92253
Contractor:
DBA:
McRae Pools and Spas
79105 Desert Stream Dr.
La Quinta, CA 92253
Lic# C -53/C-27 823017
�7
Contractor:
This letter is to confirm the review and approval of the backyard improvements at the above
listed property. It has been represented that there will be construction and improvements as per
City Code, performed by the above listed contractor. All work is to be completed in a timely
manner: Surrounding common areas for access, roadways, and entries are required to be left in a
clean condition by all contractors, subcontractors, and employees. Concrete "washout" is NOT
permitted onsite unless fully removed and cleaned by contractor at time of completion of
construction. No materials will be left on the streets, in common or HOA owned areas,
overnight.
To insure that the common areas will be left in a clean and undamaged condition, Santerra
Owners Association requires a $2000.00 performance deposit on new pool/spa construction.
This deposit will be returned to the above listed contractor following: 1) project completion; 2)
final city inspection; and 3) after final city inspection, a representative of Santerra Owners
Association's inspection of the common areas, which shall be left clean and undamaged. In the
event, activities related to the above project leaves any portion of the common areas in need of
cleaning and/or repair, Contractor herby authorizes Santerra Owners Association to apply up to
the full amount of the deposit for required cleaning and/or repairs.
Check will be made payable to:
Santerra Owners Association
57551 Barristo
La Quinta, CA 92253
Santerra Owners Association
TRevi Committee
J
B
Accepted:
ea Pool a -v,0a Construction Date
Authorized Contractor. Signature
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BUILDING & SAFETY DEPT.
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768-772%?440
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