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BPOL2014-110778-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tw�t 4 4 Q" COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BPOL2014-1107 Property Address: 79370 CANTERBURY APN: 775032004 Application Description: POOL, SPA, EQUIPMENT WALL, AND GAS Property Zoning: Application Valuation: $20,000.00 Applicant: DENNIS R INGRAM 1216EMAIN ST MEDFORD, OR 97504 NOV 12 2014 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: DENNIS R INGRAM CITY OF LA QUINTA Contractor: COMMUNITY DEVELOPMENT DEPARTMENT DENNIS R INGRAM 1216EMAIN ST MEDFORD, OR 97504 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 Professions Code, and my License is in full force and effect. License Class: License No.::AOR:1410240159483684 Date: 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).: (_) 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.). (_) 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 contractors) 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 Na Lender's Address: Date: 11/12/2014 (541)474-1111 Llc. No.::AOR:1410240159483684 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: Policy Number: _ 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 3700 of the Labor all forthwith comply with those provisions. i D/ II' I2 — %� AppXnt: / WARNING: FAILURE TO SECURE WORKERS' COMPENSATION CO ERAGE 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 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 laws relating to building construction, and hereby authorize representatives of this city to enter upo�fra ove- mentioned property for inspection purposes. D/:%%Z `�� Signature (Applicant orA t) DESCRIPTION FINANCIAL •1• ACCOUNT CITY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA Total Paid for BUILDING STANDARDS ADMINISTRATION BSA; $1.00 $1.00 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA Total Paid for ELECTRICAL: $48.34 $48.34 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF 101-0000-42404 0 $47.86 $47.86 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE WALL/FENCE - FIRST 100 LF PC 101-0000-42600 0 $60.91 $60.91 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA Total Paid for FENCE OR FREESTANDING WALL• $108.77 $108.77 DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE SWIMMING POOL/SPA PC 101-0000-42600 0 $98.62 $98.62 11/12/14 PAID BY METHOD RECEIPT # CHECK # CLTD BY DENNIS R INGRAM CHECK R2800 6233 MFA Total Paid for POOL/ SPA: $279.91 $279.91 • i m Curb Lbw Ater PvvM ky LUIS I Pod Plon 7'90170 cunt I La a ke", G v n) T/4 • GITY OF L:A: QU16VTA :. BUILDI.NG & SAFETY DEPT. . . v' PPROVE® • COIVSTRUGTIONflFOR ME �� B N • t Q1 Planter Bed Rear . P.ropert- �.Ine Poot Water Unt Planter Bed +-. ) POo.t in. . 30' L :. ` • .. �• O . Tanning Shelf PQ v e rs . N Q- � ).Ajia' ►i_�r Lawn Area ... S £. PaversTIS Pavers �cA"; 19 : REll a ��► Existing. Cc Concrete Slab Existing Concrete Slab. IIS 27� 7 v 0WAIPR : DENNIS IN6RAM }2OOL DF'rA1z F+(. 474 -fill 79370 CAwrKiToRY Bin # City Of La Quinta Building 8t Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012 7 Building Permit Application and Tracking Sheet Permit # p 14-- [ Project Address: 72370 RAI TEA HIZ Owner's Name: gxyNJs A. P. Number: Address: 12 11, hf, IfA JA/ 51r.- 7,Legal LegalDescription: City, ST, Zip: V o 7�y Contractor F Telephone: Address: Project Description: City, ST, Zip: ©0 S' Telephone: `<' <s.<:::::<<r;<<%< State Lic. 4: CityLie. #; Arch., Engr., Designer: Address: City, ST, Zip. Telephone: Construction Type: Occupancy: State Lic. #: ::.:: • . DemoJecttYPa circle one): New Addn Alter Re Name of Contact Person: ue Sq. Ft.: # Stories: #Units: Telephone #,of Contact Person: Estimated Value of Project: a p A PLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for I SS UlF (1// 0 Plan Cluck Deposit Truss Cala. Called Contact Person Plan Check Balance. Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2" 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 correctionstissue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees ,,' . `° Permit Details M PERIT N.I- "R , vitIy of La Quinta BPOL2414-1107 Description: POOL, SPA, EQUIPMENT WALL, AND GAS LINE FOR FUTURE USE Type: POOL Subtype: Status: APPROVED Applied: 11/7/2014 SKH Approved: 11/12/2014 MFA Parcel No: 775032004 Site Address: 79370 CANTERBURY LA QUINTA,CA 92253 Subdivision: TR 24317-1 Block: Lot: 3 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $20,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: POOL, SPA, , AND GAS LINE FOR FUTURE BBQ WITH 4 LF AT 4 FOOT HIGH EQUIPMENT WALL [2 INCH GAS PIPING/#8 AWG IN 1 INCH CONDUIT ELECTRICAL] THIS PERMIT DOES NOT INCLUDE ELECTRICAL AT BBQ. EQUIPMENT SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER SPECIFICATIONS. ALARMS AND BARRIERS REQUIRED TO BE INSTALLED AT PRE -PLASTER INSPECTION. 2010 CALIFORNIA BUILDING CODE. Process Summary 5 1 Applied to Approved hnT-j'If pAfl Ah n, Ifo .�tl t1lly AAA I i!•1 YI �rIW4Lfq�I Iii} II•l 11 I • ui 4, A4t'!Wj IA RIII IIA iWIIA l4 CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 11/12/14 R2800 6233 CHECK DENNIS R INGRAM I MFA Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 7 BSA: Printed: Wednesday, November 12, 201411:51:27 AM 1 of 2 LJ U SYS7FM5 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE FINAL** Printed: Wednesday, November 12, 201411:51:27 AM 2 of 2 CN?SrsrEMs CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY DEVICES, FIRST 20 101-0000-42403 0 $24.17 $24.17 11/12/14 R2800 6233 CHECK DENNIS R INGRAM MFA DEVICES, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 11/12/14 R2800 6233 CHECK DENNIS R INGRAM MFA Total Paid for ELECTRICAL: $48.34 $48.34 WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $47.86 11/12/14 R2800 6233 CHECK DENNIS R INGRAM MFA 100 LF WALL/FENCE - FIRST 101-0000-42600 0 $60.91 $60.91 11/12/14 R2800 6233 CHECK DENNIS R INGRAM MFA 100 LF PC Total Paid forFENCE OR FREESTANDING WALL $108.77 $108.77 SWIMMING POOL/SPA 101-0000-42404 0 $181.29 $181.29 11/12/14 R2800 6233 CHECK DENNIS R INGRAM MFA SWIMMING POOL/SPA 101-0000-42600 0 $98.62 $98.62 11/12/14 R2800 6233 CHECK DENNIS R INGRAM MFA PC Total Paid for POOL/ SPA: $279.91 $279.91 TOTALS: INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE FINAL** Printed: Wednesday, November 12, 201411:51:27 AM 2 of 2 CN?SrsrEMs CITY OF LA QUINTA SUB-CONTRACTOR LIST JOB ADDRESS 793 7D r_A1V3DFAF1)9 y PERMIT NUMBER OWNER ( 2)zdm /S - __BUILDER 0WN.E Z 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. .:.::::':...>;i:::::::::::>::; 4.., .. Trade . G ss� ficat on /....Ia ..:.................................................................................................................................... ":::>:»::::::::::::::»:::;;::::;::.;;:::;:i:<'::::i::::i:::;;:;::::::::i<::::::::::::::i:::::::>:{>:>:>::>::>; ;:::.:..........:>;>:;;::<>:.:Co. ..... ................... 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State d CaICo m 1 9 P "es (Format Van a xx xx x / x / ) x xxx 1 xx xx xx / / ( 1 ARTHWORK.lC 121 `f-0 ` -0 Q 0(7 - S CJ `30 :Z?_S 3r/�^ `1`i� i l% D2_ 7- / 7 / -%� 31—/ gNcftETE {c. s) .. var o r� v R ,TR G c 5 6ZE 3.27 1RU0 7..:STEEL:.(C 51.x... Cj Q 'G O GOV ME C 79/9311 '19 F F I%N 9021260—/3- 6 .2Fs'8 9-30 -1 C2 A bZ c -z g-0 2— -2-0 - erh 7t -1 o l - = 0 O' —- Dw . 12p L'A:TH' P:LdSTER: C 35'><' DR:YINA:1t?(C`9:):>[s >??< TOk1� at1)- C's3 q?!�22� 3�3/ �/8�7-�2.0)r( 7-I-J� LECTRICAL,{C�:�1 TE 2,4 Pa d i_ C. :L S �� —� U✓fJ� v ✓� ^h GI% G �I2 FI HEET. METAL -C N S U L ALT 10111, (C . 21... SEWAG_F*D.ISP ::::`.;1:? :. HINTING.., MI TILE LANDSCAPIN... .. 7 ` :<. ? BIR # City. of La Quinta Building a3L Safety Division P.O. Box 1504, 78-495 01le Tamptco " La.Quinta, CA 92253 -:(760) 777-7012 Building Permit Application and Tracking Sheet Perirut # Project Address: 197 3 70 C.A/t1 1%R Y Owner's Name:. Al A. P. Number. Address: Legal Description: Contractor. City, ST, Zip: 12 73V Telephone: Address: Project Description: City, ST, Zip 0 S 14 Telephone: C State Lie. # : City Lic. #; Atcli., Engr., Designer Address: City., ST, Zip: Telephone: State Lic. #: H may. ~ Name of Contact Person: Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # Stories: —T—Units: Telephone # of ContactPerson: Estimated Value of Project: f;2–,O 000 APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Reed Ti2ACMG PERMIT FEES Plan Sets PIan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plataplan Plans resubmitted.*. Mechanical Grading plan 21i Review, ready for correctionsfissue Electrical Subcontactor 14A Called ContactPerson Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resabmitted Grading IN ROUSE:- '^' Review; ready for corrections/issue Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr " Date of permit issue School Fees Total Permit Fees