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13-0755 (RPL)4P.O. BOX 1504 VOICE (760) 777-7012 78-495 CALLE TAMPICO '� FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT 01 INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 6/21/13 Application Number: 13-0000075S Owner: Property Address: 79883 CASSIA ST BRAYSHER MIKE APN: 649-480-004-16 -28601 - 79883 CASSIA ST D Application description: POOL - RESIDENTIAL LA QUINTA, CA 92253. Property Zoning: MEDIUM DENSITY RES ( Application valuation: 10000 JUN 1,! 21103 Contractor: Applicant: Architect or Engineer: GORDO LANDSCAPE, JAVI R CITY OF LAQUINZA P.O. BOX 7123 FINANCE DEPT LA QUINTA, CA 92248 N(760)619-4906 Lic. No.: 883625 ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm underpenalty 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 lass: • C27 D06 //�� License No.: 8883625 Date: �-' O 3 Contractor: Zs tc %Cr ([Ofab L_r, tidsckee_ 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 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 contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ 1 I am exempt under Sec. , BAP.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 ----------------------------------------------— 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: CarrierXEMPT Policy Wumber EXEMPT I certify that, in the performance of [h rk for which this permit is issued, 1 shall not employ any person in any manner so as t bemubject to the workers' compensation laws of California, and agree that, if I sho e m Lsu sect to the workers' compensation provisions of Section 3700 of the Labor e. I orthwith comolv with those orovisions. Date. 'L zl Applicant: _ WARN NG: FAILURE TO SECURE SUBJECT AN EMPLOYER TO CRII DOLLARS 1$100,000). IN ADDly SECTION 3706 OF THE LABOR C RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL \L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN . 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 ove' rmation is correct. I agree to comply with all city and county ordinances and state laws relating to but ding c s uction, and hereby authorize representatives of this co ty to/enter upon the above-mentioned pro rty for " ection purposes. Oat : V Z I Signature (Applicant or Agent): t / Application Number . . . . . 13-00000755 Permit . . . . . . POOL 2013 Additional desc . . Permit Fee 178.75 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/18/13 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 . . . . 10000 Expiration Date 12/18/13 Qty Unit Charge Per Extension 1.00 - 47.19-00 LS MISC WALL, FIRST 100 LF 47.19 ---------------------------------------------------------------------------- Special Notes and Comments POOL AND 15LF OF 6' HIGH EQUIPMENT WALL 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 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 LQPERAI IT Bin # Qty t/ of LQ Quin to Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ,..l�Lj ' Project Address: —883 ('C,-sxjj 54 Owner's Name: MiKe, R Y l A. P. Number: LO Qu-AM, Cit- ri -Z Address: c ,E> 64S )-q sf Legal Description: ] deh(-(- f {JKiJ City, ST, Zip: Qt4i,114 c 22j� 3 Contractor: ZGVc-,/ 6346 ,LeV\jSCePe,9 Address: �Ij �4��'Ser� S (�� pY Telephone: - Project Description: City, ST, Zip:U �U i�� Z�� ��u tyVt ✓1 —.G�k !r/+�� Telephone: GG State Lic. # : ff)3j(o2 City Lic. #.: 0A) Films /S � I-earttr r{ Yr 4 Arch., Engr., Designer: v'j�OC �i� �w Of pw K/6GC- Address: (Zp I jlf 14 si i h l �/LCQ g7,WA11tR QS City, ST, Zip: Niek 6"K (14 q?-66- Telephone: *71 L/-40 ;(o// � 'v r{:{;}..;.{::ivN{.i}Ay$••t}{:'{^. �. {�� ;t,:<,}�.�:;�{�.:},_;{z<;� 0. i%i..l{i+�':<sn�is<��:i/-dif Yf ?:<H.:�Lj4:fv s•'•:.;c::r:<,s>.z<::,;•ar:rr> '}'.':< : ::..:r:... :.,.::. .:.: ..�r a rtx ,o:•s'�} Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lic. #: �q rj Z.� �.v 1.a r Name of Contict Person: '/10(1 Sq. Ft.: # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: X)0- APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Cales. Called Contact Person Plan Check Balance Tide 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21" Review, ready for correctionsfissue 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 corrections/'issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit' LA Q U' NTA School Fees BU LDING & SAFETY DEPT. Total Permit Fees FOR GONb I KUU I iUly DAT Ek BY -FOOL Q tccK (�l� hU �l 0 OSE -QEF' CITY OF LA QUINTA BUILDING & SAFETY DEPT, APPROVED �- -FOR CONSTRUCTION Pgbf OW -K :INAL.L - E 1� 5 unm uN Check a License - License Detail - Contractors State License Board Page 1 of 2 DEPARTMENT OF CONSUMER AFFAIRS Contractors State License Board Contractor's License Detail - License # 883625 Al- DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. >> Per B&P 7071.17 , only construction related civil judgments.reported to the CSLB are disclosed. :> Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number 883625 JAVIER GORDO LANDSCAPE Business Information Business Phone Number: (760) 619-4906 P0BOX 7123 LA QUINTA, CA 92248 Enti Sole Ownership Issue Date 09/05/2006 Expire Date 09/30/2014 Extract Date 6/18/2013 This license is exempt from having workers compensation insurance; they certified that they have no employees at this time. - Effective Date: 07/21/2010 https://www2.cslb.ca.gov/onlineservices/checklicenseII/LicenseDetail.aspx?LicNum=8836... 6/18/2013 ACTIVE License Status This license is current and active. All information below should be reviewed. CLASS DESCRIPTION C27 LANDSCAPING Classifications B GENERAL BUILDING CONTRACTOR D06 CONCRETE RELATED SERVICES CONTRACTOR'S BOND This license filed a Contractor's Bond with WASHINGTON INTERNATIONAL INSURANCE COMPANY. Bonding Bond Number: S9156786 Bond Amount: $12,500 Effective Date: 02/01/2013 Contractor's Bond History Workers' Compensation WORKERS' COMPENSATION This license is exempt from having workers compensation insurance; they certified that they have no employees at this time. - Effective Date: 07/21/2010 https://www2.cslb.ca.gov/onlineservices/checklicenseII/LicenseDetail.aspx?LicNum=8836... 6/18/2013 �I J ky ( F -(Z C-10 (WA -5 MI l L ht7 ALL Ttt � L� 42K �'0 ��il LST TH t f GT AT :15 6S 3 SS 1 f� S l . LA�t�1tyT L, C P NCCw DF 5' 1-3 iml� l-L� ��6 L C(J�V CtLET Li�tJOSCA� -F SUB LusJ- TEIEtp: