13-0844 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
13-00000844
Property Address:
78340 BIRKDALE CT
APN:
770-280-008- - -
Application description:
POOL - RESIDENTIAL
Property Zoning:
LOW DENSITY RESIDENTIAL
Application valuation:
2300
Applicant:
eVA 1011�
Architect or Engineer:
V I1p<
4
1.1
BUILDING & SAFETY 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 Busines d Professionals Code, and my License is in full force and effect.
License Class" C53 J License No.: 802919
e': '
Datntractov/�
W E� ILDER DECLARATION
I hereby affirm under penalty of perjury that I am empt 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 Icommencing 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 (5500).:
(_ 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 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 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.I.
Lender's Name:
Lender's Address:
L QPERMiT
Owner:
LARSEN
78340 BIRKDALE COURT
LA QUINTA, CA 92253
Contractor:
AZURE POOLS AND SPAS
P.O. BOX 10641
PALM DESERT, CA 92255
(760)322-7665
Lic. No.: 802919
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 7/09/13
D Q 0
JUL 09 2013
CITY of LA QUINT:
FINANCE DEPT.
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 SOUTHERN INS Policy Number PWC002199-12
_ 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 shoutpffo
the workers' compensation provisions of Section
37Q,0)of the Labor Codeomply with those provisions.
Oat�_If�`/'/1�� '�1 ��/� Pplicant
WARNING: FAILURE TO SECURE WORKERS NSAT ION 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 ab ve information is correct. I agree to comply with all
city and county ordinances and state laws relating to buildi c ns ruction, and hereby authorize representatives
of this co nn/��y11 tc rp'i6hrJupon the above-mentioned propert or section purposes.
Da 1� -�s�gnature (Applicant or Agentl:
T
Application Number . . . . . 13-00000844
Permit . . . •POOL 2013
Additional desc . .
Permit Fee . . . . 178.75
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date 1/05/14
Qty Unit Charge Per
Extension
1.00 178.7500 EA MISC
---------'-------------------------------------------------------------------
POOL/SPA
178.75
Permit . . . WALL/FENCE
PERMIT 2013
Additional desc .
Permit Fee. . . 47.19
Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 2300
Expiration Date . . 1/05/14
Qty Unit Charge Per
Extension
1.00 47.1900 LS MISC
WALL, FIRST 100 LF
47.19
------------
---------------------------------------------------------------
Special Notes and Comments
WATER FEATURE - AT COURTYARD WITH 5LF OF
5' BLOCK WALL. 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 225.94
.00 .00
225.94
Plan Check Total .00
.00 .00
.00
Other Fee Total 98.24
.00 .00
98.24
Grand Total 324.18
.00 .00
324.18
r
LQPERMIT
Bin #
Qty of LQ Quinta
Building 8r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quints, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
r4AA1U
Owner's Name:
S
A. P. Number:
Address: ' O C
Legal Description:
City, ST, Zip:
Contractor:
S
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Telephone:
Address: k
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Project Description:/� Gl�m
City, ST, Zip:
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TeleP hone ._I 4 ZCP V.
State Lic. # :
Arch., Engr., Designer:
City Lic. #:S
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Address:
City., ST, Zip:
Telephone:
nstructionTYPa Occupancy:Co
State Lic. #:ProJect
hP (circle one): New Add' n Alter Repair Demo
Name of Contact Person:
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Sq. Ft.:
# Stories: '-
# Units:
Telephone # of Contact Person:
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(� Z� 2 D U'
Estimated Value of Project: 2
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING PERMIT FEES
Plan Sets
Plan Check submitted 1
Item
Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Title 24 Coles.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
21" 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 correctionsrssue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.P.
Pub. Wks. Appr
Date ol ifePRMLAI
School Fees
k_
UL11
BUILDINt
To
al Permit Fees
AE'
Water Feature @ Garage Courtyard Wall
Scale 1/2" — P-0"
Larsen Residence Lot 78 The Tradition
02-27-13
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
DATE (3 By S17